Multiple-Choice Questions

1. Stress can be defined as a negative emotional experience accompanied by A. biochemical and physiological changes. B. cognitive changes. C. behavioral changes. D. all of the above. Answer: D Feedbac : !efer to page 1"# $. %hich of the following co&ld be considered a stressor' A. noise B. crowding C. comm&ting to wor D. all of the above Answer: D Feedbac : !efer to page 1"# #. (ost definitions of stress foc&s on A. stressf&l events. B. physiological changes. C. emotional changes. D. the relationship between the person and the environment. Answer: D Feedbac : !efer to page 1"# ). *he fight+or+flight response A. is never adaptive. B. involves aro&sal of the parasympathetic nervo&s system and the endocrine system. C. involves aro&sal of the sympathetic nervo&s system and the endocrine system. D. is s&b,ect to large individ&al differences. Answer: C Feedbac : !efer to pages 1"#+1") ". Selye-s .1/"01 1/203 st&dies of the general adaptation syndrome investigated 44444444444444 responses to stress. A. psychological B. gastrointestinal C. adrenomed&llary D. adrenocortical Answer: D Feedbac : !efer to page 1") 0. *he correct se5&ence of phases of the general adaptation syndrome is A. alarm1 resistance1 exha&stion. B. exha&stion1 resistance1 alarm. C. resistance1 alarm1 exha&stion. D. resistance1 exha&stion1 alarm. Answer: A

Feedbac : !efer to page 1") 2. According to Selye .1/"01 1/2031 the 444444444444444 phase of the general adaptation syndrome is responsible for the physiological damage related to stress. A. alarm B. resistance C. exha&stion D. all of the above Answer: C Feedbac : !efer to page 1") 6. According to its critics1 Selye-s .1/"01 1/203 model A. fails to offer a general theory of reactions to a wide variety of stressors over time. B. fails to offer a physiological mechanism for the stress+illness relationship. C. places too m&ch emphasis on individ&al differences in response to stress. D. fails to consider the role of psychological appraisal in stress. Answer: D Feedbac : !efer to pages 1")+1"" /. *he tend+and+befriend response to stress A. is especially characteristic of females. B. is related to the release of the stress hormone1 oxytocin. C. may be protective of offspring. D. all of the above. Answer: D Feedbac : !efer to page 1"" 17. *he primary biological factor in the tend+and+befriend mechanism is A. 89A activation. B. oxytocin. C. cortisol. D. :SA. Answer: B Feedbac : !efer to page 1"" 11. *he process of primary appraisal involves the eval&ation of one-s A. c&rrent emotional state. B. perception of the event. C. coping ability. D. reso&rces. Answer: B Feedbac : !efer to page 1"" 1$. *he process of secondary appraisal involves the eval&ation of one-s A. c&rrent emotional state. B. perception of the event. C. coping ability and reso&rces. D. all of the above. Answer: C Feedbac : !efer to page 1"0 1#. According to ;a<ar&s-s model1 the s&b,ective experience of stress is a res&lt of

A. the general adaptation syndrome. B. primary appraisal. C. secondary appraisal. D. the balance between primary and secondary appraisal. Answer: D Feedbac : !efer to page 1"0 1). *he adrenal cortex prod&ces 444444444444444 in response to stress. A. epinephrine and norepinephrine B. gl&cocorticoids C. endogeno&s opioids D. AC*8 Answer: B Feedbac : !efer to page 1"2 1". Activation of the hypothalamic+pit&itary+adrenocortical .89A3 axis res&lts in the secretion of A. catecholamines. B. norepinephrine. C. cortisol. D. all of the above. Answer: C Feedbac : !efer to page 1"6 10. !esearch s&ggests that reactivity is related to individ&al differences in A. ac&te and chronic illness. B. psychological responses to stressors. C. primary and secondary appraisal. D. all of the above. Answer: A Feedbac : !efer to page 1"/ 12. A. B. C. %hich of the following sit&ations wo&ld be ;=AS* stressf&l' >ill has filed for divorce after $" years of marriage. >oe arrives at his first class of the day to find that the professor will administer a pop 5&i<. ;inda1 a f&ll+time college st&dent1 learns that she will have to find a second part+time ,ob d&e to c&ts in financial aid pac ages. D. ?arl1 a file cler 1 has been wor ing intensively for three wee s on a new ,ob responsibility. Answer: D Feedbac : !efer to pages 101+10$ 16. A. B. C. D. St&dies of children exposed to noisy environments indicate that children event&ally habit&ate to high levels of noise. who are exposed to noise exhibit performance decrements and learned helplessness. who are exposed to noise exhibit few cognitive decrements b&t do show signs of learned helplessness event&ally learn to change their tas strategies and attention foc&s to accommodate the noise in their environments Answer: B Feedbac : !efer to page 10# 1/. 9ost+tra&matic stress disorder .9*SD3 has been associated with

A. temporary changes in the brain1 involving the amygdala. B. decreased cortisol1 norepinephrine1 and epinephrine. C. biochemical and hormonal alterations that last over a long period. D. all of the above. Answer: C Feedbac : !efer to pages 10"+100 $7. *he aftereffects of stress are most deleterio&s when the stressor is A. negative. B. intense. C. anticipated. D. &npredictable. Answer: D Feedbac : !efer to page 100 $1. (ort complains that his ,ob+related stress ma es it diffic&lt to foc&s on other problems1 shortens his attention span1 and ma es him feel as if he has little time and energy for other areas of his life. (ort-s description most closely resembles the 444444444444444 theory of stress. A. cognitive costs B. physiological aro&sal C. emotional response D. learned helplessness Answer: A Feedbac : !efer to page 100 $$. ;earned helplessness is associated with 444444444444444 deficits. A. motivational B. cognitive C. emotional D. all of the above Answer: D Feedbac : !efer to page 100 $#. @n their st&dy of dormitory crowding1 Ba&m and Aalins concl&ded that st&dents developed learned helplessness as a res&lt of A. s&stained levels of aro&sal. B. high levels of intermittent noise. C. &ncontrollable personal interactions. D. all of the above. Answer: C Feedbac : !efer to page 102

Multiple-Choice Questions
1. (oderators of the stress experience may have an impact on A. stress itself. B. the relationship between stress and illness. C. the relationship between stress and psychological responses. D. all of the above. Answer: D Feedbac : !efer to page 16)

$. According to *app and Batelson-s .1/663 st&dy of the impact of stress on hamsters with inherited heart disease1 stress precipitated heart fail&re A. when stress occ&rred early in the disease process. B. when stress occ&rred after cardiac changes had time to develop. C. beca&se stress was an additional b&rden for an animal with a physical v&lnerability. D. all of the above. Answer: B Feedbac : !efer to page 16) #. According to the interactive model of the stress+illness relationship1 A. either stress or a preexisting v&lnerability is s&fficient to prod&ce illness. B. experiencing stress ca&ses individ&als to become partic&larly v&lnerable to illness. C. stress leads to illness among individ&als with a preexisting v&lnerability to illness. D. the physiological changes associated with stress increase individ&al v&lnerability to illness. Answer: C Feedbac : !efer to page 16) ). Cohen and %illiamson .1/663 fo&nd that people &nder stress got less sleep1 were less li ely to eat brea fast1 and cons&med more dr&gs and alcohol than people not &nder stress. *his st&dy provides evidence that stress is related to illness d&e to changes in A. secondary gain. B. social interaction. C. health behaviors. D. illness behaviors. Answer: C Feedbac : !efer to page 16" ". *he process of 444444444444444 involves the eval&ation of one-s reso&rces to determine whether they will be s&fficient to meet the demands of stressf&l sit&ations or events. A. primary appraisal B. secondary appraisal C. coping D. all of the above Answer: B Feedbac : !efer to page 16" 0. *he process of 444444444444444 involves an individ&al-s efforts to manage internal or external demands that tax his or her reso&rces. A. primary appraisal B. secondary appraisal C. coping D. all of the above Answer: C Feedbac : !efer to page 16" 2. A. B. C. D. *he consideration of coping as a dynamic process implies that coping involves a wide range of actions and reactions to stress. coping efforts are moderated by personal reso&rces. coping involves an ongoing set of responses by which the person contin&es to act on the environment. coping involves an ongoing set of responses by which the person and the environment are involved in a reciprocal interaction.

