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(Download PDF) Abnormal Psychology Perspectives DSM-5 Update 7th Edition Whitbourne Test Bank Full Chapter
(Download PDF) Abnormal Psychology Perspectives DSM-5 Update 7th Edition Whitbourne Test Bank Full Chapter
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Abnormal Psychology: Perspectives, 5e
Dozois
CHAPTER 7
Psychophysiological Disorders
Multiple choice:
Answer: E
Diff: 2 Type: MC Page Ref: 147
Skill: Factual
Answer: E
Diff: 1 Type: MC Page Ref: 147
Skill: Factual
Answer: A
Diff: 2 Type: MC Page Ref: 147
Skill: Factual
4) The early years of research concerning the role of psychological processes on physical
health were known as
A) psychosomatic medicine.
B) cognitive physiology.
C) dualistic behaviourism.
D) neuropsychophysiology.
E) behavioural medicine.
Answer: A
Diff: 1 Type: MC Page Ref: 147
Skill: Factual
Answer: E
Diff: 2 Type: MC Page Ref: 147
Skill: Factual
6) The psychoanalyst Franz Alexander (1950) argued that the roots of psychosomatic
disorders
A) lay in an imbalance of bodily humours.
B) stemmed from an overassertive super-ego.
C) were found in interpersonal stressors.
D) were unrelated to intrapsychic forces.
E) stemmed from characteristic intrapersonal conflict.
Answer: E
Diff: 3 Type: MC Page Ref: 147
Skill: Factual
7) The theorist __________ argued that the biomedical model of disease should be
expanded to a biopsychosocial model.
A) Franz Alexander
B) Helen Flanders Dunbar
C) George Engel
D) Walter Cannon
E) Hans Selye
Answer: C
Diff: 2 Type: MC Page Ref: 147
Skill: Factual
B) a stroke
C) essential hypertension
D) cancer
E) cardiac arrythmias due to genetic illness
Answer: C
Diff: 2 Type: MC Page Ref: 148
Skill: Conceptual
Answer: A
Diff: 3 Type: MC Page Ref: 148
Skill: Factual
Answer: A
Diff: 1 Type: MC Page Ref: 148
Skill: Factual
11) A specific code meaning “a psychological factor affecting medical condition” may be
found on Axis I under
A) “Health and psychological factors and illness.”
B) “Psychosomatic disturbances.”
C) “Psychophysiological and neurological challenges.”
D) “Psychogenic medical disorders.”
E) “Other conditions that may be a focus of clinical attention.”
Answer: E
Diff: 3 Type: MC Page Ref: 148
Skill: Factual
Answer: C
Diff: 3 Type: MC Page Ref: 148
Skill: Factual
12) A mechanism is
A) something which regulates a physical system.
B) the means by which unconscious conflict produces psychological disturbances.
C) a process, activity of a living system that mediates the influence of an antecedent
factor on disease.
D) the effect neurotic behaviour has on the family or social environment.
E) an axis of internal regulation that involves pulmonary and immunological functioning.
Answer: C
Diff: 3 Type: MC Page Ref: 148
Skill: Factual
Answer: B
Diff: 3 Type: MC Page Ref: 148
Skill: Conceptual
14) When a sign involves the specific disruption of bodily tissue or normal function of a
bodily system, these disruptions are called
A) lesions.
B) ulcers.
C) mechanisms.
D) symptoms.
E) challenges.
Answer: A
Diff: 1 Type: MC Page Ref: 148
Skill: Factual
Answer: E
Diff: 2 Type: MC Page Ref: 149
Skill: Factual
Answer: E
Diff: 2 Type: MC Page Ref: 149
Skill: Factual
17) The three body systems that are responsive to psychosocial variables are:
A) endocrine system; immune system; cardiovascular system
B) autonomic nervous system; endocrine system; cardiovascular system
C) autonomic nervous system; central nervous system; immune system
D) autonomic nervous system; endocrine system; immune system
E) somatic nervous system; endocrine system; cardiovascular system
Answer: D
Diff: 2 Type: MC Page Ref: 150
Skill: Factual
18) The body system responsive to psychosocial variables involved in the production of
hormones is the
A) immune system.
