Midterm Exam Flashcards
1
Q
What is health psychology?
A
A branch of psych that is focused on understanding the psychological influences of how people stay healthy, why people get ill and how they respond to illness
2
Q
What are the 4 main functions of the WHO?
A
- Give worldwide health knowledge
- Set global health standards
- Cooperate with governments for strengthening health programs
- Develop and transfer appropriate health info, tech, and standards
3
Q
Describe the evolution of the mind-body relationship over time
A
Early times: believed mind & body were a unit and disease occurred due to evil spirits (trephination)
Greeks: Introduced the humoral theory for understanding the link between temperament an illness (imbalance of fluids)
Middle ages: religion infiltrated medical knowledge and evil spirts were sent by god as punishment (ritualistic torture)
Renaissance: improvements in biotech (microscopy & autopsy) rejected humoral and introduced the mind-body dualism movement
Dualism: The mind was an immaterial thinking thing from the body
Rise of modern psychology and psychoanalysis (conversation hysteria)
Psychosomatic medicine emerges and highlights role of emotional conflicts and personality in disease
Behavioural medicine emerges
Current view is that physical health is correlated with both the psychological and social (culture, SES, etc.) environment
4
Q
What are the 4 essential fluids of the humoral theory?
A
Blood, black bile, yellow bile, and phlegm
5
Q
Describe the biomedical model
A
- Based on a single factor: biomedical or neurophysiological differences
- Assumes mind-body dualism (psychological and social factors are independent)
- Emphasizes illness over health
6
Q
Describe the biopsychosocial model
A
BPS assumes influences of biological, psychological, and social factors (systems theory)
Considers macro (depression, social support) and micro (chemical imbalance, cellular disorder) levels
Emphasizes both health and illness
7
Q
What are 3 clinical implications of the BPS model?
A
- Considers all 3 factors before diagnosis
- Treatment is individualized and allows for ‘team’ therapy
- Strengthens patient-practioner relationship
8
Q
Identify why health psychology is needed
A
There is an increase in chronic lifestyle-related diseases
Increasing burden of health care expenses
Realization that psych and social factors contribute to health and illness
Importance of interventions to improve peoples health
9
Q
What are the 2 main sections of the nervous system?
A
Central nervous system (CNS) and peripheral nervous system (PNS)
10
Q
What is the CNS composed of?
A
The Brain - contained by the cranial cavity and protected by the skull
The Spinal cord - contained in the spinal cavity and protected by the vertebrae
11
Q
What is the PNS composed of?
A
Somatic nervous system (voluntary)
- connects brain to voluntary muscles
- provides sensory feedback about voluntary movement
- Less protected than the CNS
Automatic nervous system (involuntary)
- connects brain to internal organs
- further divided into the sympathetic and parasympathetic systems
12
Q
Compare and contrast the sympathetic and parasympathetic systems
A
Both divisions of the autonomic nervous system
Sympathetic system mobilizes the body for action (fight or flight)
Parasympathetic system maintains and restores equilibrium (rest and digest)
13
Q
What are the 3 sections of the brain?
A
Hindbrain, midbrain, and forebrain
14
Q
What is the hindbrain composed of and what are their functions?
A
Medulla - mediates HR, BP and CO2/O2
Pons - Link between hindbrain and midbrain, helps control respiration
Cerebellum - coordinates voluntary muscle movement, balance, muscle tone/posture
15
Q
What are the functions of the midbrain?
A
Relays sensory and motor information between forebrain nd hindbrain
Production of DA in substantia nigra
Controls visual and auditory reflexes
16
Q
What does the forebrain consist of?
A
Diencephalon
Telencephalon
17
Q
What is the Diencephalon?
A
Section of the forebrain that consists of:
Thalamus
- Relays sensation, spatial sense and motor signals to cerebral cortex
- regulates consciousness, sleep, and alertness
- Is a switchboard
Hypothalamus:
- Regulates water balance, appetite, an sexual desire
- Links to the endocrine system via pituitary gland
18
Q
What is the Telencephalon?
A
Section of the forebrain that contains the right and left cerebral cortex
Cerebral cortex is:
- involved in higher order intelligence, memory, personality
- processing of sensory and motor info
- contains 4 lobes
19
Q
What two NTs does the sympathetic nervous system secrete?
