health psych exam 4
13. (p. 278) Who among the following is likely to have low NK cell activity?
#A. Martha who is using avoidant coping methods to cope with the stress caused by the death of a friend B. Amanda who is using active coping strategies to cope with stress caused by her recent divorce C. Sean who is receiving emotional support from his wife to cope up with his work stress D. Hector who is optimistic about being unemployed
3. (p. 251) Raj, who complains of chest pain, is admitted to a hospital. The diagnosis reveals that his blood vessels have narrowed and the flow of oxygen and nourishment to his heart has been interrupted. He is, in this case, suffering from _____.
#A. Alzheimer's disease B. coronary heart disease C. cardiovascular disease D. Parkinson's disease
5. (p. 276) Which of the following statements is true of the relationship between stress and the immune system?
#A. Brief stressors lead to changes in cytokine production. B. The immune system responds in the same way to all types of stress. C. Specific immunity increases in response to acute short-term stressors. D. Natural immunity decreases in response to immediate short-term stressors.
13. (p. 255) Which of the following personality qualities reflects a positive caring orientation to others?
#A. Communion B. Agency C. Unmitigated agency D. Unmitigated communion
26. (p. 258) _____ is a common treatment for cardiac patients that treats blockage of major arteries in the heart.
#A. Coronary artery bypass graft B. Transmyocardial laser revascularization C. Heart transplant D. Angioplasty
3. (p. 275) _____ levels are indicative of inflammatory activity and may increase in response to stress.
#A. Cytokine B. Serotonin C. Thyroxine D. Oxytocin
41. (p. 289) _____ is a most common difficulty experienced as a result of cancer.
#A. Depression B. Eating disorders C. Anxiety disorders D. Social awkwardness
16. (p. 279) Which of the following will improve immune functioning during stressful events?
#A. Finding benefits B. Being alone C. Being pessimistic D. Using avoidance coping
4. (p. 276) Which of the following statements is true of short-term stressors?
#A. It activates immune cells that may help defend against wounds and infection. B. It up-regulates immunity against specific invaders. C. It leads to rapid decrease in immune cells. D. It results in a shift from cellular immunity to humoral immunity.
21. (p. 257) Which of the following is true of depression?
#A. It is an independent risk factor for CHD. B. It is a psychological by-product of other risk factors for CHD. C. It is based on genetic factors. D. It is unrelated to metabolic syndrome.
36. (p. 287) All cancers result from:
A. immunocompromise. B. a dysfunction in RNA. #C. a dysfunction in DNA. D. a reduction in DNA.
6. (p. 276) Activation of the HPA axis:
A. increases the number of white blood cells. #B. reduces the release of cytokines. C. decreases the level of glucocorticoids. D. increases in humoral immunity.
22. (p. 281) The time between progression from HIV+ status to a diagnosis of AIDS is most strongly influenced by:
A. individual differences. #B. socioeconomic factors. C. sexual orientation. D. ethnicity.
55. (p. 297) Studies of diabetic control and adherence indicate that the best outcomes are found among adolescents who have:
A. individual therapy. B. family therapy. #C. parents who are actively involved in tasks such as monitoring glucose levels. D. a dense social support network.
2. (p. 275) _____ is a generalized defense against pathogens.
#A. Natural immunity B. Specific immunity C. Passive immunity D. Humoral immunity
31. (p. 286) Who among the following are likely to adhere to HAART?
#A. People with social support B. Homeless people C. IV drug users D. Alcoholics
26. (p. 282) Sarah was recently informed that she is affected by AIDS. She is very depressed and has isolated herself from her friends. Which of the following should she do to fight against AIDS?
#A. Practice meditation B. Reduce physical exercise C. Not disclose her HIV+ status D. Use avoidance coping methods
17. (p. 279) _____ may mute the adverse effects of stress on the immune system.
#A. Relaxation training B. Pessimism C. Repressing one's thoughts about the stressful event D. Considering stress to be uncontrollable
30. (p. 260) _____ are the most common drugs prescribed for patients following an acute coronary event or a stroke.
