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Abnormal Psychology: Perspectives, 5e
Dozois
CHAPTER 7
Psychophysiological Disorders
Multiple choice:
1) The idea that psychological processes can affect bodily states

A) has not yet taken hold in western culture but has in other cultures.
B) is relatively new to western culture but is starting to take hold.
C) is new unique to western culture but accepted elsewhere.
D) has a long history in western culture but is unique to western culture.
E) has a long history in western culture and may be even more deeply embedded in other
cultures.
Answer: E
Diff: 2 Type: MC Page Ref: 147
Skill: Factual
2) “Voodoo Death” is a phenomenon in which

A) sublimated drives result in heart failure.
B) death is directly caused by voodoo.
C) ritualistic suicide occurs in Caribbean culture.
D) people die as a result of a nervous breakdown.
E) the individual dies after learning that he has been cursed.
Answer: E
Skill: Factual
3) Somatoform disorders involve psychological processes that give rise to apparently

physical symptoms without medical basis; psychophysiological disorders, in contrast
A) involve psychological processes that give rise to identifiable disturbances in bodily
structures and functions.
B) involve purely emotional processes that give rise to apparent physical symptoms.
C) are the result of physical processes that have psychological consequences.
D) involve physical symptoms with physiological causes.
E) involve purely cognitive processes that result in physical symptoms, without
intermediary physiological processes.
Answer: A
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.
Copyright © 2012 Pearson Canada Inc.

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C) dualistic behaviourism.
D) neuropsychophysiology.
E) behavioural medicine.
Answer: A
Skill: Factual
5) Helen Flanders Dunbar (1935) suggested that

A) psychosomatic disorders are caused by true medical conditions.
B) the roots of classic psychosomatic disorders lay in interpersonal conflict.
C) intrapsychic forces could lead to abnormal brain states and consequently ulcers.
D) people with a chronic sense of rage suffered from high blood pressure.
E) specific disorders were the natural consequence of emotions and personality traits.
Answer: E
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
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
Skill: Factual
8) Which of the following would most likely be considered a treatable problem in

behavioural medicine?
A) gallstones

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B) a stroke
C) essential hypertension
D) cancer
E) cardiac arrythmias due to genetic illness
Answer: C
Skill: Conceptual
9) __________ is defined as the application of psychological methods and theories to

understand origins of disease, individual responses to disease and the dimensions and
determinants of good health.
A) Health Psychology
B) Behavioural medicine
C) Health Physiology
D) Biomedicine
E) Psychosomatic medicine
Answer: A
Skill: Factual
10) A medical condition may be noted on which axis of the DSM-IV-TR?

A) III
B) V
C) II
D) I
E) IV
Answer: A
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
Skill: Factual

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9) If the clinician believes that a psychological factor is affecting a medical condition,

s/he indicates this by
A) listing the factor on Axis 3.
B) listing the condition on Axis 3.
C) placing a specific code on Axis 1.
D) placing a specific code on Axis 3.
E) placing the factor and the condition on Axis 1.
Answer: C
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
Skill: Factual
13) The difference between a sign and a symptom is

A) one refers to a lesion and the other a level of functioning.
B) one is a mainly objective and the other a mainly subjective indication of illness.
C) one refers to a psychological condition and one a medical condition.
D) one is an antecedent and one is a consequence of illness.
E) neither are directly observable.
Answer: B
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
Skill: Factual

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15) The DSM-5 workgroup is considering

A) eliminating Axis 3.
B) listing all “medical” and psychological disorders on one axis.
C) eliminating Axis 2.
D) listing diagnoses in a manner similar to ICD-10 does.
E) All of the above are correct.
Answer: E
Skill: Factual
16) Illness is defined by _________ which are____________ whereas disease is defined

by ____________ that are _________________.
A) signs; subjective reports of internal states; symptoms; objective indications of a
specific process
B) symptoms; subjective reports of internal states; symptoms; objective indications of a
process
C) signs; subjective reports of internal states; signs; objective indications of a process
D) signs; subjective reports of internal states; symptoms; objective indication of a process
E) symptoms; subjective reports of internal states; signs; objective indications of a
specific process
Answer: E
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
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.