Answer: D Feedbac : !efer to pages 16"+160 6. @ndivid&als high in negative affectivity A. may be described as having a Cdisease+proneD personality. B. are more li ely to see o&t medical care for minor complaints. C. repress their stress+related symptoms b&t complain more abo&t their general health. D. are characteri<ed as being depressed1 anxio&s1 and psychotic. Answer: A Feedbac : !efer to page 160 /. According to Friedman and Booth+?ewley .1/6231 the Cdisease+proneD personality A. is characteri<ed by a pessimistic explanatory style. B. is highly correlated with the presence of chronic diseases. C. may predispose people to certain chronic diseases. D. may be the res&lt of long+term s&ffering from chronic diseases. Answer: C Feedbac : !efer to page 160 17. @ndivid&als who are high in negative affectivity A. are less li ely to &se health services. B. are partic&larly li ely to report physical symptoms. C. s&ppress symptoms of psychological distress and physical illness. D. all of the above. Answer: B Feedbac : !efer to page 160 11. An individ&al with a pessimistic explanatory style is more li ely to interpret negative events in terms of 444444444444444 factors. A. external1 &nstable1 specific B. external1 stable1 global C. internal1 &nstable1 global D. internal1 stable1 global Answer: D Feedbac : !efer to page 162 1$. %ilma has experienced increasing levels of stress d&e to her deteriorating test scores in psychology. She complains to her friend Betty1 C@ can-t seem to get the hang of this st&ff. @-m ,&st not smart eno&gh. @ may have to drop o&t of the &niversity.D Betty replies1 CEo&-re smart eno&gh1 %ilma1 b&t yo&-re ,&st not spending eno&gh time st&dying.D Betty is trying to change %ilma-s attrib&tions of A. internality. B. stability. C. globality. D. all of the above. Answer: B Feedbac : !efer to page 166 1#. A st&dy of older ad&lt men and women cond&cted by ?amen+Siegel and colleag&es .1//13 fo&nd that pessimistic explanatory style is associated with A. red&ced cell+mediated imm&nity.

B. higher rates of physical illness. C. increased &se of health facilities. D. all of the above. Answer: A Feedbac : !efer to page 166

1). Scheier1 %eintra&b1 and Carver .1/603 fo&nd that optimists may cope more effectively beca&se they are more li ely to &se 444444444444444 as a coping strategy. A. denial B. distancing C. problem+foc&sed coping D. accepting personal responsibility Answer: C Feedbac : !efer to page 166 1". Scheier1 %eintra&b1 and Carver .1/603 fo&nd that pessimism was associated with A. denial and distancing from the event. B. a foc&s directly on stressf&l feelings. C. disengagement from the goal with which the stressor was interfering. D. all of the above. Answer: D Feedbac : !efer to page 166 10. *he belief that one can determine one-s own internal states and behavior1 infl&ence one-s environment1 andFor bring abo&t desired o&tcomes is A. optimism. B. perceived control. C. self+efficacy. D. hardiness. Answer: B Feedbac : !efer to page 16/ 12. Control has been related to A. emotional well+being. B. s&ccessf&l coping. C. improved cognitive performance. D. all of the above. Answer: D Feedbac : !efer to page 1/7 16. 8igh self+esteem has been related to A. increased longevity. B. active coping strategies. C. red&cing the harmf&l effects of high levels of stress. D. red&cing the harmf&l effects of low levels of stress. Answer: D

Feedbac : !efer to page 1/7 1/. A. B. C. !esearch investigating the effectiveness of avoidant and vigilant coping strategies s&ggests that avoidant strategies are effective in dealing with long+term stressors. vigilant copers may exhibit short+term anxiety b&t cope well with long+term stressors. the &se of vigilant or confrontative coping styles may represent a ris factor for negative responses to stressors. D. both avoidant and vigilant strategies are e5&ally effective in coping with stress. Answer: B Feedbac : !efer to pages 1/7+1/1 $7. =motion+foc&sed efforts wo&ld be most effective in coping with the worry and stress d&e to A. having two final exams sched&led for the same day. B. waiting to hear if yo&r application to grad&ate school has been accepted. C. receiving a notice that yo&r taxes will be a&dited by the @!S next wee . D. any of the above. Answer: B Feedbac : !efer to page 1/# $1. @n a recent twin st&dy1 ?endler and colleag&es .1//13 discovered that two coping strategies1 t&rning to others and problem+solving1 co&ld be explained by A. early sociali<ation. B. parenting behaviors. C. genetic factors. D. all of the above. Answer: C Feedbac : !efer to page 1/# $$. !esearchers investigating disclos&re have fo&nd that s&b,ects who freely express their feelings abo&t tra&matic events A. show increased levels of physiological aro&sal. B. have diffic&lty maintaining ade5&ate levels of social s&pport. C. are no longer &pset abo&t the events after expressing themselves. D. are less li ely to have s&bse5&ent health problems. Answer: D Feedbac : !efer to page 1/) $#. 9eople who are higher in socioeconomic stat&s .S=S3 show A. lower morbidity for medical and psychiatric disorders. B. lower mortality from all ca&ses of death. C. red&ced ne&roendocrine responses to stress. D. all of the above. Answer: D Feedbac : !efer to page 1/2 $). *a ing a vacation is nown to be beneficial to A. everyone. B. middle+aged men and women. C. middle+aged men at ris for heart disease. D. parents of yo&ng children with chronic diseases. Answer: C Feedbac : !efer to page 1/6

$". @nformation from others that one is loved and cared for1 esteemed and val&ed1 and part of a networ of comm&nication and m&t&al obligation is called A. coping. B. internal reso&rces. C. social s&pport. D. external reso&rces. Answer: C Feedbac : !efer to page 1//

CHAPTER 10 PAIN AND ITS MANAGEMENT

I. Chapte !utline
@. Significance of 9ain @@. =l&sive Bat&re of 9ain A. (eas&ring 9ain B. 9hysiology of 9ain C. Be&rochemical Bases of 9ain and @ts @nhibition @@@. Clinical (anagement of 9ain A. Ac&te Aers&s Chronic 9ain B. 9ain and 9ersonality @A.9ain Control *echni5&es A. 9harmacological Control of 9ain B. S&rgical Control of 9ain C. Sensory Control of 9ain D. Biofeedbac =. !elaxation *echni5&es F. 8ypnosis :. Ac&p&nct&re 8. Distraction @. Coping *echni5&es >. :&ided @magery ?. Additional Cognitive *echni5&es to Control 9ain A. (anagement of Chronic 9ain: 9ain (anagement 9rograms A. @nitial =val&ation B. @ndivid&ali<ed *reatment C. Components of Chronic 9ain (anagement 9rograms D. @nvolvement of Family =. !elapse 9revention F. =val&ation of 9ain (anagement 9rograms

II. III. "ea nin# !$%ecti&es

1. $. #. ). ". 0. 2. 6. /.

