Health Psych Text Flashcards
Stress is the consequence of a person’s __________ process
Stress is the consequence of a person’s appraisal process
If a person is trying to understand an event and what it will mean, what type of stress appraisal is that?
Primary appraisal
Secondary appraisals assess what?
Secondary appraisals assess whether personal resources are sufficient to meet the demands of the environment.
In short, secondary appraisals assess what?
It assesses whether I have the resources to overcome the stressor
Describe how stress is determined by person-environment fit.
Person-environment fit considers both primary and secondary appraisals. It considers whether an event is harmful or threatening - then it assesses potential resources and of responding to the events.
Describe the 3 phases of Selye’s General Adaptation Syndrome.
- Alarm - reacts to stressor with diminished resistance
- Resistance - efforts to cope with the threat
- Exhaustion - if person fails to overcome the threat, it physiologically affects them
When someone is suffering from general adaptation syndrome, what might their physiological reactions look like?
enlarged adrenal cortex
shrunken thymus and lymph glands
ulceration of the stomach and duodenum
What are the criticism of General Adaptation Syndrome?
- It assigns limited role to psychological factors (and researchers believe that psychological appraisal of events is critical to experiencing stress.
- Not all stressors produce the same endocrinological responses
- Not sure if its exhaustion itself or the chronic activation that’s implicated in stress.
What is the endpoint to Seyle’s general adaptation syndrome?
He believed stress was the endpoint - that fails to acknowledge anticipated stress or post stressful events.
Describe the mechanism of Tend and Befriend.
Tend-and-Befriend works on the mechanism of oxytocin - it stipulates that oxytocin is strongly influenced by estrogen. Thus, women are more likely to relieve stress by social support.
What are the 4 most important pathways by which stress adversely affects health?
- physiological
- health behaviors
- psychosocial resources
- health care
What can repeated activation of the HPA axis do?
How is it activated?
The HPA axis is activated in response to chronic or recurring stress - repeated activation can eventually damage its functions.
Define Reactivity - how is it related to stress?
Reactivity is the degree of change that occurs in endocrine or immune response as a response to stress.
What is Allostatic Load?
Allostatic load is basically the physiological cost of chronic exposure to stress.
What is the main difference between problem-focused and emotion-focused coping?
emotion-focused coping involves regulation of emotions while problem-focused coping involves attempts to do constructive things to rid the problem
Describe Emotional-approach coping style.
Emotional-approach coping style involves clarifying, focusing on, and working through emotions.
Describe Proactive Coping - what does it require?
- Anticipate or detect potential stressors
- Coping skills to manage it
- Self-regulatory skills
What type of appraisals are beneficial for regulating emotions during stress?
Detached reappraisal and Positive reappraisal
In regards to social support, bringing some a home-cooked meal after their spouse has died is what?
Tangible assistance
Describe the buffering hypothesis of social support. What is the difference between it and the direct effect hypothesis?
The direct effect hypothesis maintains that social support is beneficial to BOTH non stressful and stressful times.
The buffering hypothesis states that social support is a reserve and resource that blunts out the effects of stress at high levels.
What is the average time before a physician will interrupt you?
23 seconds into conversation
how long does an average visit to medical office last?
12-15 minutes
What is the average nonadherence to treatment rate?
26% of people don’t adhere to treatment recommendations
What is the average nonadherence to prescription meds?
85%
What percentage of the elderly intentionally did not adhere to their medications?
73% elderly intentionally didn’t adhere
What are the 3 goals for functioning of a hospital?
Cure, Care, and Core
Cure - physician’s responsibility
Care - patient’s care is oriented towards the staff to provide humanitarian side of medicine
Core - administration is concerned with core of the hospital
T or F: The number of Health psychologists who work in hospital settings has decreased by 40%.
False - health psychologists have doubled
What type of patients show stronger placebo effects than others?
- people who have a high need for approval
- ppl with low self-esteem
- anxious people
T or F: Pain has medical significance.
True - its symptoms is the leading cause of people to seek treatment.
T or F: “Small wins approach to problems state that global environmental change occurs first with the federal government”
False - small wins approach to problems should start with local and regional environment - it will gradually influence the quality of the global environment.
What is a problem that Stolker states about how health is defined as?
Health is defined as individualistic problems with explicit emphases on the ABSENCE of personal illness or injury - and it gives little to no consideration to issues of collective well being (social support; etc).