A
Norepinephrine and epinephrine (catecholamines)
Repeated release is linked to chronic disease
20
Q
List disorders of the nervous system
A
- Epilepsy
- Parkinson’s tease
- Alzheimer’s disease
- Cerebral palsy
- Multiple sclerosis
- Huntington’s disease
21
Q
What is the endocrine system?
A
A system of ductless glands which secrete hormones directly into the blood
It interacts with the NS and causes slow and long-acting changes to the body
It is regulated by the hypothalamus and pituitary gland
22
Q
What is the pituitary gland?
A
Contains the anterior and posterior lobes
Anterior lobe secretes hormones for growth:
- somatotropic (STH), gonadotropic (GTH), thyrotropic (TSH and adrenocorticotropic hormones (ACTH)
Posterior lobe produces oxytocin (controls labour contractions) and vasopressin (water absorption in kidneys)
23
Q
Where are the adrenal glands and what is their function?
A
Two small glands that are located on the top of the kidneys that each consist of:
- Adrenal medulla: a fast pathway that secret catecholamines (E, NE)
- Adrenal cortex: slower pathway that is stimulated by the ACTH from the pituitary gland that releases hormones (steroids)
24
Q
What is the bodies physiological response to stress?
A
Stress is labeled by the cortex which sends a signal to the hypothalamus which activates the Sympathetic-adrenomedullary system (SAM) and Hypothalamic-pituitary-adrenocortical (HPA) axis
SAM: Hypothalamus initiates a fight-or-flight response -> triggers the adrenal medulla to release catecholamines (increase in HR, BP, breathing, slows digestion) and impact the immune system
HPA: Hypothalamus releases corticotropin releasing factor (CRF) -> triggers the pituitary gland to release adrenocorticotropic hormone (ACTH) -> triggers adrenal cortex to release cortisol which inhibits further CRF release, reduced inflammation, conserves carbs, brings body back to steady state
25
List some disorders of the endocrine system
- Diabetes
- Osteoporosis
- Cushing's syndrome
- Menopause
- Obesity
26
What is the cardiovascular composed of that what is its purpose?
Composed of the heart, blood vessels, and blood
Blood carries O2 from the lungs to the tissues and carries CO2 from the tissues to the lungs
Also transports nutrients, waste, and nutrients
Keeps people alive
27
Contrast the left and right side of the heart
The left side of the heart takes in O2 blood from lungs (Diastole)
The right side sends deoxygenated blood to the lungs (Systole)
28
List disorders of the cardiovascular system
- Atherosclerosis (angina pectoris, Myocardial infarction [heart attack])
- Arteriosclerosis
- Aneurysm
29
What are the 3 main functions of respiration?
- Acquire oxygen into the body
- Excrete carbon dioxide out of the body
- Regulate the composition of the blood
30
Inspiration is a ____ process and expiration is a _____ process
active; passive
Inspiration contracts muscles and lungs expands inside thorax
Expiration relaxes the lungs
31
List disorders of the respiratory system
- Chronic obstructive pulmonary disease (COPD)
- Pneumonia
- Tuberculosis
- Asthma
- Asphyxia, anoxia, hyperventilation
32
What is the main function of the immune system ?
Protect the body from foreign substances
It determines what is 'self' and what is foreign
33
What are the different ways infections can be transmitted?
- Direct (herpes, HPV)
- Indirect (influenza)
- Biological (mosquito yellow fever)
- Mechanical (hands, rats)
34
What can cause disease?
Infection
Genetic defects
Hormone imbalances
Nutritional deficiencies
35
What is the immune system implicated in?
Infection, allergies, cancer, autoimmune disorders
36
What is natural immunity?
A defence against a variety of pathogens
The largest group of cells is granulocytes which includes neurtrophils and macrophages (phagocytes) which congregate at the site of injury
37
What are the functions of macrophages?
Release cytokines which cause:
- inflammation
- fever
- promote wound healing
38
What are the functions of natural killer (NK) cells?
- Recognize viral infections or cancer cells
- Lyse cells by releasing toxic factors
- Important in signalling potential malignancies
- Limits phases of viral infections
39
What is specific immunity?