B) endocrine system.
C) autonomic nervous system.
D) central nervous system.
E) somatic nervous system.
Answer: B
Diff: 1 Type: MC Page Ref: 151
Skill: Factual
19) Perhaps the best known endocrine hormone system known to be highly responsive to
psychosocial variables involves the
A) ovaries.
B) pancreas.
C) pineal gland.
D) HPA axis.
E) testes.
Answer: D
Diff: 1 Type: MC Page Ref: 151
Skill: Factual
20) The brain structure that makes up part of the HPA axis is the
A) thalamus.
B) hypothalamus.
C) medulla.
D) hippocampus.
E) amygdala.
Answer: B
Diff: 2 Type: MC Page Ref: 151
Skill: Factual
Answer: B
Diff: 2 Type: MC Page Ref: 151
Skill: Factual
22) Glucocorticoids
A) cause inflammation.
B) have not been indicated in the development of neuronal damage in the brain.
C) prevent the development of atherosclerosis.
D) are only beneficial when released for long periods of time.
E) have been indicated in the suppression of immune system function.
Answer: E
Answer: D
Diff: 2 Type: MC Page Ref: 151
Skill: Factual
Answer: C
Diff: 1 Type: MC Page Ref: 151
Skill: Factual
Answer: A
Diff: 2 Type: MC Page Ref: 151
Skill: Conceptual
26) Immune cells are produced and stored in all of the following except the
A) thymus gland.
B) large intestines.
C) lymph nodes.
D) bone marrow.
E) small intestines.
Answer: B
Diff: 1 Type: MC Page Ref: 152
Skill: Factual
Answer: C
Diff: 1 Type: MC Page Ref: 153
Skill: Factual
28) Cells that remain permanently altered after an immune episode are called
A) B-cells.
B) Suppressor T-cells.
C) Memory T-cells.
D) Helper T-cells.
E) Natural Killer.
Answer: C
Diff: 2 Type: MC Page Ref: 153
Skill: Factual
29) In the alarm phase of Hans Selye's (1956) General Adaptation Syndrome, the body
A) waits for the brain to make a “decision” about the threat.
B) mobilizes its defences.
C) suffers tissue damage.
D) is exhausted due to depletion of energy stores.
E) actively fights or copes with the challenge to the system.
Answer: B
Diff: 3 Type: MC Page Ref: 154
Skill: Factual
30) The final phase of Hans Selye's General Adaptation Syndrome is the __________
phase.
A) adaptation
B) resistance
C) exhaustion
D) alarm
E) resolution
Answer: C
Diff: 2 Type: MC Page Ref: 154
Skill: Factual
31) Kanner, Coyne, Schaefer and Lazarus (1981) suggest that the most common sources
of stress in people's lives are
A) inner conflicts.
B) medical problems.
C) hassles.
D) drastic life changes.
E) financial.
Answer: C
Diff: 1 Type: MC Page Ref: 155
Skill: Factual
Answer: A
Diff: 2 Type: MC Page Ref: 155
Skill: Factual
Answer: A
Diff: 1 Type: MC Page Ref: 155
Skill: Factual
Answer: E
Diff: 1 Type: MC Page Ref: 156
Skill: Factual
35) Therapists might find it difficult to steer clients towards ____________ methods of
dealing with threats because ___________ methods are negatively reinforced (i.e., they
provide a rapid escape from unpleasant thoughts / feelings associated with the problem).
A) problem-focused coping; emotion-focused coping
B) reality-based action; self-medicating action
C) reality-based mood adjustment; self-medicating mood adjustment
D) practical; intellectualizing-based
E) practical; denial
Answer: A
Diff: 2 Type: MC Page Ref: 155
Skill: Conceptual / application
36) Clients with limited capacity to delay gratification will find it difficult, particularly in
the beginning, to adopt ____________ because ___________ methods provide a faster
and easier escape from the unpleasant feelings associated with threats
A) courageous; self-soothing
B) reality-based action; self-medicating
C) reality-based mood adjustment; self-medicating
D) fact-based; intellectualizing-based
E) problem-focused coping; emotion-focused coping
Answer: E
Diff: 3 Type: MC Page Ref: 155
Skill: Conceptual / application
37) In a study conducted by Lazarus and colleagues, the researchers found that by
__________ the scenes in films depicting rites of passage, arousal was decreased.
A) re-watching
B) identifying with
C) mentally modifying
D) intellectualizing or denying
E) ignoring
Answer: D
Diff: 2 Type: MC Page Ref: 156
Skill: Factual
38) Which of the following was NOT a characteristic of dominant male baboons in
Sapolsky's (1995) studies of how social status may affect stress?