(key hints: Individualistic and Absence of personal illness defines health)
Stolker believes that the majority of Health Promotion programs implemented in corporate and community settings have been focused on __________ rather than __________
Stolker believes that the majority of Health Promotion programs implemented in corporate and community settings have been focused on individuals rather than environments
According to Stolker, what is the difference between health promotion that is set on individuals vs. the environment?
Health promotion is designed to make people change their habits and lifestyles (through exercise and diets) vs. environment changes such as getting a humidifier to moisten the air.
What type of social-ecological conceptualization of health-promotive environments that
Stolker proposed a socialecological conceptualization of health promotion that includes the interactions between physical and social features of environments as they affect emotional, physical , and social well-being of individuals and groups.
What is a social-ecological perspective example of behavior modification programs for smoking cessation?
smoking cessation is increased in people whose jobs ban smoking.
What are the 3 types of pain perceptions scientists have discovered?
- mechanical noniceptors - pain perception - that results from mechanical damage to tissues of body.
- thermal damage - experience of pain due to temperature
- polymodal nociception - general category referring to pain that triggers chemical reactions from tissue damage
Which peripheral nerve fiber are involved in nociceptions?
A-delta fibers are small, mylenated fibers th transmit sharp pain (they respond to mechanical or thermal paind.
C-fibers are unmyelinated nerve fibers, involved in polymodal pain and transmit dull aching pain.
what is the biological process of “the experience of pain?”
The signal from an injured area goes to the spinal cord, where it passes to a motor nerve connected to a muscle. This causes reflex that doesn’t involve the brain. The signal ALSO goes to the thalamus from the spinal cord, where pain is perceived.
Describe chronic benign pain.
chronic benign pain persists for 6 months of longer and is unresponsive to treatment (i.e. chronic back pain)
describe recurrent acute pain.
recurrent acute pain is when there are episodes of pain that are acute in character but still chronic if it occurs for more than 6 months (i.e. migraines)
What is counterirritation?
it’s that shit i’ve been telling people about! when you’re hurt in one place, you gotta hurt yourself in another
What is biofeedback?
Biofeedback is when patients utilize technology to hear the feedback of their physiological symptoms.
This will help them attempt to change their body process.
How does relaxation affect pain?
Directly - relaxes muscles and helps blood flow
Relaxation is modestly successful for controlling what type of pains?
Modestly successful for controlling acute pains; when used in conjunction to pain medication - can help with chronic pains.
What is the most effective way to cope with low level pain?
The most effective way to cope with low level pain is Distraction.
Which of the following reduced patient’s pain more:
active or passive coping skills?
Active coping skills reduced pain more
T or F: The better coping skill for chronic pain is passive coping skills.
False - active coping skills is better for those suffering from chronic pain
T or F: patients with acute pain benefit more if they use avoidant coping strategies.
True - avoidant coping strategies work well for acute pain patients, but not for chronic pain.
What are the 8 objectives of cognitive-behavioral therapy interventions in regards to chronic pain?
- Encourage patients to go from being overwhelmed to feeling manageable
- Clients must believe that they will be taught to control the pain effectively (their belief is important)
- Clients are encouraged to go from passive to active individuals (this is where self-efficacy begins)
- Clients are encouraged to document their thoughts and feelings to reduce maladaptive thoughts from the chronic pain
- Patients are taught when to employ over and covert behaviors in order to make adaptive responses to the pain problem
- Clients are encouraged to attribute their successes to their own efforts
- Encourage patients alternative thinking about ways to coping with pain
- Clients are trained in therapies to help them control their emotional responses to pain.
Describe the components of pain management programs.
Pain management programs start with patient education, then training (relaxation, exercise, coping), group therapy, interventions (writing interventions).
Many times, family is involved and there are relapse preventions.
What is the neurochemical explanation of pain?
endogenous opioid peptides regulate pain experience
Approximately how many American suffer from chronic pain?
120 million people = chronic pain
What do scientists describe Self-Concept as?
Self-concept is the stable set of beliefs about my personal qualities and attributes.
according to Taylor text, people do not develop chronic diseases ________ do
families do
How can chronically ill patients manage to achieve high quality of life?
Resiliency - they perceive control over what happens to them, hold positive expectations about the future and have a positive view of themselves.
What type of maladapative coping styles do chronically ill children present?
Chronically ill children can develop repression, which interferes with their understanding of and management of the disease.
How has the internet helped women with breast cancer?
Studies showed that women who frequent help sites for 1 hour a day experienced greater social support.
1 hour is all they needed.
T or F: telephone intervention has been proven to be successful in improving diet and physical activity.
