Intro to Behavioral Science

Question 1

The traditional medical model that the mind and body are separate is called ___________

Answer 1

Cartesian concept

Question 2

The BPSS model postulates that health is an interaction between which four factors?

Answer 2

psychological, biological, social, spiritual

Question 3

Describe some social factors in the BPSS model

Answer 3

SES, social support, class, environment, cultural norms

Question 4

Approximately 1 in ___ Americans will have at least one mental disorder in their lifetime

Answer 4

2

Question 5

___% of those with mental disorders are treated by a family MD

Answer 5

95

Question 6

Define a somaticizer

Answer 6

Patient with vague symptoms that cannot be explained by a specific medical issue - ex stomachaches in anxiety disorder

Question 7

What population is motivational interviewing useful for?

Answer 7

More stubborn people who don’t want to make changes

Question 8

Describe the results of the asthma/RA and stressful writing study

Answer 8

Half of those in the experimental group who wrote about a stressful event improved versus 24% of those in control group that wrote about day’s activities
* thought it helped with coping

Question 9

Which of the following is not true about the asthma/RA and stressful writing study?

a) It was a blind assessment
b) There was a follow-up at 2 weeks, 2 months, and 4 months
c) Participants were not aware that it was a study on stress
d) Arthritis results were only statistically significant at 16 weeks, whereas asthma was statistically significant at each follow up

Answer 9

c)

Participants were aware it was a study on stress

Question 10

Describe advantages and disadvantages of asthma/RA and stressful writing study

Answer 10

Adv: study was brief so easy add on to treatment
Disadv: no mechanism known

Question 11

Describe the limitations of the stressful writing study

Answer 11

Don’t know seasonal effects, no follow up after 4 months, no knowledge of mechanism

Question 12

Describe the results of the psychosocial treatment of breast cancer study?

Answer 12

Survival time for intervention group was double that of control group

Question 13

Describe the design of the psychosocial treatment of breast cancer study?

Answer 13

Patients had metastatic breast Cancer

Experimental group assigned to 3 90 min sessions weekly of therapy

Question 14

Why were the patients in the breast cancer study not told the therapy would affect the course of the dz?

Answer 14

Ethics - cannot tell people that life elongation is expected with no data

Question 15

When did the divergence in survival begin during the breast cancer study?

Answer 15

after 20 months from study onset

Question 16

Out of the 15 trials included in the 2014 meta-analysis of trials, how many showed that psychotherapy does help cancer survival?

Answer 16

8

Question 17

What are the 5 elements that Spiegel’s hypothesis postulates work together to determine cancer survival?

Answer 17

depression, endocrine activation, circadian rhythms, telomeres, immune defenses

Question 18

Describe the results of the 11 year breast cancer study

Answer 18

More intervention group (83%) had survived versus control (70%) group. It was statistically significant only after 160 months

Question 19

What are confounders in the 11 year breast cancer study?

Answer 19

treatment encourage pts to be more assertive with doctor, treatment encouraged adherence to meds

Question 20

What can we conclude about studies investigating effect of psychotherapy on cancer survival?

Answer 20

MORE, LARGER studies need to be done

Question 21

Describe the results of the psychological stress and cold virus study?

Answer 21

Rates of clinical infection and colds increase in a dose-response relationship with stress (even after variables such as age, sex, smoking, alcohol controlled)

Question 22

What are alternative explanations of psych stress and cold virus study?

Answer 22

lack of sleep, lack of regular meals

Question 23

Describe the results of the social ties and common cold study

Answer 23

Those with more diverse social ties had fewer colds and better recovery

Question 24

What are confounders in the social ties and common cold study

Answer 24

Smoking and less exercise associated with people with less social ties

Question 25

Describe the results of the psychosocial interventions for heart disease meta-analysis

Answer 25

Control subjects sent to standard rehab (no psychosocial tx) had greater mortality and cardiac recurrence within 2 years follow up

Question 26

The psychosocial interventions for heart disease meta-analysis found great reductions in what (4)?

Answer 26

psychological distress, systolic BP, heart rate, cholesterol

Question 27

Give some other examples of studies linking behavior and health

Answer 27

• leisure activities –> less risk of dementia
• laughter –> lower blood sugar in type II diabetics
• lonely students –> decrease immune response to flu shot
• 30 min marital argument –> delayed wound healing by a day