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Answer: B
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
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
Skill: Factual
21) Adrenocorticotrophic hormone

A) informs cells in the liver to convert glycogen to usable sugars.
B) prompts cells in the adrenal glands to secrete cortisol.
C) is released by the pineal gland.
D) is a monoamine oxidase inhibitor.
E) is a glucocorticoid.
Answer: B
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

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Skill: Factual
23) It is increasingly recognized that __________released during stress plays an

important role in the development of abdominal obesity
A) ACTH
B) androgens
C) adrenal emissions
D) cortisol
E) catecholamines
Answer: D
Skill: Factual
24) Most organs that are innervated by the sympathetic system

A) are primarily involved in digestion.
B) are typically accompanied by an awareness of their function.
C) are also innervated by the parasympathetic branch.
D) are not innervated by the parasympathetic branch of the nervous system.
E) are under the control of the parasympathetic branch of the nervous system.
Answer: C
Skill: Factual
25) Sympathetic is to parasympathetic system as

A) accelerator is to brakes.
B) brakes are to car.
C) deceleration is to acceleration.
D) flour and sugar are to baking a cake.
E) horse is to buggy.
Answer: A
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

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Skill: Factual
27) The process of engulfing and digesting invading organisms is called

A) suppression.
B) cellular inhibition.
C) phagocytosis.
D) nonspecific immune response.
E) lymphocytosis.
Answer: C
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
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
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
Skill: Factual

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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
Skill: Factual
32) Primary appraisal involves

A) deciding whether or not an event is threatening.
B) addressing our memory to determine how to deal with a threatening event.
C) choosing an appropriate course of action for dealing with the threat.
D) inducing a different feeling state as a way to deal with a problem.
E) seeking advice from a clinical psychologist about a problem.
Answer: A
Skill: Factual
33) Secondary appraisal is analogous to asking the question

A) “is there anything I can do about this?”
B) “how can I make myself feel better?”
C) “can anyone observe how I handle this event?”
D) “why is this happening?”
E) “is this event threatening?”
Answer: A
Skill: Factual
34) Which of the following behaviours may NOT be considered emotion-focused

coping?
A) watching television
B) taking drugs
C) thinking about something unrelated to the problem
D) drinking
E) identifying and rectifying the source of the threat
Answer: E
Skill: Factual

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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
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
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
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

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Answer: C
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
Skill: Factual
40) Individuals with an internal locus of control typically believe themselves

A) to be masters of their own destiny.
B) to be more stressed by events than other people.
C) to have little control over social situations.
D) to be buffeted by the random events in the world.
E) to be less healthy than those with an external locus of control.
Answer: A
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
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.

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Answer: B
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
Skill: Factual
45) A study on predictability conducted by Weiss (1970) discovered a relationship

between
A) rats shocked after being provided with a warning tone showed the same ulceration as
rats that did not receive a warning stimulus.
B) rats shocked after being provided with a warning tone showed ulceration much higher
than shocked rats without a warning and unshocked rats.
C) rats shocked after being provided with a warning tone showed ulceration only slightly
higher than shocked rats.
D) shocked rats did not show a great deal of ulceration.
E) rats shocked and provided with a warning tone showed greater ulceration than
unshocked rats.
Answer: C
Skill: Factual
46) A study on controllability by Weiss (1971) discovered that

A) rats who could control the stressor suffered the same level of ulceration as rats who
could not control the stressor.
B) rats who could not exercise control over the stressor did not show any levels of
ulceration.
C) shocked rats did not show a great deal of ulceration.
D) rats who could exercise control over the stressor suffered milder ulceration than rats
who could not control the stressor.
E) rats who could control the stressor had higher levels of ulceration than those who
could not control the stressor.
Answer: D

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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
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
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

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Answer: E
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
Skill: Conceptual
52) In terms of cardiovascular functioning, which of the following is a controllable risk

factor?
A) jogging
B) high blood cholesterol
C) exercise
D) marriage
E) high demand occupations
Answer: B
Skill: Factual
53) Under precisely defined conditions in a doctor's office, hypertension is defined by

A) blood pressure reading of more than 140/80.
B) blood pressure reading of more than 120/70.
C) decreased tension in blood vessel walls.
D) blood pressure reading of more than 160/100.
E) cardiac distress under high demand exercise.
Answer: A
Skill: Factual
54) The stress reactivity paradigm is used

A) to determine the risk of cardiovascular disease as a function of cardiovascular
reactivity.
B) to show how cardiovascular disease causes stress.
C) to measure the effects of risk factors such as smoking on cardiovascular disease.
D) to determine the cause of “essential” hypertension.

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E) to show how the cardiovascular system can be altered by stressful psychosocial stimuli
or events.
Answer: E
Skill: Factual
55) Cardiovascular reactivity refers to

A) the relationship between cardiovascular function and arherosclerosis.
B) that relationship between psychosocial stressors and cardiovascular disease.
C) the relationship between hypertension and psychosocial stressors.
D) how much a person’s cardiovascular function changes in response to a
psychologically significant stimulus.
E) how much hypertension is caused by a psychosocial stressor.
Answer: D
Skill: Conceptual
56) Type A people in general show more of the following except

A) neurotic behaviour.
B) hyperalertness.
C) competitiveness.
D) sense of time urgency.
E) hostility.
Answer: A
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
Skill: Factual
58) The psychosocial vulnerability model suggests that hostile people

A) are innately predisposed to illness.
B) experience a more demanding interpersonal life than others.