True - telephone intervention worked
T or F: at any time, 40% of the population has a chronic condition requiring medical management.
False - 50% - half the population has chronic condition
What do Quality of Life assessments measure?
It is an important assessment for whether intervention is necessary for a patient’s medical prescription.
*is it worth feeling nauseous all day, or was the regular symptoms better?
T or F: Julie will most likely feel depressed while awaiting test results, while she becomes anxious after learning of the severity of her disease.
False - Anxiety occurs during waiting for test results or regular checkups, while depression will occur when learning about the severity of a disease.
What are positive outcomes of chronic illness?
Positive outcomes occur because patients realize what they’ve taken for granted and place greater value on those things than pre-disease.
List all of the interventions for the chronically ill.
CBT Psychotherapy Relaxation Stress Management Exercise Social Support Family therapy Support Groups
How old can an average person in the US expect to live?
78.5 years
What is the leading cause of death in the US?
Heart Disease
What is the leading cause of death in infants and children under 15?
SIDS is leading cause of death
children:
- accidents (40%)
- cancer (leukemia)
What did the Patient Self-Determination Act require Medicare and Medicaid health care facilities to do?
It required medicare and facilities to have written policies and procedures concerning a patient’s wishes for life-prolonging therapy. They can sign a DNR (do not resuscitate) waiver.
define euthanasia
euthanasia is the decision to end a life due to a painful terminal disease
when and which state first legalized euthanasia?
euthanasia was first legalized in 1994 in oregon
how can patients exercise their option for assisted death?
patients must be mentally competent and have a terminal illness with >6 months to live.
alternatives must be informed of
he or she must make this request at least 3 times
the case must be reviewed by a second physician for accuracy
how is euthanasia performed by a physician?
through lethal dose of medication or sleeping pill
What is a living will?
living wills provide advance directives, requesting that life-sustaining procedures not be used if they’re unable to make this decision on their own
T or F: Physicians ignore patients requests for a living will.
True - half of the physicians do not respect their patients enough to even mark it on their file
What are the 5 stages in adjustment to dying?
- denial - defense mechanism to avoid learning of the implications of their disease
- anger - patients are angry at their fate and not their family, however, it is directed at them unfortunately.
- bargaining - the patient decides instead to bargain for health; they may do a charitable thing suddenly
- depression - patient realizes their lack of control; physically begin to feel their deterioration; experiences anticipated grief
- acceptance - patient realizes nothing can be done at this point; too tired to be angry, too used to the thought of dying so not depressed anymore; they may remain calm and enlightened.
what is palliative care?
palliative care is care that’s designed to make patients feel comfortable
who would get burned out easier, palliative care or curative care?
nurses and doctors in palliative care will burn out more - they do more custodial work.
what is the Outline of Appropriate Death by Avery Wiseman?
The outline of Appropriate Death has goals for medical staff:
- Informed consent - each patient must know what disease they have and must be involved in their own treatment
- safe conduct - all should be helpful guides to patients during this frightening time
- significant survival - the medical staff should make sure the patient is using their time as well as possible
- anticipatory grief- -both the patient and family members should be aided in working through loss and depression
- timely and appropriate death - patient should be allowed to die when and how they want - they should have a dignified death.
what is a Thanatologist?
a thanatologists study the death and dying.
what are some successful techniques thanatologists recommend to those who are dying?
- relaxation techniques
- positive self-talk such as discussions of life’s achievements
- family therapy
describe hospice care.
hospice care is designed to help patients manage symptoms of their illness - nurses are trained to be warm and patients get to personalize their space and make choices on visits.
What is the number one killer in the US?
Coronary heart disease - 1 out of 6
What is metabolic syndrome?
What does this predict?
metabolic syndrome predicts heart attacks.
metabolic syndrome is diagnosed when someone has 3 or more of the following: obesity, high blood pressure, low levels of HDL, cholesterol, difficulties with metabolizing sugars
How early do risk factors for heart disease begin?
Risk factors for heart disease cluster around 14 years old.
Who dies of CHD more, men or women?
Women die from CHD more than men
Why do women’s risk for CHD increase after menopause?
Estrogen is implicated as it diminishes sympathetic nervous system arousal
T or F: Hostile people are more likely to have greater coffee consumption, smoking, alcohol consumption
True that
What do researchers believe in regards to hostility and stress?
Researchers believe that hostility reflects a genetically based predisposition to physiological reactivity, in response to stress.
How is depression a factor for CHD?