=xplain the medical and psychological significance of pain. =xplain the role of the social context in the experience of pain. Describe the techni5&es of pain meas&rement. =xplain the physiological aspects of pain. Describe the ne&rochemical bases of pain and pain inhibition. Compare and contrast ac&te and chronic pain. Define the different inds of chronic pain .i.e.1 chronic benign pain1 rec&rrent ac&te pain1 and chronic progressive pain3. Describe the psychological and social conse5&ences of chronic pain. Describe the relationship between individ&al differences in personality and the experience of chronic and ac&te pain. Describe pharmacological techni5&es to control pain and their effectiveness.

17. Describe s&rgical techni5&es to control pain and their effectiveness. 11. Describe the &se of co&nterirritation as a sensory method of pain control and its effectiveness. 1$. Describe the &se of biofeedbac to control pain and its effectiveness. 1#. Describe the &se of relaxation techni5&es to control pain and their effectiveness. 1). Describe the &se of hypnosis to control pain and its effectiveness. 1". Describe the &se of ac&p&nct&re to control pain and its effectiveness. 10. Describe the &se of distraction to control pain and its effectiveness. 12. Describe the &se of coping techni5&es to control pain and their effectiveness. 16. Describe the &se of g&ided imagery to control pain and its effectiveness. 1/. Describe the &se of cognitive techni5&es to control pain and their effectiveness. $7. =xplain the principles of chronic pain management. $1. Describe the nat&re of pain management programs.

I'. '. Multiple-Choice Questions

1. 9ain A. is directly related to the severity of physical symptoms. B. has an important s&rvival f&nction. C. has little medical significance o&tside of motivating most patients to see treatment. D. is an important component of most medical school c&rric&la. Answer: B Feedbac : !efer to page $0# #. Gver H444444444444444 million is spent every year on over+the co&nter dr&gs. A. 177 B. #77 C. "77 D. 277 Answer: C Feedbac : !efer to page $0)

). Beecher-s .1/"/3 st&dy of wartime in,&ries investigated the effect of 444444444444444 on pain. A. placebos B. fear C. aro&sal D. interpretation Answer: D Feedbac : !efer to pages $0)+$0" ". Athletes who contin&e to play1 despite being in,&red1 may be experiencing a short+term red&ction of pain sensitivity d&e to A. sympathetic aro&sal. B. parasympathetic aro&sal. C. effective training and coaching. D. activities that foc&s their attention on the pain. Answer: A Feedbac : !efer to page $0" 0. Cross+c&lt&ral differences have been fo&nd in the A. discrimination of painf&l stim&li. B. reporting and intensity of reactions to pain. C. sensory aspect of pain. D. all of the above. Answer: B Feedbac : !efer to page $0" 2. *he perception of pain may be infl&enced by A. context. B. sociali<ation. C. attention. D. all of the above. Answer: D Feedbac : !efer to pages $0)+$0" 6. Self+report meas&res s&ch as the (c:ill 9ain I&estionnaire typically meas&re A. pain threshold. B. the nat&re and intensity of pain. C. pain tolerance. D. pain and enco&raged tolerance level. Answer: B Feedbac : !efer to pages $00+$02 /. 9ain behaviors A. are observable1 meas&rable behaviors that are manifestations of chronic pain. B. have proven &sef&l in identifying the dynamics of different pain syndromes. C. are &sed in assessing the impact of pain on 5&ality of life. D. all of the above. Answer: D Feedbac : !efer to page $00 Feedbac : !efer to page $00

11. *he sensory aspect of pain seems to be determined primarily by A. A+delta fibers. B. C+fibers. C. the limbic system. D. the cerebral cortex. Answer: A Feedbac : !efer to page $00 1#. =ndogeno&s opioids are A. s&bstances prod&ced by the s&bstantia gelatinosa that help reg&late pain. B. s&bstances prod&ced by the brain and glands that help reg&late pain. C. speciali<ed receptor sites that play an active role in the reg&lation of pain. D. dr&gs1 s&ch as heroin and morphine1 that help control pain. Answer: B Feedbac : !efer to page $0/ 1). =ndogeno&s opioids appear to play a role in the A. inhibition of pain. B. stress response. C. f&nctioning of the imm&ne system. D. all of the above. Answer: D Feedbac : !efer to pages $0/+$27 12. Chronic pain A. decreases with the passage of time. B. begins with an ac&te pain episode. C. readily responds to treatment. D. &nli e ac&te pain1 has no s&bcategories. Answer: B Feedbac : !efer to page $27 16. Chronic low bac pain and myofascial pain syndrome are examples of A. ac&te pain. B. chronic benign pain. C. rec&rrent ac&te pain. D. chronic progressive pain Answer: B Feedbac : !efer to page $27 1/. A migraine headache is an example of A. ac&te pain. B. chronic benign pain. C. rec&rrent ac&te pain. D. chronic progressive pain. Answer: C Feedbac : !efer to page $27

$1. @n comparison with ac&te pain patients1 chronic pain patients A. share a similar psychological profile. B. experience higher levels of pain. C. are more responsive to pain management techni5&es. D. s&ffer from a syndrome involving physiological1 psychological1 social and behavioral components. Answer: D Feedbac : !efer to page $21 $#. Compensation for pain res&lting from an in,&ry may 444444444444444 the perceived severity of the pain. A. increase B. decrease C. both a and b D. neither a nor b Answer: A Feedbac : !efer to page $2$ $). According to Ciccone et al. .1///31 chronic pain patients whose spo&ses provide s&pport and positive attention A. experience good marital and sex&al f&nctioning. B. may inadvertently maintain or increase the expression of pain. C. restrict their social contact to members of their immediate family. D. ta e smaller amo&nts of pain illers than patients who do not receive s&ch s&pport. Answer: B Feedbac : !efer to page $2$ $". According to research investigating personality variables observed in chronic pain patients1 A. there is a pain+prone personality1 which1 li e the disease+prone personality1 is characteri<ed by negative affectivity. B. a significant proportion of the pop&lation appears to be predisposed to experience pain. C. personality change is often a conse5&ence of pain1 b&t personality variables are seldom involved as ca&ses. D. different personality factors may be involved in different types of pain. Answer: D Feedbac : !efer to page $2# $6. 9ain control means A. only that the patient no longer feels any pain. B. only that the patient is no longer concerned abo&t the pain. C. only that the patient no longer feels any sensation in the area that once h&rt. D. none of the above. Answer: D Feedbac : !efer to page $2)

$/. 9harmacological control of pain A. is dangero&s in that it &s&ally leads to addiction to prescription dr&gs. B. is of no concern to researchers and practitioners. C. has a low probability of leading to addiction to prescription dr&gs. D. is the treatment of last resort. Answer: C Feedbac : !efer to page $2)

#$. Biofeedbac training A. is an inexpensive pain control method. B. shows rob&st evidence for pain control. C. probably is no more effective for controlling pain than are relaxation techni5&es. D. effects are clearly &nderstood. Answer: C Feedbac : !efer to page $20 ##. !elaxation training strategies are A. seldom effective by themselves and need to be combined with other methods of pain control. B. generally less effective in red&cing chronic pain than are meditation techni5&es. C. effective in alleviating chronic b&t not ac&te pain. D. all of the above. Answer: A Feedbac : !efer to page $20 #0. 8ypnosis relies on A. physiological relaxation. B. distraction. C. reinterpretation of sensations. D. all of the above. Answer: D Feedbac : !efer to page $26 #2. Ac&p&nct&re may A. f&nction as a sensory method of controlling pain. B. be effective beca&se patients believe it will wor . C. trigger the release of endorphins. D. all of the above. Answer: D Feedbac : !efer to page $26 #/. *he res&lts of a st&dy of the &se of coping techni5&es in pain management .8olmes J Stevenson1 1//73 s&ggested that A. avoidant coping was more effective in managing chronic pain. B. attentional coping strategies were more effective in managing ac&te pain.

