Mini Exam 3 – resilience, social support, chronic illness Flashcards
1
Q
First gen resilience researchers thought of resilience as being __ or __
A
invulnerable or invincible
2
Q
What is the kauai Study?
A
- longitudinal study of 698 “high risk” infants
- 2/3 of high risk children developed neg outcomes as they aged
- 1/3 of high risk children experienced positive outcomes, despite risk factors
- positive outcome children had protective developmental factors like church or a role model
3
Q
What is a high risk environment?
A
premature birth, unstable households, mothers with mental illness
4
Q
What is resilience?
A
- dynamic process where an individual is able to recover from (or overcome) significant adversity
- a pattern of positive adaptation in the context of present or past adversity
- set of inner resources, social competencies, and cultural strategies that permit individuals to not only survive, but recover or even thrive after stressful events
5
Q
Positive outcome in face of adversity is __
A
resilience
6
Q
Positive outcome without adversity is __
A
competence
7
Q
Negative outcome in face of adversity is __
A
maladaptation
8
Q
Negative outcome without adversity is __
A
vulnerability
9
Q
resilience is NOT __
A
an individual trait
10
Q
What is the Brief Resilience Scale?
A
self report survey that ranks people’s resilience “traits”
11
Q
What are risks do children face in america?
A
poverty, abuse, juvenile arrests, firearms, academic challenges
12
Q
What are the two types of protective factors that promote resilience?
A
interpersonal and community
13
Q
What are some interpersonal protective factors?
A
close relationships with caregiving adults, authoritative parenting, parental education, positive family climate, organized home environment, close relationships to competent, prosocial and supportive peers, parental involvement
14
Q
what are some community based protective factors?
A
effective school and learning environments, + organizations and social groups, public safety strong sense of neighborhood community and social cohesion, access to public health services and care
15
Q
What do Adverse Childhood Experiences (ACEs) increase the likelihood of?
A
- 3x more likely to smoke
- 7x more likely to perpetrate violence
- 6x more likely to have unintended teen pregnancy
16
Q
How is cardiovascular health affected by resilience?
A
faster recovery from negative emotional arousal/ lab-induced stress tasks
17
Q
__ is linked to worse blood sugar among diabetics
A
stress
18
Q
What are Resilience Training Programs?
A
improved ability to recognize and self-regulate stress response
- reduced stress, negative emotions, depression
- improved team communication and cooperation
19
Q
What is social support characterized by?
A
mutual positive interactions and helpful behaviors provided to someone in need of support
20
Q
What is a social Network?
A
people’s social ties to one another and the structure of these ties
- can be supportive or detrimental
21
Q
What is social embeddedness?
A
strength of connections one has with others within their social network
22
Q
What is social climate?
A
personality of a social network
- good or bad vibes?
23
Q
What are some health trends that emerge from social networks?
A
familial patterns, behavioral clusters (smoking, obesity, fitness/exercise), well-being and happiness
24
Q
What are the 4 types of social support?
A
emotional, instrumental, informational, appraisal
25
Describe emotional support
- positive regard, care, love, trust
- most common type of support
- related to attachment theory: people are happiest when they have trusted persons they can confide in
26
Describe instrumental support
providing tangible goods and services
| - $, groceries, completing tasks, transportation
27
Describe informational support
provide info or advice, helping with problem-solving, usually comes from experts
- physicians, lawyers, financial consultants
28
Describe appraisal support
- Not to be confused with emotional support
- communicating info that is relevant to self-eval or appraisals of one's current situation
- aimed at helping form more accurate eval of one's situation
- provided alongside informational support
- remind them of qualities they have that will help them overcome obstacles
29
Social support received must match the support __
sought
30
What is the difference between perceived and actual support?
perceived support is in regards to how supported a person feels, actual support is whether the people considered friends can actually provide support
31
What are some benefits of social support?
- lower heart disease mortality
- reduced cancer risk
- improved adherence and recovery
- positive self-worth and esteem
- effective coping and adaptation
- improved quality of life
32
What are some indirect pathways in which social support influences our health?
- buffer against emotional distress
- bolster self-esteem and competence
- gives perceived control
- improved coping skills and efficacy
- instrumental support and tangible resources
- access to info and other perspectives
33
How can health affect social support networks?
- changes in health may affect the social network dynamics (bidirectional)
- someone who quit smoking will likely stop hanging out with smokers
- can also constrict social support groups
34
What is social breakdown syndrome?
phenomenon where illness limits access to social support networks
- minimized with in-home tx options, shorter hosp stays
35
How does chronic illness vary across individuals?
perceptions of illness condition, impact on quality of life and coping ability, need for tailored interventions and care
36
What are the 3 main issues with chronic disease?
physical limitations, psychological issues, social issues
37
What are social issues related to chronic disease?
