Health psych exam 2

What is the term for an event that causes stress?

Stressors

What determines how stressful an event is for you? What realization led stress researchers to arrive at this current understanding of stressors?

Person-environment fit; the interaction between individual perceptions and situational demands.

Researchers found that stress is not just about the event itself, but also about how individuals interpret and cope with it.

What are primary appraisal (all 3 parts) and secondary appraisal?

Primary appraisal: our mind accesses the environment, evaluates whether an event is harmful, a threat, or a challenge

Secondary appraisal: we assess how equipped we are to respond to the stressor

In the fight-or-flight response, what can fight look like? What does flight look like?

Fight: aggression or taking productive action

Flight: literally fleeing or ignoring the problem, going into denial, using substances

What is general adaptation syndrome?

When a stressor keeps happening for a long time and we eventually experience the exhaustion of our physical and emotional resources

What are the stages of the general adaptation syndrome?

Alarm, resistance, exhaustion

What is the tend-and-befriend response?

Caring for others or increasing social behavior

What are the four ways stress increases illness risk?

• Hampering the immune system and increasing blood pressure

• Tend to fall back into familiar, comfortable health compromising habits like eating, drugs and alcohol

• Socially withdraw, push people away or feel unhappy or discouraged

• Might delay medical care or slip out of our regular treatment plan

What are the main takeaways from the video on stress we watched in class?

The video emphasized that stress affects both mental and physical health, highlighting the importance of coping strategies and social support in managing stress. Also you can’t die from stress

Which part of our brain assess events as stressors? What part of the brain activates our nervous system to respond? Which part of the nervous system is activated?

Cerebral cortex assess if its a stressor

Hypothalamus activates our sympathetic nervous system to respond

What does the HPA axis do? How does chronic HPA activation affect fat stored?

HPA axis releases cortisol; increases fat storage

What is reactivity?

My response to a stressor depends not only on my assessment of the situation (person, environment and fit), but also on how reactive I am to stress in general (determined by nature and nurture)

What is allostasis? What is allostatic load?

Allostasis is how the body responds to stressors in order to regain homeostasis

Allostatic load: effects of long term exposure to chronic stress building up overtime in conjunction with pre existing risks

What effect does high cortisol levels in a stressed mom have on the fetus?

Having high cortisol levels act as a signal to the fetus that it is time to be born, leading to preterm birth

What kinds of events are more stressful?

Things that are unpleasant, uncontrollable/unpredictable, ambiguous, overwhelming, and important

How does anticipating a stressful event compare with the stress of the event itself?

Anticipating can be as stressful as the actual thing

What is the acute stress paradigm?

Laboratory procedure where when people perform stressful tasks (counting backward by 7s) they become psychologically distressed and show physiological arousal

When helping someone reduce their PTSD symptoms which is the better option: distraction from the triggering event or repeatedly talking about it?

Distraction from the triggering event

What major early life stressors can affect your health into adulthood? How does good parenting affect this?

Low socioeconomic status, expose to violence, acculturative stress(adapting a new culture), living in poverty-stricken neighborhoods, community level stressors, physical/sexual abuse

Good parenting mitigated these effects and those who had good parents had lower inflammation

What are the common sources of work stress? What is the major health risk of not having enough down time during the weekend?

• Work overload

• Role ambiguity

• Role conflict

• Lack of good work friends

• Lack of control

• Unemployment

Chronic stress is the major health risk

What is the Japanese word for death due to working too much?

Karoshi

When it comes to multiple roles, which roles are women vs. men more stressed with?

Women are more stressed by adverse changes in the home and men are more financial and work stress

What are stress moderators? What are the things we do to manage stressors called?

Things that change how a stressor affects us; coping : things we do to manage stress

What is negative affectivity? How does it relate to OCEAN? What are its effects?

Tendency to feel more depressed, anxious and/or hostile; cause relationship/job issues, higher reactivity, use ineffective coping strategies like avoidance or drinking

What is Type D personality?

Negative emotions; Social inhibition and isolation; distressed personality

What are the main psychosocial resources that help protect against stress?

• Optimism

• Sense of psychological control

• High self-esteem

• Conscientiousness

• Finding meaning in life

• Intelligence

How can optimism cause more stress?

When expectations aren’t met, stress is increased and compromised immune function

How can being overly cheerful impact your risk of death?

Suppressing your emotions, strained social relationships from toxic positivity, ignoring health problems: just increase risk of death, you die

What does research say about the effects of religion on health and stress?