C. patients sho&ld be trained in avoidant or attentive coping strategies depending on the nat&re of their pain. D. none of the above. Answer: C Feedbac : !efer to pages $2/+$67 )7. @n contrast to aggressive imagery1 relaxation imagery A. is more fre5&ently &sed to combat pain. B. ind&ces a positive mood state. C. foc&ses attention. D. all of the above. Answer: A Feedbac : !efer to page $67 )1. Cognitive+behavioral pain interventions A. enco&rage patients to entr&st the management of their pain to the treatment team. B. attempt to modify maladaptive cognitions b&t not overt and covert behaviors. C. enco&rage clients to attrib&te their s&ccess to the treatment intervention. D. none of the above Answer: D Feedbac : !efer to page $61 )". !elapse following initial s&ccessf&l treatment of pain is directly related to A. lac of social s&pport. B. coping styles. C. nonadherence to treatment regimen. D. all of the above. Answer: C Feedbac : !efer to page $6#

'I. 'II.

CHAPTER 11 MANAGEMENT !( CHR!NIC I""NESS

'III.
@.

Chapte !utline

I&ality of ;ife A. %hat @s I&ality of ;ife' A. %hy St&dy I&ality of ;ife'

@@. =motional !esponses to Chronic @llness A. Denial A. Anxiety A. Depression @@@. 9ersonal @ss&es in Chronic Disease A. *he 9hysical Self A. *he Achieving Self

A. *he Social Self A. *he 9rivate Self @A. Coping with Chronic Disease A. Coping Strategies and Chronic @llness A. 9atients- Beliefs Abo&t Chronic @llness A. !ehabilitation and Chronic @llness A. 9hysical 9roblems Associated with Chronic @llness A. Aocational @ss&es in Chronic @llness A. Social @nteraction 9roblems in Chronic @llness A. 9ositive Changes in !esponse to Chronic @llness A. %hen the Chronically @ll 9atient @s a Child A@. 9sychological @nterventions and Chronic @llness

A. A. A. A. A. A. B. A.

9harmacological @nterventions @ndivid&al *herapy Brief 9sychotherape&tic @nterventions 9atient =d&cation !elaxation1 Stress (anagement1 and =xercise Social S&pport @nterventions Family S&pport S&pport :ro&ps

Multiple-Choice Questions $. I&ality of life traditionally has been meas&red in terms of A. psychological and economic factors. B. s&b,ective criteria. C. morbidity and mortality. D. longevity. Answer: C Feedbac : !efer to page $62 #. A. B. C. (edical meas&res of 5&ality of life are seldom based on ob,ective criteria. poorly correlated with patients- and relatives- assessments. poorly correlated with patients- assessments b&t are moderately correlated with relativesassessments. D. moderately correlated with health psychologists- assessments. Answer: B Feedbac : !efer to page $62 ). Assessment of 5&ality of life considers A. disease+ or treatment+related symptoms. B. physical stat&s and f&nctioning. C. psychological and social stat&s. D. m&ltiple criteria that incl&des all of the above. Answer: D Feedbac : !efer to page $66 0. @mmediately after a chronic illness is diagnosed1 A. patients are in a state of crisis. B. patients find their habit&al ways of coping with problems do not wor . C. anxiety1 fear1 and depression often ta e over. D. all of the above. Answer: D Feedbac : !efer to page $6/ /. Denial is &sef&l in helping patients A. control their emotional reaction to illness. B. monitor their physical condition. C. see treatment. D. become active in their treatment regimen. Answer: A

Feedbac : !efer to page $/7 17. Gf the following sit&ations1 patient anxiety wo&ld be highest A. after the physician had explained the diagnosis and treatment regimen. B. after the patient has received a test res&lt. C. while the patient is awaiting a new and promising1 b&t invasive1 medical proced&re. D. while the patient is experiencing the side effects of a familiar medical proced&re. Answer: C Feedbac : !efer to page $/7 11. 8igh levels of anxiety have been fo&nd among patients who are A. anticipating noxio&s therapies. B. expecting s&bstantial lifestyle changes to res&lt from illness or treatment. C. lac ing information abo&t their illness and treatment. D. all of the above. Answer: D Feedbac : !efer to page $/7 1#. Kp to 444444444444444 of all medical inpatients with chronic disease s&ffer from severe depression. A. 17L B. $"L C. "7L D. 2"L Answer: B Feedbac : !efer to page $/7 1). Depression in chronically ill patients is A. independent of illness severity. B. most commonly fo&nd in the ac&te phase of illness. C. easily and reliably assessed. D. related to long+term rehabilitation and recovery. Answer: D Feedbac : !efer to page $/1 10. %hich of the following is BG* a predictor of depression among chronically ill patients' A. lac of social s&pport B. chronic pain C. marital stat&s D. becoming disabled Answer: C Feedbac : !efer to page $/$ 1/. *he degree of threat to one-s body image is infl&enced by A. disease severity. B. the amo&nt of damage or scarring. C. one-s activity level. D. all of the above. Answer: D Feedbac : !efer to pages $/$+$/#

$7. According to a st&dy of cancer patients cond&cted by D&n el+Schetter and her colleag&es .1/6631 the most fre5&ently cited stressor was A. fear and &ncertainty abo&t the f&t&re. B. limitations in physical abilities. C. pain management. D. altered physical appearance and lifestyle. Answer: A Feedbac : !efer to page $/) $$. A. B. C. D. S&ccessf&l ad,&stment to chronic illness is associated with having an appropriate or acc&rate illness schema abo&t the nat&re of one-s illness. developing an ac&te model of one-s disorder. blaming others for one-s illness and th&s minimi<ing self+blame. having a personal sense of control1 even in medical sit&ations1 in which little personal control is possible. Answer: A Feedbac : !efer to page $/" $). @n general1 high levels of perceived control facilitate ad,&stment1 =MC=9* in cases where A. patients are serio&sly debilitated1 both physically and psychosocially. B. patients m&st cope with long+term chronic illness. C. patients m&st cope with ac&te disorders and treatment. D. where act&al control is low. Answer: D Feedbac : !efer to page $/0 $2. Chemotherapy may be accompanied by A. changes in taste and the development of taste aversions. B. b&rning of the s in. C. dietary restrictions. D. weight gain. Answer: A Feedbac : !efer to page $// $6. Stress management programs are increasingly incorporated into physical treatment regimens d&e to the debilitating effects of stress on A. psychosocial ad,&stment. B. chronic diseases. C. coping strategies. D. none of the above. Answer: B Feedbac : !efer to page $// $/. A. B. C. Adherence to treatment regimens in chronically ill patients is significantly higher than in patients being treated for ac&te disorders. significantly lower than in patients being treated for ac&te disorders. &naffected by the side effects of treatment.