A slower but more specific process than natural immunity
Lymphocytes have very specific receptors for one antigen
Once activated they divide to create a proliferative response
40
Compare and contrast humoral and cell-mediated immunity
Humoral immunity is mediated by B lymphocytes to provide protection against bacteria
- Releases antibodies to recognize and neutralize toxins produced by bacteria to prevent viral infections
Cell-mediated immunity involves T lymphocytes from the thymus gland -
- Activates cytotoxic cells (Tc) cells in response to spefici antigens
- Helper T (Th) cells enhance functioning of Tc cells, B cells, and macrophages
41
What are the 3 stages in the general adaptation syndrome? (GAS)
GAS is the 3 stages during stress:
- Alarm: mobilize to meet threat
- Resistance: cope through confrontation
- Exhaustion: deplete physical resources
42
What are health behaviours?
Bet employed by people to enhance or maintain their health
Health behaviours become habits if they are well established and reinforced early
43
What are benefits of modifying health behaviours?
- Reduction in deaths due to lifestyle-related disease
- increased longevity
- longer disease-free period
- reduced overall health care costs
44
What factors influence health behaviours?
SES, age, gender, values, personal control, social influence, perceives symptoms, access to care, location, cognition, personal goals
45
What are health habits strongly influenced by in child/adolescenthood?
- Socialization: having good role models
- Teachable moment: educational opportunities
- Closing the window of vulnerability
46
What are some pros and cons of identifying people at risk?
Pros:
- May eliminate/prevent poor health habits
- Efficient & effective use of health dollars
- Helps identify risk factors in their population
Cons:
- Hypervigilance
- May become defensive and disregard risk factors
47
What are some ethical issues to be considered when deifying at risk people?
- Is there a treatment/intervention?
- Do you identify them if their risk is low?
- Identification may initiate other symptoms (depression)
- May cause interpersonal issues
48
What are ways to improve quality of life for the elderly?
- Exercise
- Participation in social activities
- Monitor alcohol consumption
- Controlled diet
- Vaccinations
49
What are different ad approaches to change health behaviours?
Educational appeals - credible, colourful, concise
Fear appeals - use fear to change behaviour, may be counterproductive
Message framing: stressing benefits
- Loss-frames: works for high-risk behaviours
- Gain-framed: works best for low-risk behaviours
50
List the models that explain health behaviour change
Social cognition model (expectancy-value theory): engage in behaviours that will be successful and they value
Health belief model: combination of perceived threat and threat reduction
Planned behaviour model: result of behavioural intervention
Transtheoretical model: includes stages of change, has treatment goals
51
Explain the health behaviour model?
Cues to action (Dad gets cancer) trigger perceived health threat
- General health values
- Perceived susceptibility
- Perceived severity
Self-efficacy triggers perceived threat reduction
- Perceived efficacy
- Perceived barriers
Health behaviour change occurs when someone has both perceived health threat and reduction
52
Explain the theory of planned behaviour
Planned behaviour model has 3 components:
1. Attitudes toward the specific action
- Beliefs about outcome
- Evaluation of the outcome
2. Subjective norms regarding the action
- Normative beliefs
- Motivations to comply
3. perceived behavioural control
These components combine to create behavioural intention which cause health behaviour change
53
Explain the theoretical model
The theoretical model is also referred as the stages of change models; it has 4 stages:
1. Precontemplation - not intention of changing behaviour
2. Contemplation - aware of the problem but have not made a commitment
3. Preparation - intention is there but no action, minor modifications may have been initiated
4. Action - modify their behaviour, commitment is made
5. Maintenance - prevent relapse, consolidate
54
What is the purpose of CBT?
A therapist helps patient identify target behaviour and make individual changes by modifying internal monologue
This is accomplished through:
- Self-observation/monitoring
- Classic conditioning
- Operant conditioning
55
What factors can increase success of CBT?
Modelling - emulate and reinforced behaviour
Stimulus contol - removing triggers
Self-control - using reinforcement/reward
56
What is broad-spectrum cognitive-behavioural therapy?
Also known as multimodal CBT
The most effective approach that uses multiple health models that can be individualized and can modify multiple health habits at once
57
What factors increase risk of relapse for an unhealthy behaviour after CBT?
- Lacking coping skills
- Decreased self-efficacy
- Abstinence violation effect
58
What are 2 types of preventable injuries?
- Home/workplace injuries
| - Motorcycle/automobile injuries
59
What are health behaviours that can improve the outcome of cancer ?