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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
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
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
Skill: Factual
61) Cognitive-behavioural techniques aimed at stress management do so by

A) teaching control of specific muscle groups.
B) helping the individual to re-assess stress causing thought patterns.
C) using biofeedback to lower physiological arousal responses.
D) encouraging people to invoke images of warmth and heaviness.
E) autogenic training.

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Answer: B
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
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
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
Skill: Factual

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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
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
Skill: Factual
68) Health psychology refers to using psychological methods to mental illnesses that
have physical consequences.
A) True
B) False
Answer: B
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
Skill: Factual

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70) A sign is a unmeasurable subjective experience of illness.

A) True
B) False
Answer: B
Skill: Conceptual
71) A lesion is a symptom of a physical illness.

A) True
B) False
Answer: B
Skill: Conceptual
72) ACTH is secreted by the pineal gland.

A) True
B) False
Answer: B
Skill: Factual
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
Skill: Factual
74) One of the effects produced by cortisol is the reduction of inflammation.

A) True
B) False
Answer: A
Skill: Factual
75) One of the effects produced by cortisol is neuronal damage that may contribute to
dementia.
A) True
B) False

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Answer: A
Skill: Factual
76) The endocrine system is characterized by manufacturing hormones that produce an

effect in “targeted” areas of the body.
A) True
B) False
Answer: A
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
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
Skill: Factual
79) In comparison to sympathetic system innervation, which relies on hormonal

transmission, the parasympathetic system operates much more quickly.
A) True
B) False
Answer: B
Skill: Factual
80) Cellular immunity is based on the action of granulocytes and monocytes.

A) True
B) False

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Answer: B
Skill: Factual
81) In humoral immunity, invading antigens are presented by macrophages to B-

lymphocytes, some of which remain as memory B-cells.
A) True
B) False
Answer: A
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
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
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
Skill: Conceptual
85) Ischemic heart disease is a condition in which the blood supply to the heart becomes
compromised.
A) True
B) False

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Answer: A
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
Skill: Factual
87) Epinephrine and norepinephrine interact directly with blood cells and the cells lining
blood vessel walls.
A) True
B) False
Answer: A
Skill: Factual
88) In 90% of cases of hypertension a specific cause can be identified.

A) True
B) False
Answer: B
Skill: Factual
89) Cardiovascular reactivity refers to how much an individual's cardiovascular function

changes in response to a psychologically significant stimulus.
A) True
B) False
Answer: A
Skill: Conceptual
90) Some key type A characteristics are hyperarousal, competitiveness, and hostility.
A) True
B) False
Answer: A
Skill: Factual

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91) Techniques employed for stress management range from teaching control of specific
muscle groups to autogenic training.
A) True
B) False
Answer: A
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: Psychophysiological disorders involve an interaction between a psychological

process (e.g., chronic fearful / anxious arousal) and a disturbance in bodily structures and
functions. The psychological process plays a causal role in the physiological
disturbance. The somatoform disorders involve an interaction between a psychological
process (e.g., the perception and experience of pain; thoughts and feelings consistent with
the experience of disease) and the experience of physical symptoms suggestive of
medical illness, but for which no bodily disturbance can be identified. In this case some
physical AND/OR psychological process is giving rise to the subjective experience.
Thus, both involve an interaction between mental and physical processes but only in the
former category are the physical processes observable.
Diff: 3 Type: ES Page Ref: 137; 147

93) Describe Engel's (1977) argument for a biopsychosocial model of disease.
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
94) Outline the differences between signs and symptoms.
Answer: Symptoms are subjective reports of internal states. An example would be a

person suffering from the flu complaining of being hot and tired. Signs are objective
indications of an underlying disease process, observable directly by a person with the
appropriate training or indirectly through the administration of a specific test.

23
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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.
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
97) Explain the process of cellular immunity.
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.
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

24
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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.
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?
Answer: This is neither a stress-as-stimulus nor a stress-as-response model. In this model,

stress is an ongoing series of transactions between an individual and his or her
environment. Central to this theory is the idea that people constantly evaluate what is
happening to them and its implications for themselves.
Skill: Conceptual
100) Define emotion-focused and problem-focused coping. Provide an example of each.

In simple terms and in one sentence, describe how utilization of each type of coping is
reinforced (i.e., met with reward, or loss of reward, punishment or escape from
punishment).
Answer: Emotion-focused coping refers to strategies aimed at reducing negative feelings

associated with exposure to the threat. Examples include anything that removes the
threat from awareness, resulting in escape (e.g., intellectualization; use of substances;
highly stimulating and distracting behaviors, such as eating-to-soothe, video-gaming,
gambling, use of pornography). These methods are reinforced immediately by escape
from the negative (punishing) feelings associated with awareness of the threat. Problem-
focused coping refers to strategies aimed at realistically dealing with the threat itself,
such as identifying the source of the problem and taking steps to rectify it. Problem-
focused coping is rewarded eventually, through negative reinforcement (i.e., actual
removal or reduction of the threat). The rewards are often delayed and require effort, and
the experience of additional stress while coping with the problem.