- stigma (HIV)
- social isolation (people hiding conditions)
- negative rxns from others (just world hypothesis)
38
What are psych issues related to chronic illness?
- anxiety, depression
- denial, perceived isolation, loneliness
- helplessness – low self efficacy
39
What are some examples of challenges of coping?
- Tx mgmt
- managing soc relationships
- coping w uncertainty
- managing loss
- maintaining a sense of well-being
40
What are some challenges with Tx mgmt?
- medical terminology (jargon)
- comm with physician team (need to manage care oneself)
- med schedules (may be overwhelming >> nonadherence)
- financial and opportunistic cost (chronic illness = $$$)
41
What are some challenges with managing social relationships?
- soc isolation (may have new identity, hard to preserve soc relationships)
- burden on loved ones (marital strain)
- cynicism and hopelessness (about outcomes, push others away)
42
What are some challenges with coping with uncertainty?
- need for social support (informational)
| - accept uncertainty and integrate into life
43
What are some challenges with managing loss?
- maintain body integrity (∆appearance)
- limitations/disruptions to work and other activities
- loss of autonomy
44
What are some challenges with maintaining a sense of well-being?
- coping w self-blame, guilt
| - incorporating changes into self-concepts
45
What is successful adjustment to chronic illness characterized by?
- mastery of tasks related to disease
- maintain functionality/normalcy
- absence of psychological disorders (no anxiety or depression)
46
Adjustment to chronic illness is a __ process
dynamic
- continuous, but not constant
- highs and lows, not steady
- disease can worse or improve
47
What are some coping mechanisms?
Most of these have a positive and negative side
- info avoidance/distancing (min anxiety/nonadherence, denial)
- info seeking (sense of control/overwhelm doctor, anxiety)
- requests for reassurance (good soc support/unwanted support
- setting goals (achievable/too optimistic)
- search for meaning (seek liver lining/no neg)
- visualization (picture what's going on in the body/no neg)
48
What is an example of a goal to help coping with chronic illness?
live as long as possible as normally as possible
49
normalization
attempt to est and maintain as normal an existence as possible
50
identity spread
people view obvious sx as signs that a chronically ill person cant fnx well
- lead to overgeneralization
- look sick therefore not capable
51
passing
sick people w/o obvious sx engage in NL interactions bc others dont know they are ill
- may cause anxiety, hiding parts of self
52
What are the types of CVD?
CAD, CHD, MI Angina, stroke, HTN
53
What do CHD, CAD and stroke develop through?
Atherosclerosis and arteriosclerosis
54
what is atherosclerosis?
depositing of fatty plaques on arteries
55
what is arteriosclerosis?
hardening and thickening of artery walls
56
What is CHD?
damage to myocardium
57
What is CAD?
missing blood supply to heart muscle
58
What are common risk factors of heart disease?
age, fhx, gender effects, ethnicity
- older = more risk
- genetics = more risk
- gender = men >> women CVD mortality, ?hormones, lifestyle (men show more unhealthy behaviors)
- ethnicity = AAs have greater mortality risk due to high risk of HTN
59
Define health disparity
disproportionate rates of disease or death between different populations
- sex, gender ID, ethnicity, sexual orientation, SES, disability
60
What are some CVD health disparities seen due to ethnicity?
- AAs and latinx report higher rates of HTN than whites (even with matching lifestyles)
- AAs have higher incidence of stroke (higher severity and mortality)
- Latinx report higher CVD risk factors but show lower rates of CVD/CHD (hispanic paradox)
- Asian American males show higher rates of smoking
61
What are some CVD health disparities seen due to SES?
From 1971-02
- high SES groups show major declines in smoking, chol, HTN
- minor changes in low SES
- increased rate of DM in low SES
62
Why is education strongest and most consistent SES indicator related to CVD?
- related to lifestyle, income, social skills, abilities
| - higher self-efficacy, peer groups and soc support networks, access to healthcare
63
What are the main behavioral risk factors for CVD?
- smoking (3x CVD risk, MI risk)
- weight and diet (Na+ > High BP > CVD; sat fats > chol + atherosclerosis > CVD)
- physical activity (sedentary vs exercise; 60% adults dont exercise, 150+ mins exercise qw
64
What are the main psychosocial risk factors for CVD?