- Breast cancer screening (self-exam, clinical exam, mammogram)
- Prostate cancer screening
- Colorectal cancer screening
- Reducing sun tanning
60
How much aerobic exercise should you get to reep the mental and physical benefits?
150 min/ week
min 10 min/segment
61
Can can cause resistance to changing your diet?
1. when the choice is not self-motivated (Dr told you)
2. Health vs image - less likely to be successful if you are doing it for your image
3. When diet is restrict, expensive, or laborious
4. Related to stress
62
On average who is more likely to be obese? Men or Women?
More women are overweight and obese compared to men
63
What factors influence obesity?
- Family history (genetic vs. lifestyle factors)
- SES and culture
- Stress (quantity of intake, type of food, emotional state)
64
What are the characteristics of health-compromising behaviours?
- Began during window of vulnerability in adolescence
- Tied up in self-presentation : it looks cool
- Provides pleasure
- Behaviour occurred gradually
- Predictive factors (eg. poor impulse control, conflict with parents, etc.)
- Similar profile of other substance abusers (low SE, work long hours, problematic family, etc)
- Socio-economic drivers -
65
Define substance abuse
When an individual repeatedly self-administers an agent resulting in physical dependence, tolerance, withdrawal, and compulsive behaviour (addiction)
66
What is Harms reduction?
An approach that focuses on the risks and consequences of substance use rather than on the drug itself
Ex. methadone clinic, needle exchange programs
67
What are some benefits of the Insite Program?
- Reduces transfer of infectious diseases
- Lowers costs to health care system
- Improves health care access
- Safer environment for the community
68
What are the 4 main classes of illicit drugs?
- Opiates
- Cocaine
- Cannabis/THC
- Amphetamine-type stimulants
69
What are the consequences of illicit drug use?
- Physical issues (physiological damage & infection disease)
- mental health issues (anxiety & rebound depression)
- Social issues (misjudgement & risky sexual behaviours)
70
What is the difference between an alcoholic and a problem drinker?
An alcoholic is physically addicted to alcohol - displays both withdrawal and tolerance and has a loss of control
Problem drinkers have social, psychological, and medical problems related to alcohol
71
What factors put an individual at risk for alcohol abuse?
- Genetics
- Gender
- Socio-economic status
- Stress
- Social cues
- Cultural cues
72
What factors influence alcohol abuse treatment?
- Age: people tend to mature as they age
- Socio-economic status
- Access to care and social support
73
What are alcohol abuse treatments?
- AA
- CBT
- Detoxification
74
Are there benefits to drinking in moderation?
- Reduced risk of heart disease
- Increase of HDL (good fats) vs LDL (bad fats)
- Polyphenols (red wine) inhibit hardening of the arteries
- Can boost immune system
75
What are synergistic effects of smoking?
- Smoking & Cholesterol: reduces HDL production increasing CVD risk
- Smoking & Stress: Men increase HR reactivity; Women decreases HR but increases BP (increases cardiac crisis risk)
- Smoking & Cancer: Increases risk of breast and cervical cancer
- Smoking & Depression: elevate WBC production, decrease NK cells, put people at risk for developing cancer
76
What factors influence why an individual smokes?
- Genetically linked (DA regulators)
- Social Drivers (peer and family influences)
- Body image (weight control)
- Self-presentation (looking cool)
- Mood state (tied to aggressive and depressive episodes)
77
What is the mechanism for nicotine?
Nicotine attaches to the a4B2 nACh receptor found on the presynaptic nerve terminals of DA, ACh, and Glu neurons
It increases DA levels in the limbic system
78
What are the two strategies to reduce smoking?
1. Smoking prevention
- Changing social views
- Social influence intervention: high-status non-smoker models
- Life-skills training
- Community/social drivers: packaging, increase taxes, laws
2. Smoking Cessation
- Nicotine replacement therapy (NRTs)
- CBT
- Pharmacotherapies
- Treat comorbid issues
79
What are NRTs?
Nicotine replacement therapy options include:
- Transdermal patch
- Nicotine gum
- Nicotine nasal spray
- Nicotine inhalers
- E-cigarettes
80
What are the potential pros and cons of vaping?
Pros:
- Safer than traditional smoking (less adverse effects, better addiction management)
- Less impact to local environment
- Less costly (depending on freq.)