D. especially problematic in complex and long+term treatment regimens. Answer: D Feedbac : !efer to page $// #7. Bonadherence to treatment regimens d&e to negative side effects is highest in patients &ndergoing A. hypertension management programs. B. end+stage renal therapy. C. ins&lin regimens. D. none of the above. Answer: A Feedbac : !efer to page $// #1. Adherence to treatment of hypertension and diabetes has been lin ed to A. self+efficacy beliefs. B. expectations that one-s health is &nder one-s own control. C. information abo&t treatment regimen. D. all of the above. Answer: D Feedbac : !efer to page #77 ##. Begative reactions to chronically ill patients incl&de A. blatant discrimination. B. nonverbal behavior comm&nicating rev&lsion. C. ambivalence. D. all of the above. Answer: D Feedbac : !efer to page #7) #). Adverse changes in social interactions after a diagnosis of chronic disease are more li ely to be observed in A. family members. B. friends and ac5&aintances. C. employers. D. intimate others. Answer: B Feedbac : !efer to page #7)

#2. (ost caregiving for the chronically ill is provided by A. formal services s&ch as home health n&rses or n&rsing homes. B. men. C. women. D. friends. Answer: C Feedbac : !efer to page #7" #6. !esearchers investigating gender differences in the receipt of social s&pport have fo&nd that A. disabled women are more effective than disabled men in establishing effective social s&pport networ s. B. being married appears to protect men1 b&t not women1 from instit&tionali<ation.

C. married women spend fewer days in n&rsing homes than married men. D. disabled men are less li ely to be married than disabled women. Answer: B Feedbac : !efer to page #70 #/. Collins et al. .1//73 reported that more than 444444444444444 of the cancer patients in their st&dy reported at least some beneficial changes in their life as a res&lt of the cancer. A. $7L B. )"L C. 2"L D. /7L Answer: D )1. =motional disorders associated with chronic illness are especially li ely among patients who A. enter into very aggressive medical treatment regimens. B. are motivated to find meaning and to compensate for any negative impact of chronic illness on their 5&ality of life. C. have a history of depression or other mental illness. D. all of the above. Answer: C Feedbac : !efer to page #7/ )$. Compared to therapy with other clients1 psychotherapy provided to medical patients is more li ely to A. be contin&o&s and long term in nat&re. B. involve collaboration with the patient-s family and physician. C. be expensive and time cons&ming. D. challenge the client-s defenses and promote a realistic assessment of his or her sit&ation. Answer: B Feedbac : !efer to page #7/

CHAPTER 1) HEART DISEASE* H+PERTENSI!N* STR!,E* AND DIA-ETES

I.. Chapte !utline
@. Coronary 8eart Disease A. %hat @s C8D' B. !ole of Stress C. %omen and C8D D. Cardiovasc&lar !eactivity1 8ostility1 and C8D =. Depression and C8D F. Gther 9sychological !is Factors and C8D :. (odification of C8D !is +!elated Behavior 8. (anagement of 8eart Disease 8ypertension A. 8ow @s 8ypertension (eas&red' B. %hat Ca&ses 8ypertension' C. !elationship Between Stress and 8ypertension

@.

D. 9sychosocial Factors and 8ypertension =. *reatment of 8ypertension F. 9roblems in *reating 8ypertension @@@. Stro e A. !is Factors for Stro e B. Conse5&ences of Stro e C. *ypes of !ehabilitative @nterventions @A. (anagement of Diabetes

A. B. C. D. =.

*ypes of Diabetes 8ealth @mplications of Diabetes 9roblems in Self+(anagement of Diabetes @nterventions with Diabetics Special 9roblems of Adolescent Diabetics

.. .I. T ue-(alse Questions

1. * $. * F F Diabetes is a ris factor for coronary heart disease. *r&e: !efer to page #)) Across the life span1 women seem to be protected against coronary heart disease relative to men. False: !efer to pages #)"+#)2 #. * F !esearch has disco&nted the role of *ype A behavior in the development of coronary heart disease. *r&e: !efer to page #)6 ). * F !ed&cing speech rate and lo&dness is associated with a significant red&ction in cardiovasc&lar reactivity. *r&e: !efer to page #"# ". * 0. * 2. * 6. * F F F F Aspirin has been fo&nd to significantly red&ce the ris for fatal heart attac . *r&e: !efer to page #") (ild hypertension is defined by a diastolic press&re consistently between 17" and 11/. False: !efer to page #"6 *he mortality rate is aro&nd #7L d&ring the first month after a stro e. *r&e: !efer to page #0) @n terms of emotional response1 patients with left brain damage from a stro e seem indifferent to their sit&ation. False: !efer to page #00 /. * F %hereas stress adversely affects adherence to treatment and diet1 stress has not been fo&nd to directly affect *ype @ and *ype @@ diabetes. False: !efer to page #27 17. * F Depression often is a complication of diabetes. *r&e: !efer to page #2)

.II. .III.
1. A. B. C.

Multiple-Choice Questions

*he n&mber one iller in the Knited States1 acco&nting for $7L of all deaths1 is diabetes. coronary heart disease. hypertension.

D. cancer. Answer: B Feedbac : !efer to page #)# $. %hich of the following is BG* one of the ris factors for coronary heart disease' A. hypertension B. high ser&m cholesterol C. cigarette smo ing D. alcohol cons&mption Answer: D Feedbac : !efer to page #)) #. *he combination of obesity centered aro&nd the waist1 high levels of triglycerides1 low levels of 8D; cholesterol1 and diffic&lty metaboli<ing blood s&gar are symptomatic of A. inflammation d&e to c reactive protein. B. metabolic syndrome. C. angina pectoris. D. cardiac arrest. Answer: B Feedbac : !efer to page #)) ). %hich of the following ,ob factors has been fo&nd to be related to increased ris of C8D' A. high wor demands and low control B. a discrepancy between one-s ed&cation level and one-s occ&pation C. low ,ob sec&rity D. all of the above Answer: D Feedbac : !efer to page #)" ". @n $7711 C8D acco&nted for 444444444444444 of all female deaths. A. $1L B. #"L C. )#L D. ")L Answer: D Feedbac : !efer to page #)" 0. %omen A. show greater increases in cardiovasc&lar ne&roendocrine and some metabolic responses in response to stress than do men. B. experience an increased ris of myocardial infarction or C8D+related death after menopa&se. C. develop C8D on the average abo&t 1" years earlier than do men. D. seem to be protected at yo&ng ages against C8D d&e to their lower levels of 8D; cholesterol. Answer: B Feedbac : !efer to page #)0 2. *he personality 5&ality CagencyD is associated with 4444444444444441 whereas Ccomm&nionD is associated with 444444444444444. A. good physical and mental health o&tcomesN red&ced psychological stress B. good physical and mental health o&tcomesN few relations to physical and mental health o&tcomes C. few relations to physical and mental health o&tcomesN good physical and mental health o&tcomes