A) higher levels of circulating lymphocytes
B) reduced concentrations of cortisol
C) lower levels of high-density lipoprotein cholesterol
D) a greater ability to recover from provocation
E) lower blood pressure
Answer: C
Diff: 3 Type: MC Page Ref: 157
Skill: Conceptual
39) __________ control over stressful events is sufficient to reduce their harmful effects.
A) Perceived
B) Direct
C) Physical
D) Internal
E) Emotional
Answer: A
Diff: 1 Type: MC Page Ref: 157
Skill: Factual
Answer: A
Diff: 1 Type: MC Page Ref: 157
Skill: Factual
41) An example of a job rated as high in decision control and low in psychological
demand is
A) forester.
B) waiter/waitress.
C) janitor.
D) truck driver.
E) secretary.
Answer: A
Diff: 1 Type: MC Page Ref: 158
Skill: Factual
42) In a study conducted employing cold viruses, Cohen, Tyrrell, and Smith (1993)
discovered that subjects with higher perceived stress and negative affect were
A) more likely to have died after a five-year follow-up study.
B) more likely to show “hard” immune system changes.
C) less likely to recover within a 5-day period.
D) more likely to develop another more debilitating illness.
E) less likely to show clinical evidence of a cold.
Answer: B
Diff: 2 Type: MC Page Ref: 160
Skill: Factual
44) According to Alexander (1950) the role psychological factors might play in the
development of ulcers is
A) unconscious conflict creates neuronal death in the hypothalamus.
B) certain personality types are prone to overeating causing medical problems.
C) lowered immune function as a result of stress allows for bacterial infection.
D) an unsatisfied desire for love results in an overactivity in the digestive system.
E) stress decreases the effectiveness of the mucosal stomach lining.
Answer: D
Diff: 3 Type: MC Page Ref: 160
Skill: Factual
Answer: C
Diff: 1 Type: MC Page Ref: 163
Skill: Factual
Answer: D
Diff: 1 Type: MC Page Ref: 163
Skill: Factual
47) Which of the following is NOT evidence collected indicating that Helicobacter pylori
plays a primary role in the genesis of ulcers?
A) Antibodies to the bacterium have been found in the serum of healthy controls.
B) This bacterium is present in the stomachs of a large proportion of individuals with
ulcer disease.
C) Twenty percent of people who test positive for the bacterium show evidence of ulcer.
D) Animals injected with H. pylori suffered from ulcer disease.
E) The condition of patients treated with drugs to kill H. Pylori improves.
Answer: D
Diff: 2 Type: MC Page Ref: 163-164
Skill: Factual
48) Since the 1950s deaths due to heart attack and stroke have declined by almost
A) 25%.
B) 10%.
C) 70%.
D) 50%.
E) 90%.
Answer: D
Diff: 1 Type: MC Page Ref: 164
Skill: Factual
49) Consistent with the water pump analogy of the cardiovascular system, the peak of the
wave of blood flow corresponds with
A) the point in the cardiac cycle called the systole.
B) the peripheral resistance found in the right ventricle.
C) cardiac output.
D) the point in the cardiac cycle called the diastole.
E) the contraction of the right ventricle.
Answer: A
Diff: 1 Type: MC Page Ref: 165
Skill: Factual
50) Which of the following are most closely tied into the regulation of the cardiovascular
system?
A) serotonergic agonists
B) glucocorticoids
C) monamine oxidase inhibitors
D) dopaminergic antagonists
E) catecholamines
Answer: E
Diff: 3 Type: MC Page Ref: 165
Skill: Factual
51) Consistent with the plumbing analogy of the cardiovascular system, which of the
following best describes atherosclerosis?