#A. Statins B. Diuretics C. Beta-blockers D. Vitamins
43. (p. 292) Susan, Sarah, and Charlotte are suffering from breast cancer. Susan is a middle-class white woman with advanced breast cancer. Her family and friends provide her with emotional and instrumental social support. Sarah is a Hispanic woman from a working-class family. Her parents are deceased, her siblings do not contact her, and her husband and children are too frightened to be of much support. Charlotte is an African-American woman who was widowed recently. According to the scenario, who is more likely to survive the longest?
#A. Susan B. Sarah C. Charlotte D. There is no way to predict mortality in these cases.
45. (p. 293) Susan has breast cancer. She is anxious and depressed. Although she receives a lot of help from her family and friends, she is unable to manage her treatment regime. She is scared of losing the organ and is worried about the reoccurrence of the cancer and pain. She is also worried that her cancer might be fatal. Her oncologist is like to recommend her therapy that follows the _____ format.
#A. crisis intervention B. intensive psychotherapy C. self-help D. psychoanalysis
18. (p. 281) HIV primarily affects:
#A. helper T cells and macrophages. B. monocytes and granulocytes. C. natural killer cells. D. B cells.
42. (p. 292) Cancer patients who receive social support are likely to express:
#A. improved immunologic responses, as it helps to improve their psychological status. B. problems in psychological adjustment, because the support is usually not provided by professionals. C. social awkwardness, because they are surrounded by people who do not know what they are experiencing. D. depression, because it leads to the thought that they may not live as long as the others.
18. (p. 256) The relation between hostile style and enhanced cardiovascular reactivity to stress is most reliable for _____.
#A. men B. women C. children D. adults
15. (p. 279) Studies of personality and coping styles have found that the stress-immune functioning relationship is moderated by:
#A. optimism. B. avoidance coping. C. isolation. D. pessimism.
16. (p. 255) Cynical hostility is characterized by:
#A. suspiciousness. B. optimism. C. infrequent angry episodes. D. trust in others.
53. (p. 295) Which of the following statements is true of osteoarthritis?
A. It cannot be managed through active coping methods. #B. It can be managed by reducing one's weight. C. It affects the muscles around the bones. D. It is common in children.
54. (p. 295) Which of the following statements is true of Type I diabetes?
A. It develops relatively late in life (after age 40). B. It accounts for 90 percent of all diabetics. #C. It is characterized by an abrupt onset of symptoms. D. It is primarily managed by reducing the sweet intake.
8. (p. 277) Which of the following best describes rheumatoid arthritis?
A. It is a disease of lifestyle. B. It is a disease that typically attacks men. C. It is a disorder that can be cured by diet. #D. It is an autoimmune disorder.
14. (p. 255) Which of the following best describes unmitigated communion?
A. It is a focus on the self. B. It is a focus on social unity. #C. It is an extreme focus on others. D. It is an extreme focus on oneself.
46. (p. 294) Which of the following best describes rheumatoid arthritis?
A. It is an autoimmune disease that only attacks the thin membrane surrounding the joints. B. It is a chronic disorder in which complete recovery is not possible. #C. It usually results in depression which may enhance the pain. D. It occurs only in middle-aged and older people.
48. (p. 294) Which of the following statements is true of rheumatoid arthritis?
A. It is the least crippling form of arthritis. #B. It primarily occurs in middle-aged people and the elderly. C. It is usually fatal. D. It is relatively unaffected by stress and psychological variables.
11. (p. 278) Juan is very stressed about his recent divorce. He is preoccupied with his ex-wife. How is this stress likely to affect his immune system?
A. It will not affect his immune system. #B. His immune system will be less active than before. C. His immune system will be more active than before. D. Certain immune parameters will function better than before.
37. (p. 288) Which of the following statements is true of cancer?
A. Most cancers are genetically inherited. #B. Many cancers have small growth cycle. C. The same treatment is used for all cancers. D. The same symptoms are expressed by all cancer patients.