It can promote well-being, have greater life satisfaction, personal happiness, helpful with coping with stress and leading to better health practices

What is resilience?

Ability to handle stressors, adapt and bounce back when things go wrong

What kinds of stressors respond well to avoidance-oriented coping vs. approach-oriented coping? Which is better overall?

Distraction is good for avoidance-oriented coping since its short-term; Long term stressors like money problems is good for approach coping since you’re working to make things better

Approach oriented coping is better and more effective

What are problem-focused coping, emotional focused coping, and proactive coping?

Problem- focused coping: working to fix the problem (constructive)

Emotional-focused coping: working through your feelings (regulate emotions)

Proactive coping: planning ahead to avoid problems in the future

What are the main resources that help people cope more effectively?

• Money

• Social support

• Time

• Education

• Good job

• Comfortable life

• Positive life events

• Few relative stressors

How do health psychologists assess the effectiveness of a person’s coping efforts?

• Reducing or eliminating stressors

• Tolerating or adjusting to negative events or realities

• maintaining a positive self-image

• maintaining emotional equilibrium

• continuing satisfying relationships with other

• enhancing the prospects of recovery (if ill)

What are the main interventions used in coping skills training? What type of psychology do most of these fall under?

Mindfulness meditation, acceptance and commitment therapy, expressive writing, self-affirmation, relaxation training, stress management (combat stress program)

Falls under stress management

What is a stress carrier?

A person in someone’s environment that causes them stress

What is social support? What are the 4 categories of social support?

Social support: messages that you’re valued, cared for and you belong

1. Giving practical things like money, needed items or helpful task (tangible assistance)

2. Sharing knowledge about something important or stressful (informational support)

3. Nurturance, compassion, and assurance that you’re cared for (emotional support)

4. Help you get without knowing you got it (invisible support) is even more beneficial to your health since you won’t feel any guilt or any inadequacy

How effective is invisible support compared to other kinds?

Knowing it’s there even if the person is unaware, if needed is very beneficial

How can social support be both good for your health and health behaviors and bad for them?

Social support improves health and health behaviors like lowering the likelihood of illnesses and sticking with their medical regimens, but also bad if the group smokes, drinks heavy, or takes drugs, or a lot of stress in the group

What is the direct effects hypothesis? What is the buffering hypothesis? Which is correct?

Direct effects hypothesis: social support is beneficial during stressful and non stressful times

Buffering hypothesis: maintains the physical and mental health benefits

Both are correct

How does having a satisfying marriage affect men vs. women? How does having an unhappy marriage affect men vs. women?

A satisfying marriage is among the most effective, but more so for men

An unhappy marriage is harmful to health, though, especially for women

What is the matching hypothesis?

Social support works best when its matches your partner

What things affect our likelihood of noticing physical symptoms?

• Focus our attention on ourselves rather than environment

• When were stressed or in a bad mood

• Thinking we’ve have an illness/condition from something with a past experience

What is the new term for hypochondriasis?

Illness anxiety disorder

What information fits in each part of a commonsense model of illness?

• Identity- name of the disease

• Causes- what leads to the illness

• Consequences- symptoms, how it may impact the quality of life and how it is treated

• Timeline- how long it lasts

• Control/Cure- the belief of how well it can be managed

• Emotional representation- how you feel about the illness and treatment

• Coherence- how will all of this fit together in a reasonable model of illness

What is the lay referral network?

Thinking you might have an illness and asking family, friends or google to answer your concerns

Who is more likely to use health services? What explains gender differences here?

Kids, elderly people, women, higher SES (socioeconomic status), and people who are isolated.

Women use healthcare more because they have greater sensitivity to body sensations and having to go to more than one doctor for different things while men are seen as tough and only have one doctor

How much of doctors’ time is spend with patients whose symptoms are psychosocial rather than medical?

Between half and two-thirds of doctors time

What are the main reasons for misuse of health services?

Not seeing a doctor when needed to, some psychological symptoms feel like medical problems, delaying help

What are the four periods of delay?

Appraisal delay: the time it takes you to decide a symptom is serious enough to get it looked at

Illness delay: from when you decide a symptom is serious to when you decide to see a doctor

Behavioral delay: from when you decide to see a doctor to when you actually make an appointment

Medical delay: from when you make an appointment to when you get the right treatment; this is more likely when the person doesn’t fit the profile of someone who is likely to get that illness

For HMOs, does it seem like a colleague orientation or a patient orientation would be preferred by patients? Do you typically need a referral or reapproval to see a specialist? What is patient-centered care?