A) The tubing expands reducing pressure.
B) The tubing develops calcium deposits from the water.
C) The pump begins to operate sporadically.
D) The tubing branch points dry out and become brittle.
E) The pump begins to leak water.
Answer: B
Diff: 2 Type: MC Page Ref: 165
Skill: Conceptual
Answer: B
Diff: 3 Type: MC Page Ref: 165
Skill: Factual
Answer: A
Diff: 2 Type: MC Page Ref: 166
Skill: Factual
E) to show how the cardiovascular system can be altered by stressful psychosocial stimuli
or events.
Answer: E
Diff: 2 Type: MC Page Ref: 166
Skill: Factual
Answer: D
Diff: 2 Type: MC Page Ref: 166
Skill: Conceptual
Answer: A
Diff: 2 Type: MC Page Ref: 167
Skill: Factual
57) A number of studies using the __________ have found an association between
hostility and increased risk of heart disease.
A) The Anger Interview
B) Cook-Medley Hostility Scale
C) Turner Interruption Test
D) Stroop Colour-Word Conflict Test
E) Structured Interview
Answer: B
Diff: 1 Type: MC Page Ref: 167
Skill: Factual
C) are more likely to engage in unhealthy behaviours and less likely to have healthy
practices, such as exercise.
D) are more at risk for diseases because they experience exaggerated autonomic and
neuroendocrine responses during stress.
E) create a social world that is antagonistic and unsupportive.
Answer: B
Diff: 1 Type: MC Page Ref: 167
Skill: Factual
59) Frasure-Smith, Lesperance, and Talajic (1993) found that depression soon after the
heart attack
A) had no effect on the risk of dying.
B) was associated with a greater than five-fold increase in the risk of dying within six
months.
C) was associated with a greater than five-fold increase in the risk of another heart attack
within 6 months.
D) was associated with a greater than five-fold increase in the risk of dying within six
months only in men, but not in women.
E) was associated with a greater than ten-fold increase in the risk of another heart attack
within 6 months.
Answer: B
Diff: 3 Type: MC Page Ref: 169
Skill: Factual
60) The INTERHEART study found that of the nine risk factors, the following three had
the greatest impact on the risk of heart attack.
A) abdominal obesity, psychosocial factors, and low physical activity
B) raised lipids, smoking, and psychosocial factors
C) psychosocial factors, high blood pressure, and raised lipids
D) low consumption of fruits and vegetables, high blood pressure, and diabetes
E) smoking, low physical activity, and lack of consumption of moderate amounts of
alcohol
Answer: B
Diff: 3 Type: MC Page Ref: 170
Skill: Factual
Answer: B
Diff: 1 Type: MC Page Ref: 170
Skill: Factual
62) In a series of interventions for stress performed by Dean Ornish and colleagues
(1996), found that __________ predicted the extent of coronary lesions.
A) hours spent meditating in a week
B) aerobic exercise
C) the amount of practice patients devoted to stress management
D) the switch to a vegetarian diet
E) the number of people involved in group support meetings
Answer: C
Diff: 2 Type: MC Page Ref: 170
Skill: Factual
63) Linden and Chambers (1994) in their study on hypertension, discovered that stress
management could
A) never be as effective as drug treatment.
B) actually worse a patient's condition when standard prescription drugs were not given.
C) be effective if coupled with drug treatment.
D) be as effective as drug treatment if targeted and individualized to each patient.
E) be as effective as drug treatment if implemented in a standardized fashion.
Answer: D
Diff: 2 Type: MC Page Ref: 170
Skill: Factual
64) Friedman et al. (1986) found that after three years of cardiac counselling
implemented through the Recurrent Coronary Prevention Project, patients showed
A) an increase in the amount of type A behaviour.
B) no change in the amount of type A behaviour.
C) half as many occurrences of cardiac events as controls.
D) no difference from controls in the occurrences of cardiac events.
E) half as many occurrences of cardiac events as controls, but also no reduction in
measured Type A behaviour.