Depression may be closely linked to C-reactive proteins in hostile people and in african americans. This is biological and has no relations to health behaviors, social isolation; etc,
Social support is important, but what can interfere with it?
Hostility can interfere with social support
What is the main reason for high rates of mortality and disability following heart attacks?
Due to delayed treatment
What does the drug called ‘statins’ treat?
acute coronary events
What is cardiac invalidism?
This is when people belief that those who suffered from heart attacks are impaired - thus studies where wives SAW their husbands on a treadmill were more likely to believe in their capabilities whereas wives who were just told about their husband’s performance still believed their husbands were impaired.
Describe hypertension
Also known as CVD (cardiovascular disease), occurs when blood supply through vessels is excessive.
Describe the difference between Systolic and Diastolic pressure.
Systolic pressure is the HARDEST my heart is pumping
Diastolic pressure is when the heart is relaxed and its resistance of blood flow
T or F: Blood pressure reactivity in childhood and adolescence does not predict later development of hypertension.
False - blood pressure reactivity DOES predict hypertension in adult years
What is John Henryism?
John Henryism is when people work themselves too hard and push themselves to the point of death.
It is a way to refer to a personality disposition to cope actively with psychosocial stressors.
T or F: Relaxation and reducing levels of stress is sufficient enough to keep hypertension at bay.
False - this is the “common sense” approach - most don’t realize they still need medication. The combination of cog-behavioral therapy and medication is best to keep hypertension at bay.
How does aspirin help with preventing reoccurring strokes?
According to studies, following a stroke, a few weeks use of aspirin can reduce the risk of recurrent strokes as much as by a third. (1/3 = no strokes due to aspirin)
What is Transient Ischemic Attacks (TIA)?
Little strokes that produce temporary weakness, loss of feeling, dimness and loss of vision, loss of speech of slurred speech
Why are motor difficulties common following a stroke?
The right side of the brain controls movement to the left, and so on - motor impairments occur contralaterally
What might someone with left brain damage due to a stroke suffer from?
Left brain damage - language aphasia, short term memory
What might someone with right brain damage due to a stroke suffer from?
Right brain damage - visual feedback (shaving one side of the face only), bumping into stuff
Emotional problems after a stroke occur mostly for which side of the brain?
Left side damage affects peoples anxiety and depression levels, whereas the right side damage seem to show indifference.
T or F: anti-depressants may promote growth of new neurons and can be employed to treat strokes.
True! it helps to regenerate neurons. Cholesterol lowering drugs also do the same.
Which is the 3rd most chronic illness of US?
Type 2 Diabetes
T or F: Type 2 Diabetes is considered a pandemic at this point.
True - there are over 1.9 million new cases yearly
What is diabetes associated with?
Diabetes is associated with a thickening of the arteries due to the buildup of waste in the blood
What is the leading cause of blindness in adults?
Diabetes
What is Alzheimer’s disease being recognized as?
As a metabolic disorder involving the brain’s inability to respond to insulin
What is the so-called deadly Quartet?
Diabetes
Abdominal Fat
Hypertension
Lipids
The Dahl Quartet
What is the main reason why people don’t adhere to their diabetes medication?
They just forget or run out
What type of multiple risk factors are there with diabetics? How should treatment be framed?
There’s a lot of eating going on during social activities so social support doesn’t really help diabetics as much.
Treatment should involve focus on SOCIAL skills and PROBLEM SOLVING skills so diabetics can manage high risk situations.
Which emotion undermines glucose control (in diabetics)?
Anger undermines glucose control
What is the most successful way to reduce incidence of diabetes?
A lifestyle intervention with medication appeared to be the best thing for diabetics, as opposed to those who didn’t take meds or just got lifestyle recommendations
According to Taylor, coronary heart disease is a disease of ___________ caused by smoking, obesity, hostility; etc.
CHD is a disease of lifestyle caused by smoking, obesity, hostility; etc.
What type of treatments of CHD reduces mortality and morbidity?
relaxation training, stress management can both reduce CHD
hypertension affects 1 out of __ Americans
hypertension affects 1 out of 4 Americans
What type of medication helps treat hypertension?
Diuretics or beta-blocking drugs or CBT
T or F: Symptoms of hypertension include pain in the left side of the chest, slurred speech.
False - there are NO symptoms with hypertension
What results from a disturbance of blood flow to the brain?
Strokes occur due to disturbances of blood flow to the brain
What is behavioral immunization?
Behavioral immunization is programs such as DARE -