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

25
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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).
102) Explain both internal and external loci of control. How may an internal locus of
control influence the disease process?
Answer: In an internal locus of control the individual believes himself to be master of

his/her own destiny. Those with an external locus of control see themselves as being
buffeted by the random events of the world. Those with internal loci of control are likely
protected against the harmful effects of stress on their health.
Skill: Conceptual
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.
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

26
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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.
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.
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

27
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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.
Skill: Factual / application

28
Another random document with
no related content on Scribd:
The ducks talked endlessly to one another in a friendly, serious,
capable way.
There were a couple of mother ducks, each with a flock of young

ones around her. They were constantly teaching their young ones
things. And the little ones were always learning them. Sometimes one
or the other of the mothers would give a warning. Then the young
ducks would dash off in all directions. They would scatter and glide
away perfectly noiselessly. Bambi saw how the smallest ones, who
could not fly yet, would paddle among the thick rushes without
moving a stem that might betray them by swaying. He would see the
small dark bodies creep here and there among the reeds. Then he
could see nothing more.
Later one of the mothers would give a short call and in a flash
they would all flock around her again. In an instant they would
reassemble their flotilla and go on cruising quietly about as before.
Bambi marveled anew at it each time. It was a constant source of
wonder to him.
After one such alarm, Bambi asked one of the mothers, “What
was it? I was looking closely and I didn’t see anything.”
“It was nothing at all,” answered the duck.
Another time one of the children gave the signal, turning like a
flash and staring through the reeds. Presently he came out on the
bank where Bambi was standing.
“There wasn’t anything,” the young one replied, shaking its tail
feathers in a grown-up way and carefully putting the tips of its wings
in place. Then it paddled through the water again.
Nevertheless Bambi had faith in the ducks. He came to the
conclusion that they were more watchful than he, that they heard and
saw things more quickly. When he stood watching them, that
ceaseless tension that he felt within himself at other times relaxed a
little.
He liked to talk with the ducks, too. They didn’t talk the nonsense
that he so often heard from the others. They talked about the broad
skies and the wind and about distant fields where they feasted on
choice tidbits.
From time to time Bambi saw something that looked like a fiery
streak in the air beside the brook. “Srrrri!” the humming bird would cry
softly darting past like a tiny whirring speck. There was a gleam of
green, a glow of red, as he flashed by and was gone. Bambi was
thrilled and wanted to see the bright stranger near to. He called to
him.
“Don’t bother calling him,” the sedge-hen said to Bambi from
among the reed clumps, “don’t bother calling. He’ll never answer
you.”
“Where are you?” asked Bambi peering among the reeds.
But the sedge-hen only laughed loudly from an entirely different
place, “Here I am. That cranky creature you just called to won’t talk to
anyone. It’s useless to call him.”
“He’s so handsome,” said Bambi.
“But bad,” the sedge-hen retorted from still another place.
“What makes you think him bad?” Bambi inquired.
The sedge-hen answered from an altogether different place, “He
doesn’t care for anything or anybody. Let anything happen that wants
to, he won’t speak to anybody and never thanked anybody for
speaking to him. He never gives anybody warning when there’s
danger. He’s never said a word to a living soul.”
“The poor ...” said Bambi.
The sedge-hen went on talking, and her cheery, piping voice
sounded from the far side again. “He probably thinks that people are
jealous of his silly markings and doesn’t want them to get too good a
look at him.”
“Certain other people don’t let you get a good look at them either,”
said Bambi.
In a twinkling the sedge-hen was standing in front of him. “There’s
nothing to look at in my case,” she said simply. Small and gleaming
with water, she stood there in her sleek feathers, her trim figure
restless, animated and satisfied. In a flash she was gone again.
“I don’t understand how people can stand so long in one spot,”
she called from the water. And added from the far side, “It’s tiresome
and dangerous to stay so long in one spot.” Then from the other side
she cried gayly once or twice. “You have to keep moving,” she cried
happily, “you’ve got to keep moving if you want to keep whole and
hearty.”
A soft rustling in the grass startled Bambi. He looked around.
There was a reddish flash among the bushes. It disappeared in the
reeds. At the same time a sharp warm smell reached his nostrils. The
fox had slunk by.
Bambi wanted to cry out and stamp on the ground as a warning.
But the sedges rustled as the fox parted them in quick leaps. The
water splashed and a duck screamed desperately. Bambi heard her
wings flapping and saw her white body flash through the leaves. He
saw how her wings beat the fox’s face with sharp blows. Then it grew
still.
At the same moment the fox came out of the bushes holding the
duck in his jaws. Her neck hung down limply, her wings were still
moving, but the fox paid no attention to that. He looked sidewise at
Bambi with sneering eyes and crept slowly into the thicket.
Bambi stood motionless.
A few of the old ducks had flown up with a rush of wings and were
flying around in helpless fright. The sedge-hen was crying warnings
from all directions. The tit-mice chirped excitedly in the bushes. And
the young orphaned ducks splashed about the sedge, crying with soft
voices.
The hummingbird flew along the bank.
“Please tell us,” the young ducks cried, “please tell us, have you
seen our mother?”
“Srrri,” cried the hummingbird shrilly, and flew past sparkling,
“what has she got to do with me?”