Answer: C
Diff: 2 Type: MC Page Ref: 170
Skill: Factual
True/False:
65) People sometimes mistakenly use the term psychosomatic disorders to refer to
illnesses more properly called somatoform disorders.
A) True
B) False
Answer: A
Diff: 1 Type: TF Page Ref: 147
Skill: Factual
66) There is considerable evidence that experience or expression of anger plays a role in
heart disease.
A) True
B) False
Answer: A
Diff: 1 Type: TF Page Ref: 148
Skill: Factual
67) A DSM-5 workgroup recommends placing all disorders on Axis 1, eliminating the
distinction between psychological and medical disorders in psychiatry.
A) True
B) False
Answer: A
Diff: 1 Type: TF Page Ref: 149
Skill: Factual
68) Health psychology refers to using psychological methods to mental illnesses that
have physical consequences.
A) True
B) False
Answer: B
Diff: 2 Type: TF Page Ref: 148
Skill: Factual
69) A mechanism is a process, an activity of a living system that mediates the influence
of an antecedent factor on disease.
A) True
B) False
Answer: A
Diff: 1 Type: TF Page Ref: 148
Skill: Factual
Answer: B
Diff: 2 Type: TF Page Ref: 148
Skill: Conceptual
Answer: B
Diff: 1 Type: TF Page Ref: 148
Skill: Conceptual
73) The three body symptoms affected by psychosocial variables are the autonomic
nervous system, the somatic nervous system and the immune system.
A) True
B) False
Answer: B
Diff: 1 Type: TF Page Ref: 150
Skill: Factual
Answer: A
Diff: 1 Type: TF Page Ref: 151
Skill: Factual
75) One of the effects produced by cortisol is neuronal damage that may contribute to
dementia.
A) True
B) False
Answer: A
Diff: 2 Type: TF Page Ref: 151
Skill: Factual
Answer: A
Diff: 1 Type: TF Page Ref: 151
Skill: Factual
77) Evidence has been found to indicate glucocorticoids suppress immune function and
promote the development of atherosclerosis.
A) True
B) False
Answer: A
Diff: 1 Type: TF Page Ref: 151
Skill: Factual
78) Most, but not all organs that are innervated by the sympathetic system are also
innervated by the parasympathetic branch.
A) True
B) False
Answer: A
Diff: 2 Type: TF Page Ref: 151
Skill: Factual
Answer: B
Diff: 1 Type: TF Page Ref: 152
Skill: Factual
Answer: B
Diff: 2 Type: TF Page Ref: 153
Skill: Factual
Answer: A
Diff: 2 Type: TF Page Ref: 153
Skill: Factual
82) In the resistance phase of the GAS, the body mobilizes its defenses, in order to deal
with a stressor.
A) True
B) False
Answer: B
Diff: 2 Type: TF Page Ref: 155
Skill: Conceptual
83) Primary appraisal may be thought of as if a person were asking the question “is this a
threat to me?”
A) True
B) False
Answer: A
Diff: 1 Type: TF Page Ref: 155
Skill: Conceptual
84) In terms of psychosocial factors that may affect disease, a dominance hierarchy in
monkeys may be seen as analogous to socio-economic-status.
A) True
B) False
Answer: A
Diff: 2 Type: TF Page Ref: 157
Skill: Conceptual
85) Ischemic heart disease is a condition in which the blood supply to the heart becomes
compromised.
A) True
B) False
Answer: A
Diff: 1 Type: TF Page Ref: 164
Skill: Factual
86) Cardiac output, one of the aspects of blood pressure, specifically refers to the
diameter of the blood vessels.
A) True
B) False
Answer: B
Diff: 2 Type: TF Page Ref: 165
Skill: Factual
87) Epinephrine and norepinephrine interact directly with blood cells and the cells lining
blood vessel walls.
A) True
B) False
Answer: A
Diff: 2 Type: TF Page Ref: 165
Skill: Factual
Answer: B
Diff: 2 Type: TF Page Ref: 166
Skill: Factual
Answer: A
Diff: 1 Type: TF Page Ref: 166
Skill: Conceptual
90) Some key type A characteristics are hyperarousal, competitiveness, and hostility.