D. red&ced psychological stressN good physical and mental health o&tcomes Answer: B Feedbac : !efer to page #)2 6. *he *ype A behavior pattern was tho&ght to be characteri<ed by A. hostility1 time &rgency1 and competitive achievement strivings. B. negative affectivity1 hostility1 and competitive achievement strivings. C. commitment1 chronic stress1 and time &rgency. D. commitment1 hostility1 and competitive achievement strivings. Answer: A Feedbac : !efer to page #)6 /. Compared to *ype Bs1 *ype A individ&als A. wor harder and at a faster pace b&t do not wor longer and more discretionary ho&rs. B. may have tro&ble coping in sit&ations that re5&ire a narrow foc&s of attention. C. are less driven. D. s&ffer from &nfoc&sed hostility. Answer: D Feedbac : !efer to page #)6 17. Cynical hostility is characteri<ed by A. s&spicio&sness. B. little resentment. C. infre5&ent angry episodes. D. tr&st in others. Answer: A Feedbac : !efer to page #)6 11. 8igher levels of hostility have been fo&nd among A. men. B. non+%hites. C. people low in socioeconomic stat&s .S=S3. D. all of the above. Answer: D Feedbac : !efer to page #)6 1$. 9eople who are both hostile and 444444444444444 show the greatest association between cardiovasc&lar responses and C8D. A. s&spicio&s B. angry C. defensive D. *ype A Answer: B Feedbac : !efer to page #)6 1#. 8ostility has been traced to A. an oppositional orientation toward others. B. child+rearing patterns characteri<ed by interference and p&nitiveness. C. family environments that are nons&pportive and high in conflict. D. all of the above. Answer: D Feedbac : !efer to pages #)6+#)/

1). @ndivid&als who are high in hostility A. have chronically higher blood press&re. B. show more prono&nced heart rate reactivity to laboratory stressors. C. show more prono&nced physiological reactions in response to interpersonal stressors. D. all of the above. Answer: C Feedbac : !efer to page #)/ 1". Depression may be a ris factor for C8D d&e to its relationship with A. c reactive protein. B. the metabolic syndrome. C. both a and b. D. neither a nor b. Answer: C Feedbac : !efer to page #"1 10. Social dominance A. is related to C8D. B. is related to all+ca&se mortality. C. is a pattern of attempting to dominate social interactions. D. all of the above. Answer: D Feedbac : !efer to page #"1 12. St&dies .Bl&menthal et al.1 1//1N 1/663 assessing the effectiveness of exercise in red&cing cardiovasc&lar ris have concl&ded that aerobic exercise A. red&ces behavioral reactivity to stress. B. red&ces systolic and diastolic blood press&re. C. benefits both men and women at ris for coronary heart disease. D. all of the above. Answer: D Feedbac : !efer to page #"$ 16. %hich of the following has BG* been fo&nd to be associated with delay before see ing treatment for myocardial infarction' A. interpretation of symptoms as mild disorders B. being yo&ng and white C. history of angina or diabetes D. experiencing an attac d&ring the daytime Answer: B Feedbac : !efer to page #"# 1/. Beta+bloc ers are &sed in cardiac rehabilitation A. to activate the parasympathetic nervo&s system. B. to resist the effects of sympathetic nervo&s system stim&lation. C. to control the pain of angina pectoris. D. when behavioral stress management interventions fail. Answer: B Feedbac : !efer to page #")

$7. 44444444444444 are the most common dr&g treatment for red&cing the incidence of death1 heart attac 1 and stro e. A. Statins B. Di&retics C. Beta+bloc ers D. Aitamins Answer: A Feedbac : !efer to page #") $1. Cardiac rehabilitation programs involve A. aerobic exercise. B. smo ing cessation. C. red&ced alcohol cons&mption. D. all of the above. Answer: D Feedbac : !efer to page #")+#"" $$. Depression and anxiety following a myocardial infarction are implicated in A. red&ced mortality. B. increased heart variability. C. impaired a&tonomic nervo&s system f&nctioning. D. all of the above. Answer: C Feedbac : !efer to page #"0 $#. According to st&dies of recovery from coronary heart disease .?&li J (ahler1 1//#31 social s&pport A. was most effective when it was provided by the spo&se rather than a confidante. B. became increasingly effective over time as the patient-s recovery progressed. C. was most infl&ential d&ring the six months immediately after hospitali<ation. D. none of the above. Answer: C Feedbac : !efer to page #"2 $). Cardiac invalidism occ&rs when A. patients and their spo&ses &nderestimate the patient-s physical abilities. B. spo&ses &nderestimate the extent of disability. C. patients malinger in order to reap secondary gains associated with the sic role. D. patients feel that they are &nable to control the stressors in their daily lives. Answer: A Feedbac : !efer to page #"2+#"6 $". @n a st&dy of cardiac invalidism .*aylor et. al1 1/6"31 wives- perceptions of their h&sbands- cardiac and physical efficiency were highest when they had A. been provided information abo&t their h&sband-s medical and psychological condition. B. observed their h&sband-s performance on a treadmill tas . C. personally experienced the treadmill tas themselves. D. all of the above. Answer: C Feedbac : !efer to page #"2+#"6 $0. S&dden death from heart attac is most li ely to occ&r

A. at home. B. at wor . C. on vacation. D. while the patient is asleep. Answer: A Feedbac : !efer to page #"6 $2. Diastolic press&re is related to A. resistance of the blood vessels to blood flow. B. the amo&nt of force developed d&ring contraction of the heart. C. the vol&me of blood leaving the heart. D. the arteries- elasticity. Answer: A Feedbac : !efer to page #"6 $6. (ales are at greater ris for hypertension A. across the life span. B. before age "7. C. after age "7. D. none of the above. Answer: B Feedbac : !efer to page #"/ $/. According to a st&dy of hypertension ris factors by =wart .1//131 the family environment that fosters 444444444444444 may then contrib&te to hypertension. A. negative affectivity B. chronic anger C. excessive competitiveness D. cynical distr&st Answer: B Feedbac : !efer to page #"/ #7. *he role of stress in the development and exacerbation of hypertension A. is the same for people at ris for hypertension and those who are not at ris . B. does not change as hypertension progresses. C. may be different for people at ris for hypertension. D. has not been st&died eno&gh to determine what the role is. Answer: C Feedbac : !efer to page #07 #1. *he prevalence of hypertension among lower+income African Americans may be traced to A. parental histories of hypertension. B. racial differences in ne&ropeptide and cardiovasc&lar response to stressors. C. expos&re to chronic environmental stressors. D. all of the above. Answer: D Feedbac : !efer to page #01 #$. C>ohn 8enryismD is a personality predisposition A. that helps African American men cope with racism.

B. that defines men-s1 b&t not women-s1 effective coping strategies when active coping is li ely to be &ns&ccessf&l. C. that is &sed to cope actively with psychosocial stressors. D. fo&nd only in white men. Answer: C Feedbac : !efer to page #0$ ##. A. B. C. D. Dr&g treatments for hypertension are more effective than dietary modification and exercise. significantly red&ce the incidence of coronary artery disease1 morbidity1 or mortality. show some s&ccess in red&cing blood press&re witho&t negative side effects. may effectively red&ce the complications of hypertension while increasing the ris for coronary heart disease ca&sed by enhanced sympathetic nervo&s system activity. Answer: D Feedbac : !efer to page #0$ #). A. B. C. D. Cognitive+behavioral techni5&es may s&bstit&te for dr&g treatments1 even in cases of severe hypertension. are associated with lower rates of nonadherence than are dr&g treatments. are typically combined with dr&g treatment of hypertension. designed to control the expression of anger have been moderately s&ccessf&l in the treatment of hypertension. Answer: C Feedbac : !efer to pages #0$+#0# #". *he correlation between beliefs abo&t level of blood press&re and act&al blood press&re is A. high. B. moderate. C. low. Answer: C Feedbac : !efer to page #0# #0. *he ris factors for stro e A. are independent of those for heart disease. B. decrease with age. C. are not s&b,ect to modification by lifestyle changes. D. incl&de cigarette smo ing. Answer: D Feedbac : !efer to page #0" #2. 9atients with right+brain damage d&e to stro e typically s&ffer A. comm&nication disorders s&ch as aphasia. B. impaired performance on cognitive tas s that re5&ire the &se of short+term memory. C. diffic&lty in processing vis&al feedbac . D. extreme anxiety and depression. Answer: C Feedbac : !efer to page #00 #6. Alexithymia A. involves diffic&lty in &nderstanding others and expressing oneself. B. involves diffic&lty in identifying and describing emotion.