- Ability to control intake
Cons:
- uncertain health risks (LT consequences unknown)
- Inappropriate use in youth
- Marketed towards youth
- Overwhelming flavour options
81
What is the severe pulmonary illness rated to vaping?
Vaping-related pulmonary illness includes:
- Shortness of breath, cough, chest pain
- Pulmonary infiltrate - pus, blood, or protein in the lungs
- Negative results for lung infection test
- No evidence of alternative diagnosis
- History of vaping 90 days prior to onset of symptoms
82
What are the two pharmacotherapies for smoking cessation?
Bupropion and Varenicline
83
What are the 2 common eating disorders?
1. Anorexia Nervosa: obsessive disorder amounting to self-starvation
2. Bulimia: characterized by cycles of binge eating and purging
84
What tools are used to facilitate weight loss?
- Diet pills
- Restricted diet
- Use of laxatives
- Cigarette smoking
- Self-induced vomiting
85
What are risk factors for developing anorexia?
- Genetic link (genes involves in 5-Ht, DA, estrogen systems)
- Hyperactive HPA axis
- Social cues (cultural views of feminine beauty)
86
What are the physical symptoms of anorexia?
- High blood pressure
- HR reactivity to stress
- High urinaty levels of cortisol
- Cognitive issues (depression, anxiety, low SE)
87
Who is at risk for developing bulimia?
- People who of normal weight or overweight
- People under stress
- People with cognitive issues
88
What is a major barrier of bulimia treatment?
Self-realization
| - most people done believe their problem is a serious one
89
What is stress?
A negative emotional experience to a stressor that has predictable biochemical, physiological, cognitive, and behavioural changes to are wither toward altering or accommodating to the stressor
90
What are examples of stressors ?
- Noise
- Overcrowding, large population
- Bad relationships
- Work related activities
91
Explain the Person-Environment Fit
Individuals will respond differently to the same stressor because their perception of stress is different
An indicate assesses their personal resources to determine the degree of stress
- If a person has adequate resources they have low stress
- If a person has inadequate resources they become stressed out
92
What can stress lead to?
- Enlarged adrenal cortex
- Shrinking of thymus and lymph glands
- Ulceration of the stomach and duodenum
Chronic stress leads to wear and team of our system
93
What are limitations of the GAS model?
- Assigns limited role to psychological factors/appraisals
- Assumes that responses to stressors are uniform (perceptions, personalities etc. influence stress response)
- Assessed stress as an outcome and that stress is only evident in the presence of a stressor
94
Explain the tend and befriend model?
This model maintains that in addition to fight-or-flight, people respond to stress with social and nurturant behaviour (tending to your problem by befriending support)
- More prevalent in women
- Oxytocin release which increases affiliative behaviours
95
What appraisals evaluate the degree of stress?
Primary appraisal determines if the event is positive, negative, or neutral
- If negative to what extent is it harmful, threatening or poses a challenge?
Secondary appraisal determines coping abilities and resources available
96
What is an allostatic load?
Refers to the fact that physiological systems within the body fluctuate to meet the demanfs from stress, called allostasis
Over time, allostatic load builds up (physiological costs of chronic exposure)
Marked by:
- decreased cell-immunity
- inability to shut of cortisol release
- lowered HR variability
- Elevated epinephrine levels
- Decreased hippocampus volume
97
What occurs when the body is exposed to chronic stress?
Excess discharge of catecholamines and cortisol can:
- suppress immune system
- Increase BP and HR
- Cause arrhythmias
- Cause neurochemical imbalances (mood disorders)
- Increase lipids and fatty acids
- Disrupt sleep
98
What are some characteristics of potential stressors that make them more likely to be appraised as stressful?
- They are negative events
- The events are uncontrollable/unpredictable
- The event is ambiguous
- Level of individual tasks (overloaded)
- Central life stressors compared to peripheral stressors
99
Will people eventually habituate or chronic stress or will they develop chronic strain?
Psychological adaption:
- Most can adapt to moderate stress
- Difficult to adapt to highly stressful events
- Does not cancel out any potential physiological changes
Physiological adaptation:
- Habituation and chronic strain exist
- Can accommodate across multiple organ systems (pushes allostatic load)
- LT stressors can compromise immune function
Depends on the type of stressor, subjective experience of stress, and which indicator of stress is considered
100
Must a stressor be ongoing to be stressful?