A) True
B) False
Answer: A
Diff: 1 Type: TF Page Ref: 167
Skill: Factual
91) Techniques employed for stress management range from teaching control of specific
muscle groups to autogenic training.
A) True
B) False
Answer: A
Diff: 1 Type: TF Page Ref: 170
Skill: Factual
Essay Questions:
92) Identify one similarity and one difference between the psychophysiological disorders
and the somatoform disorders. Specify how mind interacts with body in each category of
disorder.
Answer: Engel's argument is that any model explaining disease should incorporate a
range of factors. Among these factors are psychological characteristics and societal
forces. This spawned from the realization that many, and perhaps all, disease states are
influenced directly or indirectly by social or psychological factors.
Diff: 1 Type: ES Page Ref: 147
Skill: Conceptual
95) Describe the functioning of the endocrine system. Include the relevant organs,
method of transmission, and both the nature and role of cortisol.
Answer: The endocrine system functions mainly through the release of hormones into the
bloodstream in order to reach target areas. These target areas include the heart, liver or
bones. The main organs involved are the hypothalamus, pituitary, and adrenal gland.
Cortisol is a highly active hormone that produces a variety of effects in the body
including suppressing inflammation, mobilizing glucose from the liver, increasing
cardiovascular tone, producing immune-system changes, and inhibiting the activity of
other endocrine structures.
Diff: 1 Type: ES Page Ref: 151
Skill: Factual
96) Explain the functioning of the autonomic nervous system. Include in your
explanation the functioning of both the sympathetic and parasympathetic branches.
Answer: The Autonomic Nervous System seems to operate almost entirely out of range
of conscious control. The ANS operates of two anatomically distinct parts. The
sympathetic branch consists of nerve fibres that emanate from the thoracic and lumbar
regions of the spinal cord and make contact with a large number of body organs. These
include the: heart, stomach and blood vessels. The parasympathetic branch consists of
fibres emanating from the cranial and sacral regions of the spinal cord. The sympathetic
system arouses the body for vigorous action. The parasympathetic system returns the
body to a more quiescent state.
Diff: 1 Type: ES Page Ref: 151-152
Skill: Factual
Answer: Cellular immunity is based on the action of a class of blood cells called T-
lymphocytes. The “T” designation refers to the locus of their production, the thymus
gland. Cellular immunity results from a cascade of actions of various types of T-
lymphocytes. An antigen is presented to T-lymphocytes by macrophages. The T-cells
proliferate and then circulate in the body. Other T-cells participate including Helper T-
cells, Natural Killer T-cells and Suppressor T-cells.
Diff: 2 Type: ES Page Ref: 153
Skill: Factual
98) State and explain the three stages of Hans Selye's (1956) General Adaptation
Syndrome. Does this model treat stress as stimulus or as response?
Answer: This is a stress-as-response model. In the alarm phase, the body attempts to
adapt by mobilizing its defences. If the challenge persists, the body then enters the
resistance phase. In this phase the body actively fights or copes with the challenge
through immune and neuroendocrine changes. If the challenge persists still further then
the body enters the exhaustion phase. At this point the body has depleted its energy store
and can not maintain resistance. It is at this stage that the body may succumb to a disease
of adaptation.
Diff: 2 Type: ES Page Ref: 155
Skill: Conceptual
99) Briefly explain Lazarus and colleagues' (Lazarus & Folkman, 1984) transactional
model of stress. Does this model treat stress as stimulus or as response?
101) Use the transactional model to identify the psychological processes that give rise to
the disease-related physiological processes described in the chapter. What exactly are the
psychological events or processes that interact with the body and how? Briefly list the
bodily impact (the physiological systems affected by) of these events and processes?