Bambi turned and went away. He wandered through a whole sea
of goldenrod, passed through a grove of young beeches, crossed
through old hazel thickets until he reached the edge of the deep ditch.
He roamed around it, hoping to meet the old stag. He had not seen
him for a long while, not since Gobo’s death.
Then he caught a glimpse of him from afar and ran to meet him.
For a while they walked together in silence, then the old stag asked:
“Well, do they still talk about him the way they used to?”
Bambi understood that he referred to Gobo and replied, “I don’t
know. I’m nearly alone now.” He hesitated, “But I think of him very
often.”
“Really,” said the old stag, “are you alone now?”
“Yes,” said Bambi expectantly, but the old stag remained silent.
They went on. Suddenly the old stag stopped. “Don’t you hear
anything?” he asked.
Bambi listened. He didn’t hear anything.
“Come,” cried the old stag and hurried forward. Bambi followed
him. The stag stopped again. “Don’t you hear anything yet?” he
asked.
Then Bambi heard a rustling that he did not understand. It
sounded like branches being bent down and repeatedly springing up
again. Something was beating the earth dully and irregularly.
Bambi wanted to flee but the old stag cried, “Come with me,” and
ran in the direction of the noise. Bambi at his side ventured to ask,
“Isn’t it dangerous?”
“It’s terribly dangerous,” the old stag answered mysteriously.
Soon they saw branches being pulled and tugged at from below
and shaken violently. They went nearer and saw that a little trail ran
through the middle of the bushes.
Friend Hare was lying on the ground. He flung himself from side to
side and writhed. Then he lay still and writhed again. Each of his
motions pulled at the branches over him.
Bambi noticed a dark threadlike leash. It ran right from the branch
to Friend Hare and was twisted around his neck.
Friend Hare must have heard someone coming, for he flung
himself wildly into the air and fell to the ground. He tried to escape
and rolled, jerking and writhing in the grass.
“Lie still,” the old stag commanded. Then sympathetically, with a
gentle voice that went to Bambi’s heart, he repeated in his ear, “Be
easy, Friend Hare, it’s I. Don’t move now. Lie perfectly still.”
The Hare lay motionless, flat on the ground. His throttled breath
rattled softly in his throat.
The old stag took the branch between his teeth, and twisted it. He
bent down. Then he walked around putting his weight cunningly
against it. He held it to the earth with his hoof and snapped it with a
single blow of his antlers.
Then he nodded encouragingly to the Hare. “Lie still,” he said,
“even if I hurt you.”
Holding his head on one side, he laid one prong of his antlers
close to the Hare’s neck and pressed into the fur behind his ear. He
made an effort and nodded. The Hare began to writhe.
The old stag immediately drew back. “Lie still,” he commanded,
“it’s a question of life and death for you.” He began over again. The
Hare lay still gasping. Bambi stood close by, speechless with
amazement.
One of the old stag’s antlers, pressing against the Hare’s fur, had
slipped under the noose. The old stag was almost kneeling and
twisted his head as though he were charging. He drove his antlers
deeper and deeper under the noose, which gave at last and began to
loosen.
The Hare could breathe again and his terror and pain burst from
him instantly. “E-e-eh!” he cried bitterly.
The old stag stopped. “Keep quiet!” he cried, reproaching him
gently, “keep quiet.” His mouth was close to the Hare’s shoulder, his
antlers lay with a prong between the spoonlike ears. It looked as if he
had spitted the Hare.
“How can you be so stupid as to cry at this time?” he grumbled
gently. “Do you want the fox to come? Do you? I thought not. Keep
quiet then.”
He continued to work away, slowly exerting all his strength.
Suddenly the noose broke with a loud snap. The Hare slipped out
and was free, without realizing it for a moment. He took a step and
sat down again dazed. Then he hopped away, slowly and timidly at
first, then faster and faster. Presently he was running with wild leaps.
Bambi looked after him. “Without so much as a thank you,” he
exclaimed in surprise.
“He’s still terrified,” said the old stag.
The noose lay on the ground. Bambi touched it gently. It creaked,
terrifying Bambi. That was a sound such as he had never heard in the
woods.
“He?” asked Bambi softly.
The old stag nodded.
They walked on together in silence. “Take care when you’re going
along a trail,” said the old stag, “test all the branches. Prod them on
all sides of you with your antlers. And turn back at once if you hear
that creak. And when you’ve shed your antlers be doubly cautious. I
never use trails any more.”
Bambi sank into troubled thought.
“He isn’t here,” he whispered to himself in profound astonishment.
“No, He’s not in the forest now,” the old stag answered.
“And yet He is here,” said Bambi shaking his head.
The old stag went on and his voice was full of bitterness. “How did
your Gobo put it...? Didn’t Gobo tell you He is all-powerful and all-
good.”
“He was good to Gobo,” Bambi whispered.
The old stag stopped. “Do you believe that, Bambi?” he asked
sadly. For the first time he had called Bambi by his name.
“I don’t know,” cried Bambi hurt, “I don’t understand it.”
The old stag said slowly, “We must learn to live and be cautious.”
CHAPTER XXI
One morning Bambi came to grief.
The pale gray dawn was just creeping through the forest. A milky-
white mist was rising from the meadow and the stillness that
precedes the coming of light was everywhere. The crows were not
awake yet, nor the magpies. The jays were asleep.
Bambi had met Faline the night before. She looked sadly at him
and was very shy.
“I’m so much alone now,” she said gently.
“I’m alone too,” Bambi answered with some hesitation.
“Why don’t you stay with me any more?” Faline asked sorrowfully,
and it hurt him to see the gay and lively Faline so serious and
downcast.
“I want to be alone,” he replied. And gently as he tried to say it, it
sounded hard. He felt it himself.
Faline looked at him and asked softly, “Do you love me still?”
“I don’t know,” Bambi answered in the same tone.
She walked silently away from him, leaving him alone.
He stood under the great oak at the meadow’s edge and peered
out cautiously, drinking in the pure and odorless morning air. It was
moist and fresh from the earth, the dew, the grass and the wet
woods. Bambi breathed in great gulps of it. All at once his spirit felt