No
Anticipated stressors can be just as stressful
People also report adverse after-effects of stress such as decrease in performance and attention span
After-stress effects are seen in post-traumatic stress disorder which can persist for years and include cognitive deficits, sleep disturbances, feelings of guilt, violence, etc.
101
What are long-term effects of early life stress?
- Increases a broad range of health risks
- Linked to chronic impact of physical and mental systems
- Stress systems can become dysregulated
- Early family environment impacts physiological reactivity to stress because they influence how someone appraises events
102
What is coping?
The thoughts and behaviours used to manage the internal and external demands of situations that are appraised as stressful
103
The relationship between coping and a stressful event is a _______ process
Dynamic
Coping is a series of transactions between a person, who has a set of resources/values/commitments and a particular environment with its own resources/demands/constraints
104
Which personality features contribute to poor coping skills?
1. Negative affectivity (neuroticism)
- Linked to poorer health
- Can show symptoms when they aren't sick
2. Pessimistic Explanatory Style
- Explain the negative events in their levels in terms of internal, stable, global qualities of themselves
- Linked to poor health
- Reduced immunocompetence
3. Perfectionism
- Constant pursuit of ideal standards
- Unrealistic goals can lead to stress
105
What personality features contribute to effective coping?
1. Dispositional optimism
- Positive outlook on life (glass 1/2 full)
- More positive appraisal of stressors
- Better mental & physical health
2. Self-compassion
- Treating oneself with kindness, being aware of distress
- Helps diffuse negative self-evaluation/criticism
- Benefits health and age-related stress
- More robust than SE
3. Gratitude
- Noticing the positives and appreciating life
- Benefits sleep quality/duration and sleep-related cognitive outcomes
4. Psychological control
- The feeling of having control over environment, behaviour, and desired outcomes
- Liked to butter health
5. Self-esteem
- More protective in low levels of stress and may moderate stress-illness
- Higher confidence lowers effects of stress
- Ego-strength: Feeling dependable, trustworthy, and having a lack of impulsivity has health benefits
106
Contrast the avoidant and approach coping styles
Avoidant is a minizmixing coping style
- Deals well with ST stress but not LT
Approach is a confrontative coping style
- Better for LT stress and considered the more beneficial style
107
Contrast the problem-focused and emotion-focused coping types
Problem focused coping takes a contructive approach
Emotion focused coping tries to regulate emotions to stress
Typically typically use a combination of both
108
What are external coping resources?
Coping skills can be influenced by factors outside ones control:
- Low SES is a strong external driver to poor coping
- The presence of multiple stressors influence coping capacity
109
What can increase resilience?
- Having positive life events
- Taking breaks (rest, vacation)
- Ability to experience positive emotion during stress
- External factors (SES, social support)
110
What are the different coping interventions?
1. Mindfulness-based stress reduction (MBSR): systematic training in mediation to focus on stressors and remove all other factors
- Improves QoL, sleep quality, and lowers stress
2. Disclosure and coping: dialogue around emotional and psychological factors
- Both verbal and written dialogue was beneficial for reduced distress, personal growth, self-acceptance, changed self-perception
3. Stress Management: program-based learning (workshops, groups) that include 3 stages:
- Identify stressors
- Acquire/practice coping skills for stress
- Practice oping skills in real world examples
4. Interactive stress-management program: self-guided stress programs common in university settings
- Identify stressors, warning signs, stress antecedents; complete stress-self assessment; receive tips on management, relaxation, test-taking, and time management
5. Social Support: takes multiple forms:
- Tangible assistance involves the provision of material support, such as services, financial assistance or goos
- Information support helps someone to understand stressful evens and determine resources/coping strategies
- Emotional support reassures the person that they are cared for
111
Compare the different forms of social support. What are the benefits?
Social Support takes multiple forms:
1. Tangible assistance involves the provision of material support, such as services, financial assistance or goods
2. Information support helps someone to understand stressful evens and determine resources/coping strategies
3. Emotional support reassures the person that they are cared for
Many of the benefits of social support actually comes from the perception that support is available.
112
Contrast implicit vs. explicit social support
Explicit support is designed to target a specific problem or is meant for a specific purpose (tangible, informational, or emotional)
Implicit social support with when support originates from social networks without being directly targeted at a specific problem (knowing you have support)
113
Are animals & pets effective at providing social support?
Animal therapy has been effective in reducing physiological indicators of stress