8. (p. 252) According to a study by Troxel et al. (2003), _____ are disproportionately exposed to chronic stress and are at an elevated risk for CHD.
A. Native Americans #B. African Americans C. Asian Americans D. Pacific Islanders
47. (p. 294) Which of the following is a symptom of rheumatoid arthritis?
A. Nausea #B. Inflammation C. Poor vision D. Poor cognitive functioning
28. (p. 282) Which of the following has been found to contribute to positive adjustment and long-term survival among people with AIDS?
A. Passive coping methods B. Concealing one's sexual orientation #C. Disclosing one's HIV-seropositive status D. Pessimism
33. (p. 286) Who among the following are likely to be better adjusted and most successful in coping with AIDS?
A. Paul, who is confident that the medical personnel who staff his experimental treatment program are outstanding in the field B. Mary, who contracted AIDS through a transfusion and feels that she has no personal control over the disease C. Tom, who has turned to alternatives of traditional medicine and feels that his holistic practitioner can best arrest the progression of the disorder #D. John, who feels that he can control the disease and its symptoms and has taken personal responsibility for its treatment
35. (p. 287) Hayden found out that he is HIV seropositive during his last general checkup. But, Hayden has not experienced any of the symptoms that indicate the onset of AIDS. Which of the following will lead to the onset of the disease in Hayden?
A. Positive beliefs about self and future #B. Negative expectations of the disease C. Being surrounded by friends and family D. Disclosing his HIV seropositive status
27. (p. 258) Patients with myocardial infraction are treated in a(n) _____ unit where their cardiac functioning is continually monitored.
A. hospice care #B. coronary care C. home care D. acute care
39. (p. 289) Which of the following psychological factors are associated with the onset or progression of cancer?
A. Emotional support #B. Anxiety C. Social support D. Optimism
40. (p. 289) Albert has been suffering from cancer for a year. The progression of the disease was faster in the first few months and later decreased gradually. Although Albert was suffering from cancer, the symptoms were more controlled in the later months. Which of the following is most likely the reason for the change in the course of the disease?
A. He was sleeping more and used active coping methods during the first few months. B. He was using repressive coping methods to deal with cancer during the later months. C. He accepted the fact that his cancer was fatal, and he will die during the later months. #D. He was not able to accept that he was suffering from cancer during the first few months.
24. (p. 257) _____ remains an underdiagnosed and untreated contributor to CHD morbidity and mortality.
A. High cholesterol B. Hostility C. Genetics #D. Depression
24. (p. 281) Who among the following is likely to develop AIDS slower?
A. Hispanics who test positive for HIV B. Blacks who test positive for HIV #C. Whites who test positive for HIV D. People from lower socioeconomic status who test positive for HIV
9. (p. 278) Evidence suggests that some of the adverse effects of depression on immunity may be mediated by:
A. hostility. B. disturbed hypothalamic functioning. C. poor maturation of the immune system. #D. sleep disturbances.
9. (p. 253) Which of the following is true of the impact of social factors on CHD?
A. Industrialized countries have a very low incidence of CHD. B. People who are less mobile have a higher frequency of CHD. C. Social stability is linked to higher rates of CHD. #D. Migrants have a higher incidence of CHD.
52. (p. 295) Which of the following statements best describes osteoarthritis?
A. It affects only the small joints of the wrists and hands. B. It affects only the joints in the spine. #C. It involves the deterioration of cartilage in weight-bearing joints. D. It is a genetic disorder.
7. (p. 251) According to a study by Lawlor et al. (2005), risk factors for heart disease begin to cluster by age _____ for those low in SES.
A. 32 B. 43 #C. 14 D. 25
4. (p. 251) Which of the following is a risk factor for coronary heart disease?
A. Abnormal weight loss B. Low serum cholesterol C. Curvature of the spine #D. Diabetes
38. (p. 289) Who among the following are likely to develop fewer cancers?