freer than for a long time. He walked happily onto the mist-covered
meadow.
Then a sound like thunder crashed.
Bambi felt a fearful blow that made him stagger.
Mad with terror, he sprang back into the thicket and kept running.
He did not understand what had happened. He could not grasp a
single idea. He could only keep running on and on. Fear gripped his
heart so that his breath failed as he rushed blindly on. Then a killing
pain shot through him, so that he felt that he could not bear it. He felt
something hot running over his left shoulder. It was like a thin,
burning thread coming from where the pain shot through him. Bambi
had to stop running. He was forced to walk slower. Then he saw that
he was limping. He sank down.
It was comfortable just to lie there and rest.
“Up, Bambi! Get up!” the old stag was standing beside him, and
nudging his shoulder gently.
Bambi wanted to answer, “I can’t,” but the old stag repeated, “Up!
Up!” And there was such compulsion in his voice and such
tenderness that Bambi kept silent. Even the pain that shot through
him stopped for a minute.
Then the old stag said hurriedly and anxiously, “Get up! You must
get away, my son.” My son! The words seemed to have escaped him.
In a flash Bambi was on his feet.
“Good,” said the old stag, breathing deeply and speaking
emphatically, “come with me now and keep close beside me.”
He walked swiftly ahead. Bambi followed him but he felt a burning
desire to let himself drop to the ground, to lie still and rest.
The old stag seemed to guess it and talked to him without
stopping. “Now you’ll have to bear every pain. You can’t think of lying
down now. You mustn’t think of it even for a moment. That’s enough
to tire you in itself. You must save yourself, do you understand me,
Bambi? Save yourself. Or else you are lost. Just remember that He is
behind you, do you understand, Bambi? And He will kill you without
mercy. Come on. Keep close to me. You’ll soon be all right. You must
be all right.”
Bambi had no strength left to think with. The pain shot through
him at every step he took. It took away his breath and his
consciousness. The hot trickle, burning his shoulder, seared him like
some deep heartfelt trouble.
The old stag made a wide circle. It took a long time. Through his
veil of pain and weakness, Bambi was amazed to see that they were
passing the great oak again.
The old stag stopped and snuffed the ground. “He’s still here,” he
whispered. “It’s He. And that’s His dog. Come along. Faster!” They
ran.
Suddenly the old stag stopped again. “Look,” he said, “that’s
where you lay on the ground.”
Bambi saw the crushed grasses where a wide pool of his own
blood was soaking into the earth.
The old stag snuffed warily around the spot. “They were here, He
and His dog,” he said. “Come along!” He went ahead slowly, snuffing
again and again.
Bambi saw the red drops gleaming on the leaves of the bushes
and the grass stems. “We passed here before,” he thought. But he
couldn’t speak.
“Aha!” said the old stag and seemed almost joyful, “we’re behind
them now.”
He continued for a while on the same path. Then he doubled
unexpectedly and began a new circle. Bambi staggered after him.
They came to the oak again but on the opposite side. For the second
time they passed the place where Bambi had fallen down. Then the
old stag went in still another direction.
“Eat that,” he commanded suddenly, stopping and pushing aside
the grasses. He pointed to a pair of short dark-green leaves growing
close together near the ground.
Bambi obeyed. They tasted terribly bitter and smelt sickeningly.
“How do you feel now?” the stag asked after a while.
“Better,” Bambi answered quickly. He was suddenly able to speak
again. His senses had cleared and his fatigue grew less.
“Let’s move on again,” the old stag commanded after another
pause. After Bambi had been following him for a long time he said,
“At last!” They stopped.
“The bleeding has stopped,” said the old stag, “the blood’s
stopped flowing from your wound. It isn’t emptying your veins now.
And it can’t betray you any more either. It can’t show Him and His dog
where to find you and kill you.”
The old stag looked worried and tired but his voice sounded joyful.
“Come along,” he went on, “now you can rest.”
They reached a wide ditch which Bambi had never crossed. The
old stag climbed down and Bambi tried to follow him. But it cost him a
great effort to climb the steep slope on the farther side. The pain
began to shoot violently through him again. He stumbled, regained
his feet, and stumbled again, breathing hard.
“I can’t help you,” said the old stag, “you’ll have to get up
yourself.” Bambi reached the top. He felt the hot trickle on his
shoulder again. He felt his strength ebbing for the second time.
“You’re bleeding again,” said the old stag, “I thought you would.
But it’s only a little,” he added in a whisper, “and it doesn’t make any
difference now.”
They walked very slowly through a grove of lofty beeches. The
ground was soft and level. They walked easily on it. Bambi felt a
longing to lie down there, to stretch out and never move his limbs
again. He couldn’t go any further. His head ached. There was a
humming in his ears. His nerves were quivering, and fever began to
rack him. There was a darkness before his eyes. He felt nothing but a
desire for rest and a detached amazement at finding his life so
changed and shattered. He remembered how he had walked whole
and uninjured through the woods that morning. It was barely an hour
ago, and it seemed to him like some memory out of a distant, long-
vanished past.
They passed through a scrub-oak and dogwood thicket. A huge,
hollow beech trunk, thickly entangled with the bushes, lay right in
front of them, barring the way.
“Here we are,” Bambi heard the old stag saying. He walked along
the beech trunk and Bambi walked beside him. He nearly fell into a
hollow that lay in front of him.
“Here it is,” said the old stag at the moment, “you can lie down
here.”
Bambi sank down and did not move again.
The hollow was still deeper under the beech trunk and formed a
little chamber. The bushes closed thickly across the top so that
whoever was within lay hidden.
“You’ll be safe here,” said the old stag.
Days passed.
Bambi lay on the warm earth with the mouldering bark of the fallen
tree above him. He felt his pain intensify and then grow less and less
until it died away more and more gently.
Bambi lay on the warm earth with the mouldering bark of the
fallen tree above him.
Sometimes he would creep out and stand swaying weakly on his