Answer: Cognitive appraisals of threat and their emotional significance are what trigger
the disease-related physiological processes describe in the chapter. The cognitive-
affective components are understood as subjective stress or stressors and the behavioral
responses are called coping. The transactional model examines stress from a
psychological level of analysis. We can then use the biological level of analysis to study
the physical impact of these psychological states and coping behaviors. The transactional
model views stress as resulting from ongoing transactions between an individual and her
environment. Transactions include attention to and identification and appraisal of threat,
followed by a coping behavior, followed by an environmental response, followed by re-
appraisal and so on. Primary appraisal determines if the stimulus constitutes a threat
whereas secondary appraisals determine what, if anything can be done about it. A
behavioral coping response is selected, executed and evaluated in terms of effectiveness –
the impact on the stimulus in the environment. These cognitive appraisals occur together
with changes in the emotional state of the person, which shift dynamically over time
(across multiple transactions) in concert with the unfolding appraisal process. Although
we cannot neatly “cleave” the cognitive and affective components, it can be said that it’s
the affective component (i.e., fear / anxiety) that directly interacts with HPA and
sympathetic nervous system, triggering the processes related to disease that are describe
in the chapter (i.e., autonomic, endocrine, immune, and cardiovascular systems and
processes).
Diff: 3 Type: ES Page Ref: 155-156
Skill: Conceptual / application
102) Explain both internal and external loci of control. How may an internal locus of
control influence the disease process?
103) Explain the evidence for and against the role Helicobacter pylori plays in the
formation of gastric ulcers.
Answer: The bacterium is present in large proportions of individuals with ulcer disease.
Antibodies are present in their serum. Treatment with drugs to eliminate this bacterium
produces improvement in affected patients. But, the antibodies are found in normal
controls. The bacterium is associated with other diseases. Patients have also been shown
to improve without the bacteria being treated.
Diff: 2 Type: ES Page Ref: 163-164
Skill: Factual
104) Describe the plumbing analogy for the human cardiovascular system (be sure to
include in your description both systolic and diastolic blood pressure).
Answer: The heart is a pump, the vasculature is a hose. As the heart pumps, the blood
constituents will be transmitted through the tube in cycles that correspond to the pumping
action. The peak of the wave of blood flow corresponds to contraction of the left ventricle
of the heart at a point during the cardiac cycle, called the systole. When the pump is at
rest (the point called the diastole) blood will still be flowing but at a much reduced
pressure. So, the blood is always flowing but depending on when the pump was last
primed (the heart last contracted; the pressure level is higher or lower. The pressure can
be affected by either the amount of blood or the diameter of the tubing.
Diff: 2 Type: ES Page Ref: 165-165
Skill: Conceptual
105) Name and define the three general psychosocial factors that have been shown to
influence disease. For each, and in one sentence, summarize the link that research has
supported between the psychosocial factor and physical disease.
Answer: Each of the three general psychosocial factors can be understood within the
transactional framework: they exert their effects by way of the threat appraisal-and-
coping transactions that the individual makes with her environment. The first factor,
social status refers to an individual’s position in a social hierarchy. Research shows that
people and animals in higher positions live longer, an effect mediated by differences in
neuroendocine, autonomic and immune system profiles: higher status persons / animals
are reactive to stressors, but show a faster return to resting conditions, and normalized
immune system response. The presence of social supports refers to the extent to which
an individual feels connected to other people in meaningful ways. The presence of high
social support is associated with reduced mortality, especially in men; the absence of
social support appears to make existing disease worse. Controllability refers to a
person’s ability to control potentially stressful events. Research shows that people who
have perceived control over a stressor and/or who have internal (vs. external) locus of
control show reduced sympathetic arousal than those who do not believe they have
control and are protected against the harmful effects of stress on health.
Diff: 3 Type: ES Page Ref: 156-158
Skill: Factual / conceptual
106) Compare and contrast the 5 models of the relationship between hostility and health
risk. What is the status of each in the research literature? What model should be chosen
on the basis of current knowledge?
Answer: The psychophysiolocial reactivity model suggests that hostile people are at
higher risk because they experience exaggerated autonomic and neuroendocrine response
during stress. The psychosocial vulnerability model suggests that hostile people
experience a more demanding interpersonal life than do others. The transactional model
suggests that hostile people actively construct a world that has high interpersonal stress
and a lack of social support, which increases vulnerability. Presumably this hybrid model
includes higher physiological reactivity to the same psychosocial stressors, which adds to
the impact of elevated stress for persons high in hostility. The health behavior model
suggests that hostile people, perhaps as a result of their higher stress levels, are at
increased risk of choosing unhealthy behaviors (e.g., smoking). The constitutional
vulnerability model posits that a third variable causes both hostility and increased risk of
disease. Each of these models has received research support. Therefore the best model
would be one that incorporates all five: a truly transactional model that includes increased
probability of engaging in unhealthful behaviors, and where a portion (but not all) of the
shared variance (between hostility and health risk) is accounted for by a third variable –
constitutional vulnerability.