A. Alcoholics #B. Married people C. People who are malnourished D. People who consume fat
50. (p. 295) _____ is an autoimmune disease that tends to affect the weight-bearing joints: the hips, knees, and spine.
A. Blood cancer #B. Osteoarthritis C. Lyme disease D. Cushing's disease
49. (p. 295) _____ develops when the smooth lining of a joint, known as the articular cartilage, begins to crack or wear away because of overuse, injury, or other causes.
A. Cancer B. Leprosy #C. Osteoarthritis D. HIV
10. (p. 253) Which of the following job factors relates to increased risk of CHD?
A. Discrepancy between occupation and diet B. Discrepancy between occupation and family life C. High social support at work #D. High work demands and low control
7. (p. 277) Which of the following best defines autoimmune diseases?
A. Diseases in which the immune system is not able to produce antibodies B. Diseases in which the immune cells' attacks do not affect the foreign agent C. Diseases in which the immune system fails to recognize the foreign agents that have entered the body #D. Diseases in which the immune system attacks the body's own tissues, falsely identifying them as invaders
21. (p. 281) Which of the following will occur first in a person affected with AIDS?
A. Reduction in helper T cell activity #B. Swollen glands C. Chronic diarrhea D. Skeletal pain
25. (p. 258) _____ refers to chronically searching the environment for potential threat.
A. Rumination B. Due diligence #C. Vigilant coping D. Type-A behavior
23. (p. 281) Which of the following is an early symptom of central nervous system impairment in people suffering from AIDS?
A. Seizure B. Disorientation C. Profound dementia #D. Psychomotor retardation
51. (p. 295) Which of the following parts of the body will be affected by osteoarthritis?
A. Skin #B. Spine C. Blood D. Kidney
29. (p. 283) Who among the following is most likely to disclose their HIV status?
A. Someone who wants to protect his family B. People with a strong support network C. Those who are less likely to use condoms during intercourse #D. People with Latin origin
11. (p. 254) Which of the following is true of heart diseases in women?
A. They are less likely to die from a first heart attack than men. #B. They experience an increased risk of cardiovascular disease after menopause. C. They develop CHD on the average about 15 years earlier than do men. D. They are protected at young ages against CHD due to their lower levels of HDL cholesterol.
30. (p. 286) Which of the following statements is true of cognitive-behavioral interventions?
A. They need to be directed only at improving health behaviors. B. They need to be directed only at stress management. #C. They can help in maintaining adherence. D. They have no effect on the viral load.
10. (p. 278) Which of the following is a positive effect of depression?
A. Undisturbed sleep #B. Rapid wound healing C. Increase in cellular immunity D. Shorter inflammatory responses
12. (p. 255) The personality quality "agency" is associated with _____.
A. a focus on others #B. a focus on oneself C. relationships D. self-sacrifice
25. (p. 282) The most promising development in the treatment of AIDS is:
A. an HIV vaccine. B. AZT. #C. HAART. D. DDI.
22. (p. 257) Depression in people who are hostile and in African Americans is likely to be closely linked to:
A. atypical antidepressant. B. monoamine oxidase inhibitor. #C. C-reactive protein. D. tricyclic antidepressant.
23. (p. 257) Depression is typically treated with Prozac which is a(n):
A. atypical antidepressant. B. monoamine oxidase inhibitor. #C. serotonin reuptake inhibitor. D. tricyclic antidepressant.
20. (p. 281) AIDS is caused by a _____.
A. bacterial virus B. protozoan #C. retrovirus D. bacteria
1. (p. 251) The number one killer in the United States, accounting for one out of every six deaths, is:
A. diabetes. #B. coronary heart disease. C. hypertension. D. cancer.
5. (p. 251) The combination of obesity centered around the waist, high levels of triglycerides, low levels of HDL cholesterol, and difficulty metabolizing blood sugar are symptomatic of:
A. diabetes. #B. metabolic syndrome. C. angina pectoris. D. hypertension.
19. (p. 256) Hostile people exhibit a _____ response to sympathetic activity in response to stress.