unsteady legs. He would take a few steps to look for food. He ate
plants now that he had never noticed before. Now they appealed to
his taste and attracted him by their strange, enticing acrid smell.
Everything that he had disdained before and would spit out if it got
accidentally into his mouth, seemed appetizing to him. He still disliked
many of the little leaves and short, coarse shoots, but he ate them
anyway, as though he were compelled to, and his wound healed
faster. He felt his strength returning.
He was cured, but he didn’t leave the hollow yet. He walked
around a little at night, but lay quietly on his bed by day. Not until the
fever had entirely left his body did Bambi begin to think over all that
had happened to him. Then a great terror awoke in him, and a
profound tremor passed through his heart. He could not shake
himself free of it. He could not get up and run about as before. He lay
still and troubled. He felt terrified, ashamed, amazed and troubled by
turns. Sometimes he was full of despair, at others of joy.
The old stag was always with him. At first he stayed day and night
at Bambi’s side. Then he left him alone at times, especially when he
saw Bambi deep in thought. But he always kept close at hand.
One night there was thunder and lightning and a downpour of rain,
although the sky was clear and the setting sun was streaming down.
The blackbirds sang loudly in all the neighboring tree-tops, the
finches warbled, the tit-mice chirped in the bushes. Among the
grasses or from under the bushes, the metallic, throaty cackling of the
pheasants sounded at intervals. The woodpecker laughed exultantly
and the doves cooed their fervid love.
Bambi crept out of the hollow. Life was beautiful. The old stag was
standing there as though he expected Bambi. They sauntered on
together. But Bambi did not return to the hollow or the old stag again.
CHAPTER XXII
One night when the air was whispering with the autumnal fall of
leaves the screech-owl shrieked piercingly among the branches.
Then he waited.
But Bambi had spied him already through the thinning leaves, and
stopped.
The screech-owl flew nearer and shrieked louder. Then he waited
again. But Bambi did not say anything.
Then the owl could restrain himself no longer. “Aren’t you
frightened?” he asked, displeased.
“Well,” Bambi replied, “a little.”
“Is that so?” the screech-owl cooed in an offended tone. “Only a
little. You used to get terribly frightened. It was really a pleasure to
see how frightened you’d get. But for some reason or other you’re
only a little frightened now.” He grew angrier and repeated, “Only a
little!”
The screech-owl was getting old, and that was why he was so
much vainer and so much more sensitive than before.
Bambi wanted to answer, “I wasn’t ever frightened before either,”
but he decided to keep that to himself. He was sorry to see the good
old screech-owl sitting there so angry. He tried to soothe him. “Maybe
it’s because I thought of you right away,” he said.
“What?” said the screech-owl becoming happy again, “you really
did think of me?”
“Yes,” Bambi answered with some hesitation, “as soon as I heard
you screech. Otherwise, of course, I’d have been as scared as ever.”
“Really?” cooed the owl.
Bambi hadn’t the heart to deny it. What difference did it make
anyhow? Let the little old child enjoy himself.
“I really did,” he assured him, and went on, “I’m so happy, for a
thrill goes through me when I hear you so suddenly.”
The screech-owl fluffed up his feathers into a soft, brownish-gray,
downy ball. He was happy. “It’s nice of you to think of me,” he cooed
tenderly, “very nice. We haven’t seen each other for a long time.”
“A very long time,” said Bambi.
“You don’t use the old trails any more, do you?” the screech-owl
inquired.
“No,” said Bambi slowly, “I don’t use the old trails any more.”
“I’m also seeing more of the world than I used to,” the screech-owl
observed boastfully. He didn’t mention that he had been driven from
his old hereditary haunts by a pitiless younger rival. “You can’t stay
forever in the same spot,” he added. Then he waited for an answer.
But Bambi had gone away. By now he understood almost as well
as the old stag how to disappear suddenly and noiselessly.
The screech-owl was provoked. “It’s a shame....” he cooed to
himself. He shook his feathers, sank his bill deep into his breast and
silently philosophized, “You should never imagine you can be friends
with great folks. They can be as nice as pie but when the time comes
they haven’t a thought for you, and you’re left sitting stupidly by
yourself as I’m sitting here now....”
Suddenly he dropped to the earth like a stone. He had spied a
mouse. It squeaked once in his talons. He tore it to pieces, for he was
furious. He crammed the little morsel faster than usual. Then he flew
off. “What do all your great folks mean to me?” he asked. “Not a
thing.” He began to screech so piercingly and ceaselessly that a pair
of wood-doves whom he passed awoke and fled from their roost with
loud wingbeats.
⁂
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.