PERCEIVED SOCIAL SUPPORT (lack of)
- single status, lack of community membership/religious group, small social network size, lack of contact with friends/family
65
What are the behavioral mechanisms of psychosocial risk factors?
social support may approve or disapprove of habits, leads people to change their habits
66
What are the biological mechanisms of psychosocial risk factors?
stress response is aided by social support
| - poor autonomic reg in isolated individuals
67
How is depression related to CVD risk?
- 1 in 5 pts suffer w major depression
| - depressive sx predict increased incidence and worse prognosis of CVD
68
How does depression increase CVD risk?
depression leads to CVD due to:
- poorer health behaviors
- inflammatory processes
- HR variability
* important to screen for depression among CVD pts and vice versa
69
What are attitudes?
generalized dispositions (hostility)
* in the moment I am feeling anger, generally I am hostile
70
what are emotions?
state of feeling (anger)
* in the moment I am feeling anger, generally I am hostile
71
How does early life hostility relate to CVD?
increases HTN, causes later CVD risks
72
What is eudaimonic well-being?
meaning in life, self acceptance, personal growth
73
what is hedonic well-being?
happiness, + emotions (joy, gratitude, love), emotion focused
74
What are the ABCS of the "million hearts" study?
Aspirin use for high risk pts
BP control
Chol mgmt
Smoking cessation
75
What are the targets of chronic disease intervention?
psych, behavioral, social, biological targets
76
What are psychological targets of disease intervention trying to do?
- reduce depression, anxiety, stress
- increase self-esteem and self-efficacy
- changing attitudes and outlook
77
What are behavioral targets of disease intervention trying to do?
- changing health behaviors
| - increasing adherence to tx
78
What are social targets of disease intervention trying to do?
- increasing social support , outreach and community integration
79
What are biological targets of disease intervention trying to do?
- reducing autonomic imbalances (stress responses)
| - disease oriented process (asthma – inhaler)
80
What is psycho-oncology?
Subspecialty of cancer care, studies:
- psych rxns
- psych factors predict cancer risk, detection and survival
81
What are the most stressful times of a cancer patient?
diagnostic experience, hospitalization/tx, release from hospital
82
What are some stigmas cancer patients have to overcome?
- just world hypothesis: ppl get what they deserve
| - victim blaming: pt did something to deserve it
83
What are some special challenges in cancer?
- ∆ physical appearance
- communication w/ physicians
- uncertainty
- relationships w/ others
- support services
84
cancer and depression are commonly __
comorbid
*in breast ca pts depression in 1st yr post-dx linked to > mortality
85
What is depression linked to?
- tx nonadherence
- lower QoL
- >> mortality
86
What are some psych interventions for patients with cancer?
- individual/group therapy
- psychotropic medication
- fam therapy/counseling
- mindfulness/relaxation
- pt advocacy
- palliative care
87
What is an autoimmune disease?
where a system attacks itself, does not recognize self
88
What is inflammation?
process that brings immune cells to sites of tissue damage to destroy foreign cells
89
what are cytokines?
released by immune cells and regulate immune responses
*pro-inflammatory cytokines coordinate inflammatory responses in body
90
Resilience describes a _______ by which core adaptive systems continue to operate in an effective manner despite threats and risk factors
process
91
Resilience ________ against maladaptive coping behaviours
protects
92
What helps buffer against ACEs? Why?
- Parental support
- Having a parent involved in your life and knowing they trust you can protect can help bolster self esteem and self worth
93
stress responses lead to the activation of __ and __
HPA axis: secrete cortisol
| SNS: secrete norepi
94
stress decreases the body's __
lymphocytes
95
What is the sherbert experiment?
People were either given sherbert followed by epi shot or salt water shot
- Those given epi shot developed an immune response to sherbert
- classical conditioning example
96
What is AIDS? (Acquired Immune Deficiency Syndrome)
progression of HIV to the point where most T-cells have been destroyed
- tx exists to control HIV viral loads
- antivirals, pre-exposure prophylaxis
97
What is HIV?
destroys immune cells (T-cells), makes it hard to fight infx
98
How is HIV transmitted?
body fluids like blood, birth, unprotected sex
99
What is AIDS?
progression of HIV
100
What are two types of HIV interventions?
reducing transmission and managing life w HIV
101
What are transmission reduction interventions for HIV?
- safe sex (condom, PrEP)
- needle exchange
- testing and screening
102
What is rheumatoid arthritis (RA)?
immune system attacks lining of joints
| - joint pain and deformity
103
anxiety and depression are often __ with RA
comorbid
104
How are RA flareups predicted?
stress and mood changes
105
what are some psych interventions for RA?
CBT, self-reg techniques, stress management, mindfulness