C. involves diffic&lty in recogni<ing individ&al faces. D. res&lts from the acc&m&lating effects of small stro es and often mimics the effects of Al<heimer-s disease. Answer: B Feedbac : !efer to page #00 #/. 9redictors of depression in stro e patients incl&de A. overprotection by a caregiver. B. site and severity of stro e. C. lac of meaning in life. D. all of the above. Answer: D Feedbac : !efer to page #00

CHAPTER 1/ PS+CH!NE0R!IMM0N!"!G+* AIDS* CANCER* AND ARTHRITIS

Chapter G&tline @. 9sychone&roimm&nology A. *he @mm&ne System A. Assessing @mm&nocompetence A. Stress and @mm&ne F&nctioning A. Begative Affect and @mm&ne F&nctioning A. Stress1 @mm&ne F&nctioning1 and @nterpersonal !elationships A. Coping and Coping !eso&rces as (oderators of the StressO@mm&ne F&nctioning !elationship A. @nterventions to =nhance @mm&nocompetence A. Stress and the Developing @mm&ne System

@@. A@DS A. A Brief 8istory of A@DS A. A@DS in the Knited States B. 9sychosocial @mpact of 8@A @nfection A. @nterventions to !ed&ce the Spread of A@DS A. Coping with 8@AP Stat&s and A@DS A. 9sychosocial Factors that Affect the Co&rse of A@DS @@@. Cancer A. %hy @s Cancer 8ard to St&dy A. %ho :ets Cancer' A Complex 9rofile A. 9sychosocial @ss&es and Cancer A. 9sychosocial Factors and the Co&rse of Cancer A. (echanisms ;in ing Stress1 Coping1 and Cancer A. Ad,&sting to Cancer A. 9sychosocial 9roblems and Cancer A. Coping with Cancer B. @nterventions

1. *

*r&e+False I&estions F 8&moral imm&nity operates at the cell&lar level and is mediated by * lymphocytes. False + !efer to page #67

$. *

St&dies with h&man s&b,ects indicate that expos&re to stressors is related to imm&nologic change. *r&e + !efer to pages #61+#6$

#. *

St&dies have fo&nd impaired imm&ne f&nctioning among bereaved individ&als1 even if these individ&als do not show evidence of depression. False + !efer to pages #6)+#6"

). *

@mpaired imm&ne f&nctioning has been fo&nd in samples of ad&lts who have experienced short+term marital conflict1 marital separation1 and divorce. *r&e + !efer to pages #6"+#60

". *

Gne of the most common symptoms for women with A@DS is a gynecologic infection. *r&e + !efer to page #/$

0. *

A person may test 8@A+seropositive .8@AP31 b&t be free of a diagnosis of A@DS for years. *r&e + !efer to page #/#

2. *

9ast sex&al practice is an important predictor of A@DS+related ris behaviors. *r&e + !efer to page #/2

6. *

>apanese+American women are more s&sceptible to breast cancer the longer they have lived in the Knited States and the more they have adopted the American c&lt&re. *r&e + !efer to page )71

/. *

*he most prevalent of the a&toimm&ne diseases is cancer. False + !efer to page )11

17. *

Ancient drawings of people with arthritic ,oints have been fo&nd in caves. *r&e + !efer to page )11

(&ltiple+Choice I&estions 1. Bat&ral iller cells A. recogni<e1 ingest1 and destroy antigens. B. contrib&te to inflammatory and allergic reactions. C. assist in the activation of * cells thro&gh the secretion of cyto ine. D. attac and destroy cells infected by vir&ses. Answer: D Feedbac : !efer to page #2/

$. * lymphocytes A. play an important role in h&moral imm&nity. B. confer imm&nity by the prod&ction and secretion of antibodies. C. secrete toxic s&bstances that ill infected cells. D. release antibodies into the blood. Answer: C Feedbac : !efer to page #67 #. 8elper * .*83 cells A. respond to specific antigens. B. enhance the f&nction of *C cells1 B cells1 and macrophages by prod&cing lympho ines. C. prod&ce lympho ines that s&ppress imm&ne activity. D. prod&ce imm&noglob&lins1 which are the basis of antigen+specific reactions. Answer: B Feedbac : !efer to page #67 ). 444444444444444 s&ggests that the imm&ne system is wor ing 444444444444444. A. @mm&nocompetenceN effectively B. AsymptoteN effectively C. @mm&nocompetenceN ineffectively D. AsymptoteN ineffectively Answer: A Feedbac : !efer to page #61 ". @ntense1 short+term stressors A. recr&it cells that may help defend against wo&nds and infection. B. &preg&late imm&ne f&nctioning in ways li ely to ward off threats posed by pathogens. C. affect most meas&res of imm&ne f&nctioning adversely. D. all of the above. Answer: A Feedbac : !efer to pages #61+#6$ 0. Stress has been related to A. rates of infectio&s disease in children and ad&lts. B. the development of herpes vir&s infections. C. slower wo&nd healing. D. all of the above. Answer: D Feedbac : !efer to page #6# 2. Academic stress has been associated with A. decreases in total *1 *81 and *S lymphocytes. B. increases in nat&ral iller cells. C. higher rates of infectio&s disease in ad&lts b&t not children. D. increased distress b&t few changes in imm&ne f&nctioning. Answer: A Feedbac : !efer to page #6) 6. by A. B. C. 8erbert and Cohen-s .1//#3 review of the literat&re fo&nd s&pport for the notion that imm&ne f&nctioning is impaired hardiness. anxiety. depression.

D. hostility. Answer: C Feedbac : !efer to page #6) /. =vidence s&ggests that some of the adverse effects of depression on imm&nity may be mediated by A. hostility. B. dist&rbed hypothalamic f&nctioning. C. poor mat&ration of the imm&ne system. D. sleep dist&rbances. Answer: D Feedbac : !efer to page #6) 17. *he 5&ality of one-s interpersonal relationships has been implicated in imm&nocompromise. %hich of the following has BG* been fo&nd to be associated with physical and emotional illness' A. being single B. bereavement C. short+term marital conflict D. divorce and separation Answer: A Feedbac : !efer to pages #6"+#60 11. ;ong+term provision of care to friends or family members with long+term illness has been lin ed with a range of health+related problems. *his can be attrib&ted to caregiversA. poor health habits. B. disr&pted sleep patterns. C. experience of severe and long+term stressors. D. all of the above. Answer: C Feedbac : !efer to page #60 1$. *he tendency to see social s&pport and the perception that one had good emotional s&pport were associated with 444444444444444 s&ggesting b&ffering of stress responses. A. low B? cell activity B. high B? cell activity C. increases in lymphocyte responses D. all of the above Answer: B Feedbac : !efer to page #60 1#. St&dies of personality and coping styles have fo&nd that the stressOimm&ne f&nctioning relationship is moderated by A. optimism. B. self+efficacy. C. perceived control. D. all of the above. Answer: D Feedbac : !efer to pages #60+#62 1). According to Band&ra .1/6/31 perceived self+efficacy may A. directly red&ce the experience of stress. B. red&ce the tendency to develop depression in response to stressf&l events. C. mod&late imm&nologic reactivity via the central nervo&s system. D. all of the above. Answer: D Feedbac : !efer to page#60+#62