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1) The idea that psychological processes can affect bodily states

2) “Voodoo Death” is a phenomenon in which

3) Somatoform disorders involve psychological processes that give rise to apparently

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5) Helen Flanders Dunbar (1935) suggested that

8) Which of the following would most likely be considered a treatable problem in

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9) __________ is defined as the application of psychological methods and theories to

10) A medical condition may be noted on which axis of the DSM-IV-TR?

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9) If the clinician believes that a psychological factor is affecting a medical condition,

13) The difference between a sign and a symptom is

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15) The DSM-5 workgroup is considering

16) Illness is defined by _________ which are____________ whereas disease is defined

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21) Adrenocorticotrophic hormone

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Diff: 2 Type: MC Page Ref: 151

23) It is increasingly recognized that __________released during stress plays an

24) Most organs that are innervated by the sympathetic system

25) Sympathetic is to parasympathetic system as

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27) The process of engulfing and digesting invading organisms is called

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32) Primary appraisal involves

33) Secondary appraisal is analogous to asking the question

34) Which of the following behaviours may NOT be considered emotion-focused

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40) Individuals with an internal locus of control typically believe themselves

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45) A study on predictability conducted by Weiss (1970) discovered a relationship

46) A study on controllability by Weiss (1971) discovered that

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52) In terms of cardiovascular functioning, which of the following is a controllable risk

53) Under precisely defined conditions in a doctor's office, hypertension is defined by

54) The stress reactivity paradigm is used

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55) Cardiovascular reactivity refers to

56) Type A people in general show more of the following except

58) The psychosocial vulnerability model suggests that hostile people

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61) Cognitive-behavioural techniques aimed at stress management do so by

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70) A sign is a unmeasurable subjective experience of illness.

71) A lesion is a symptom of a physical illness.

72) ACTH is secreted by the pineal gland.

74) One of the effects produced by cortisol is the reduction of inflammation.

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16) Illness is defined by _ which are____ whereas disease is defined