A. friendly B. strong pessimistic C. favorable #D. weak antagonistic
20. (p. 256) Individuals who are high in hostility:
A. have chronically lower blood pressure. B. show lower heart rate reactivity to laboratory stressors. #C. show exaggerated cardiovascular reactivity. D. show strong antagonistic responses to sympathetic activities.
1. (p. 275) The interactions among behavioral, neuroendocrine, and immunological processes of adaptation are referred to as:
A. health psychology. #B. psychoneuroimmunology. C. behavioral medicine. D. psychosomatic medicine.
44. (p. 293) In therapy that is based on _____, therapists try to focus on the specific issues faced by the cancer patient.
A. long-term analysis of a patient's psyche B. intense psychotherapy model C. passive coping techniques #D. crisis intervention format
14. (p. 278) The tendency to seek social support and the perception that one had good emotional support were associated with _____ suggesting buffering of stress responses.
A. low NK cell activity #B. high NK cell activity C. high T cell activity D. low T cell activity.
12. (p. 278) Long-term provision of care to friends or family members with long-term illness has been linked to adverse effects on almost all functional measures of the immune system. This can be attributed to caregivers':
A. poor eating habits. B. disrupted sleep patterns. #C. experience of severe stressors. D. poor hygiene.
27. (p. 282) Educational interventions are an effective means of:
A. primary prevention for HIV+ individuals. #B. reducing behaviors that might infect others. C. primary prevention for uninfected participants. D. understanding the progression of the disease.
6. (p. 251) Gerard is obese around the waist. He has high blood pressure and low levels of good cholesterol. These are symptomatic of:
A. stroke. B. hypertension. C. multiple sclerosis. #D. metabolic syndrome.
15. (p. 255) People who are both hostile and _____have an increased risk for metabolic syndrome and CHD.
A. suspicious #B. angry C. defensive D. ambitious
28. (p. 259) Successful cardiac rehabilitation depends critically on:
A. the cost involved in the treatment. B. a medical practitioner's involvement. #C. a patient's active participation and commitment. D. the level of cynical hostility shown by medical staff.
32. (p. 286) Cognitive-behavioral intervention programs that work with other at-risk populations may not work as well with IV drug users because:
A. their peer group has too much influence. #B. they may lack good impulse control. C. methadone programs don't work with them. D. needle exchange programs are ineffective.
29. (p. 259) Beta-blockers are used in cardiac rehabilitation:
A. to activate the parasympathetic nervous system. #B. to resist the effects of sympathetic nervous system stimulation. C. to control the pain of angina pectoris. D. to restrict the negative side effects of the administered drugs.
19. (p. 281) HIV is transmitted by _____ a person suffering from AIDS.
A. touching #B. sharing needles with C. breathing the air near D. being near
2. (p. 251) Coronary heart disease is:
A. unrelated to the changes in diet. #B. a disease of modernization. C. prevalent among children. D. unrelated to social status.
34. (p. 287) People who use the Internet to manage their HIV seropositive status are likely to _____ than those not using the Internet.
A. use passive coping skills B. have less social support #C. engage in more information-seeking coping D. be less knowledgeable about the disease and more interested in sharing their experience.
17. (p. 255) Higher levels of hostility have been found among:
A. women. B. whites. C. people high in socioeconomic status (SES). #D. men.
69. (p. 289-290) How do psychosocial factors influence the initiation and course of cancer?
Avoidance, or the inability to confront the disease, has been tied to a more rapid course of the disease. Depression is implicated in the progression of cancer, both by itself and in conjunction with other risk factors. Cancer progression may be related to use of denial or repressive coping strategies. Avoidant or passive coping is also a risk factor for psychological distress, depression, poor sleep, and other risk-related factors, which may represent additional influences on the course of cancer. Level: Conceptual
68. (p. 281-282, 286-287) Your roommate has just confided in you that a friend of hers has tested HIV+. Knowing that you are taking a health psychology course, she's asking for advice on two matters: (1) she would like to have any information that might be helpful in understanding how to help her friend cope, and (2) she would like to know what to expect in terms of her friend's medical condition. What advice would you give her?