1". 444444444444444 may m&te the adverse effects of stress on the imm&ne system. A. !elaxation training B. Social contact C. !epressing one-s tho&ghts abo&t the stressf&l event D. Stress management s ills Answer: A Feedbac : !efer to page #62 10. 8@A affects primarily A. helper * cells and macrophages. B. le& ocytes. C. nat&ral iller cells. D. B cells. Answer: A Feedbac : !efer to page #/7 12. *he most common mode of transmission of A@DS worldwide is via A. heterosex&al sex&al activity. B. homosex&al sex&al activity. C. blood transf&sions. D. intraveno&s dr&g &se. Answer: A Feedbac : !efer to page #/1 16. *he time between progression from 8@AP stat&s to a diagnosis of A@DS is most strongly infl&enced by A. individ&al differences. B. socioeconomic factors. C. sex&al orientation. D. ethnicity. Answer: B Feedbac : !efer to page #/$ 1/. *he most promising development in the treatment of A@DS is A. an 8@A vaccine. B. AQ*. C. protease inhibitors. D. DD@. Answer: C Feedbac : !efer to page #/$ $7. According to the Centers for Disease Control and 9revention .CDC31 the n&mbers of A@DS cases are growing fastest among A. ethnic minorities. B. gay men. C. minority women. D. @A dr&g &sers. Answer: C Feedbac : !efer to page #/$ $1. A. B. C. D. According to the text1 whose germs are seen as less threatening' Sally1 whom yo& disli e intensely. S&sanF*om1 yo&r lover. *ony1 whom yo& have ,&st met. Francoise1 whom yo& met on the streets of 9aris.

Answer: B Feedbac : !efer to page #/# $$. An important time .or teachable moment3 to provide A@DS ed&cation is A. in elementary school before sex&al activity begins. B. following the death of a partner1 partic&larly for men. C. when a man has a new primary partner. D. both b and c Answer: D Feedbac : !efer to pages #/)+#/" $#. A review of $2 p&blished st&dies that provided 8@A co&nseling and testing information fo&nd this type of ed&cation was an effective means of A. secondary prevention for 8@AP individ&als. B. red&ced behaviors that might infect others. C. primary prevention for &ninfected participants. D. both a and b Answer: D Feedbac : !efer to page #/" $). 9erceptions of self+efficacy have been related to A. fre5&ency of condom &se. B. n&mber of sex&al partners. C. n&mber of anonymo&s sex&al partners. D. all of the above. Answer: D Feedbac : !efer to page #/" $". Condom &se among adolescents A. appears to be decreasing. B. is independent of other behavioral problems s&ch as dr&g and alcohol &se. C. has been fo&nd to be related to peer norms and perceptions of personal efficacy. D. all of the above. Answer: C Feedbac : !efer to page #/"+#/0 $0. Cognitive+behavioral interventions program that wor with other pop&lations may not wor as well with @A dr&g &sers beca&se A. their peer gro&p has too m&ch infl&ence. B. they may lac good imp&lse control. C. methadone programs don-t wor with them. D. needle exchange programs are ineffective. Answer: B Feedbac : !efer to page #/2 $2. !esearch s&ggests that those who &se the @nternet in con,&nction with managing their seropositive stat&s 444444444444444 than those not &sing the @nternet. A. had fewer active coping s ills B. had less social s&pport C. had less acc&rate 8@A disease nowledge. D. none of the above1 the @nternet appears to be a promising1 potentially important reso&rce in 8@AFA@DS care. Answer: D Feedbac : !efer to page #//

$6. St&dies have fo&nd that 444444444444444 beliefs abo&t the self and the f&t&re are associated with the onset of A@DS in individ&als with 8@A. A. positive B. negative C. ne&tral D. none of the above Answer: B Feedbac : !efer to page #// $/. According to the research cited in yo&r text1 which of the following patients wo&ld be expected to be better ad,&sted and most s&ccessf&l in coping with A@DS' A. 9a&l1 who is confident that the medical personnel who staff his experimental treatment program are o&tstanding in the field and his best chance for s&rvival B. (ary1 who contracted A@DS thro&gh a transf&sion and feels that she has no personal control over the disease C. *om1 who has t&rned to alternatives to traditional medicine and feels that his holistic practitioner can best arrest the progression of the disorder D. >ohn1 who feels that he can control the disease and its symptoms and has ta en personal responsibility for its treatment Answer: D Feedbac : !efer to page #// #7. %hich of the following has BG* been fo&nd to contrib&te to positive ad,&stment and long+term s&rvival among people with A@DS' A. ability to find meaning in being 8@AP B. concealing one-s sex&al orientation and 8@A stat&s C. social s&pport D. optimism Answer: B Feedbac : !efer to pages #//+)77 #1. All cancers res&lt from A. imm&nocompromise. B. a dysf&nction in !BA. C. a dysf&nction in DBA. D. a red&ction in DBA. Answer: C Feedbac : !efer to page )77 #$. St&dies of the development of cancer across species indicate that A. there is little between+species variability. B. there is little within+species variability. C. some s&bgro&ps within a species may be more s&sceptible to certain cancers than others. D. none of the above. Answer: C Feedbac : !efer to page )77 ##. *he fact that many cancers r&n in families may be explained by A. a genetically inherited predisposition to cancer. B. lifestyle factors that may infl&ence the development of cancer. C. ethnic differences in the development of certain cancers. D. all of the above. Answer: D Feedbac : !efer to page )71

#). !esearch investigating the relationship between personality traits and cancer has fo&nd A. a positive association between cancer and emotional repression. B. a positive association between cancer and depression. C. no relationship between psychosocial variables and depression. D. all of the aboveN research to date is inconcl&sive. Answer: D Feedbac : !efer to page )7# #". Stress may be lin ed to cancer via which of the following mechanisms' A. imm&nocompromise B. B? cell activity C. both a and b D. neither a nor b Answer: C Feedbac : !efer to page )7) #0. According to the Centers for Disease Control and 9revention .CDC31 each year cancer ca&ses approximately 444444444444444 deaths in the Knited States. A. $771777 B. #"71777 C. )$01777 D. ")$1777 Answer: D Feedbac : !efer to page )7" #2. *he conse5&ence of receiving chemotherapy in the same place by the same person &nder the same circ&mstances is A. conditioned na&sea. B. conditioned imm&ne s&ppression. C. impaired long+term compliance. D. all of the above. Answer: A Feedbac : !efer to page )7" #6. For cancer patients1 social s&pport A. improves imm&nologic responses. B. improves psychological ad,&stment C. can be problematic. D. all of the above. Answer: D Feedbac : !efer to page )70 #/. A st&dy of cancer patients cond&cted by D&n el+Schetter and her colleag&es .1//$3 fo&nd that patients who coped with their cancer+related problems via 444444444444444 showed more emotional distress. A. social s&pport B. cognitive escape+avoidant strategies C. distancing D. none of the above Answer: B Feedbac : !efer to page )72 )7. Several interventions have been employed to facilitate cancer patients- coping with chemotherapy. %hich of the following interventions has been fo&nd to be effective' A. relaxation B. g&ided imagery

C. distraction D. all of the above Answer: D Feedbac : !efer to page )72