Diff: 3 Type: ES Page Ref: 167-168
Skill: Factual / application
⁂
The storm swept the woods for several days and tore the last
leaves from the branches. Then the trees stood stripped.
Bambi was wandering homewards in the gray dawn in order to
sleep in the hollow with the old stag.
A shrill voice called him once or twice in quick succession. He
stopped. Then the squirrel scampered down from the branches in a
twinkling and sat on the ground in front of him.
“Is it really you?” he shrilled, surprised and delighted. “I
recognized you the minute you passed me but I couldn’t believe ...”
“Where did you come from?” asked Bambi.
The merry little face in front of him grew quite troubled. “The oak
is gone,” he began plaintively, “my beautiful old oak, do you
remember it? It was awful. He chopped it down!”
“My beautiful old oak, do you remember it? It was awful. He
chopped it down!”
Bambi hung his head sadly. His very soul felt sorry for the
wonderful old tree.
“As soon as it happened,” the squirrel related, “everybody who
lived in the tree fled and watched how He bit through the trunk with a
gigantic flashing tooth. The tree groaned aloud when it was wounded.
It kept on groaning and the tooth kept gnawing, it was dreadful to
hear it. Then the poor beautiful tree fell out on the meadow.
Everybody cried.”
Bambi was silent.
“Yes,” sighed the squirrel, “He can do anything. He’s all-powerful.”
He gazed at Bambi out of his big eyes, and pointed his ears. But
Bambi kept silent.
“Then we were all homeless,” the squirrel went on, “I don’t even
know where the others scattered to. I came here. But I won’t find
another tree like that in a hurry.”
“The old oak,” said Bambi to himself, “I knew it from the time I was
a child.”
“O well,” said the squirrel. “But to think it’s really you,” he went on
delightedly. “Everybody said you must be dead long ago. Of course
there were some people now and then who said you were still alive.
Once in a while someone said he had seen you. But nobody could
find out anything definite. And so I thought it was only gossip,” the
squirrel gazed at him inquisitively, “since you didn’t come back any
more.”
Bambi could see how curious he was and how he was fishing for
an answer.
Bambi kept silent. But a gentle anxious curiosity was stirring in
him, too. He wanted to ask about Faline, about Aunt Ena, and Ronno
and Karus, about all his childhood companions. But he kept silent.
The squirrel still sat in front of him, studying him. “What antlers!”
he cried admiringly. “What antlers! Nobody in the whole forest, except
the old Prince, has antlers like that.”
Once Bambi would have felt elated and flattered by such praise.
But he only said, “Maybe.”
The squirrel nodded quickly with his head. “Really,” he said,
surprised, “you’re beginning to get gray.”
Bambi wandered on.
The squirrel perceived that the conversation was over and sprang
through the bushes. “Good day,” he shouted down. “Good-by. I’m
very glad I met you. If I see any of your acquaintances I’ll tell them
you’re still alive. They’ll all be glad.”
Bambi heard him and again felt that gentle stirring in his heart. But
he said nothing. When he was still a child the old stag had taught him
that you must live alone. Then and afterwards the old stag had
revealed much wisdom and many secrets to him. But of all his
teachings this had been the most important; you must live alone, if
you wanted to preserve yourself, if you understood existence, if you
wanted to attain wisdom, you had to live alone.
“But,” Bambi had once objected, “we two are always together
now.”
“Not for very much longer,” the old stag had answered quickly.
That was a few weeks ago. Now it occurred to Bambi again, and he
suddenly remembered how even the old stag’s very first words to him
had been about singleness. That day when Bambi was still a child
calling for his mother, the old stag had come to him and asked him,
“Can’t you stay by yourself?”
Bambi wandered on.