Answers will vary Feedback: Early symptoms of central nervous system impairment are similar to those of depression and include forgetfulness, inability to concentrate, psychomotor retardation, decreased alertness, apathy, withdrawal, diminished interest in work, and loss of sexual desire. In more advanced stages, patients may experience confusion, disorientation, seizures, profound dementia, and coma. A common symptom for women with AIDS is gynecologic infection. Interventions that reduce depression are, thus, useful in the fight against AIDS. Coping skills training and the practice of meditation may also improve adjustment to the disease. Stress and its neuroendocrine consequences foster a more rapid course of illness in people who are infected with HIV and lead to more opportunistic or more aggressive symptoms. Social support is very important to people with HIV infection or AIDS. Social support has been tied to greater adherence and lower viral load. Support from family appears to be especially important for preventing depression. Optimism, active coping, extraversion, conscientiousness, and spirituality all predict slower disease progression.
70. (p. 296) Why do people suffering from Type I diabetes show low adherence to self-management programs and their treatment regimen?
Answers will vary Feedback: Many type I diabetic patients do not adhere to self-management programs and treatment regimens, because many of the severe complications of diabetes are not evident until 15-20 years after its onset, these risks do not frighten people into being adherent. They may feel no symptoms, and so fail to adhere to their treatment regimen. Many of the errors made by diabetics in adhering to their treatment regimen, then, are errors of omission rather than commission. Diabetic patients often fail to self-monitor their blood glucose level. Instead, like hypertensive patients, they rely on what their blood glucose level "feels like," and they rely strongly on their mood for making this judgment.
57. (p. 276) Humoral immunity operates at the cellular level and is mediated by T lymphocytes.
FALSE
64. (p. 293) The most prevalent of the autoimmune diseases is cancer.
FALSE
65. (p. 296) People suffering from Type I diabetes have higher adherence to self-management programs compared to the other programs.
FALSE
56. (p. 275) Studies have found impaired immune functioning among bereaved individuals.
TRUE
58. (p. 276) Studies with human subjects indicate that exposure to stressors is related to immunologic change.
TRUE
59. (p. 278) Impaired immune functioning has been found in samples of adults who have experienced short-term marital conflict, marital separation, and divorce.
TRUE
60. (p. 281) One of the most common symptoms for women with AIDS is a gynecologic infection.
TRUE
61. (p. 281) A person may test HIV-seropositive (HIV+) but be free of a diagnosis of AIDS for years.
TRUE
62. (p. 281) Past sexual practice is an important predictor of AIDS-related risk behaviors.
TRUE
63. (p. 289) Japanese American women are more susceptible to breast cancer the longer they have lived in the United States and the more they have adopted the American culture.
TRUE
67. (p. 278) How are depression, loneliness, and interpersonal conflict associated with the immune system?
There is a fairly straightforward relationship between depression and immunity, such that the more depressed a person is, the more cellular immunity is likely to be compromised. Depressive symptoms can be associated with prolonged inflammatory responses as well, which may link depression to other diseases such as heart disease. Lonely people have poorer health and immunocompromise, compared to people who are not lonely. Chronic interpersonal stress as early as adolescence predicts inflammatory activity over time; this pathway may underlie the relation of social stress to such disorders as depression and atherosclerosis. Level: Conceptual
66. (p. 276) Explain how stress is related to immune functioning and how the immune system responds to stress.
Two basic principles are important for understanding the relation of stress and immunity. The first is that different kinds of stressors require different kinds of defenses, and so a particular immune response may be favored over another in response to certain stressors. For example, short-term stressors raise the risk of injury, and so immune system changes involved in wound repair are very likely in response to short-term stress. A second important principle is that a maximally efficient immune response to any situation entails costs, and so some aspects of immunity may be adaptively suppressed as others are actively engaged. Level: Conceptual