Patient orientation; typically need a referral for HMO; patient centered care is providing patients with information, involving them in decisions regarding care, and consideration of psychosocial issues such as social support needs

What things make miscommunication between the patient and provider more likely?

• Time spent with the provider is often short

• Doctors will interrupt you on average within the first 23 seconds

• the symptoms you think are important may not match up with what the provider thinks are important

• providers may not listen effectively or use jargon or baby talk

• nonperson treatment

What is nonperson treatment?

Providers talk about the illness like the patient isn’t even there

Doctors of what gender give better care? Doctors prefer patients of what gender?

Women doctors give better care; doctors prefer male patients

What portion of patients fail to take all of their antibiotics?

About 1/3 of patients

What makes treatment adherence more likely?

When the doctor gives clear and jargon free instructions, its written down and repeated, the doctor goes over unclear instructions again, and the patient is repeated what they understand; more likely to adhere to advice seen as medical

What is creative nonadherence?

Modifying a prescribed treatment; taking less medicine than prescribed to save money or supplementing it with over-the-counter medications that can sometimes interfere

What are the three main goals of a hospital?

Cure: treating the patient with the goal of healing them (mostly by doctors)

Care: helping the patient be physically and emotionally comfortable (mostly by nurses)

Core: keeping the hospital functioning smoothly and staying afloat financially (administrator)

How does anxiety level effect how well a person does after surgery?

Highly anxious person: did worse after surgery

very low anxious person: did worse after surgery

moderately anxious person: did the best since they knew what to expect because they weren’t too anxious to listen, or too chill to pay attention

What is the goal of the National Center for Complementary and Alternative Medicine?

Evaluate the usefulness and safety of CAM therapies through rigorous scientific investigation and to discern what roles such therapies might have in improving health and health care

After reading about all of the CAM treatments in the chapter, what is the general consensus of research findings about their effectiveness?

Insufficient evidence, not super effective

What does research show about the effectiveness of hypnosis for pain management?

The effects are mixed; Beneficial in reducing pain may be due at least in part to the composite effects of relaxation, reinterpretation, distraction and drugs; for chronic pain its comparable to progressive muscle relaxation

What is a placebo? What qualities of the provider, patient, and treatment make the placebo effect stronger?

Medical procedure that works because the patient believes it will work not because of its physical effects

Effects are stronger when:

• the provider is warm, empathetic, confident, believes in treatment and seems competent

• patients who are easily persuadable, have a need for approval or anxious

• treatments- the situation seems medical and when the drug looks like a drug

What is the nocebo effect?

Hearing about side effects and it can most likely make you experience them

What kind of experiment do drug companies have to use before they can market their drug as effective?

Double line experiment

What is the most common reason patients ask their doctors to help them end their lives?

Not being able to deal with the pain

What is a pain behavior?

Pain behavior are things we do in response to pain, like facial expressions, saying ouch, adjusting our gait or posture and avoidance of activity

How do pain and unpleasant emotions interact?

They both interact w each other, pain makes unpleasant emotions worse and vise versa

What are the four types of nociception?

• Mechanical- damage from pressure, tearing, puncture

• Thermal damage- damage from heat and cold

• Chemical damage- damage from irritating chemicals

• Polymodal- when more than one pain pathway is activated at once

Know the basics of the gate-control theory of pain from the video in class: What is the gate and what does it do, what things can close the gate? What type of pain do A-delta fibers vs. C-fibers transmit?

• The gate control theory of pain explains how pain is transmitted to the brain to be perceived and how pain perception can be reduced

• a delta- fast pains, C fiber short slow 

• The brain decides if it hurts or not by the gate, other things can turn it off

Know the four types of pain: acute, chronic benign, recurrent acute, chronic progressive.

• Acute pain- usually comes from an injury and goes away as it heals; sudden, sharp pain that last a short time

• Chronic pain - starts as acute pain, lasts more than 3 months, 3 types of chronic

  • Chronic benign: 6 months or more, any of several muscle groups, varies in severity, not much response to treatment, does not have clear identifiable cause

  • Recurrent acute pain: acute pain that recurs intermittently for 6 months or more; episodes of sudden, sharp pain that comes and goes

  • Chronic progressive pain: pain that persists for a prolonged period, lasts 6 months or more and gets worse over time

What is the secondary gain people with chronic pain might get from their pain behaviors?

receiving reinforcing attention from others (secondary gains) that encourage pain behaviors 

What personality traits and tendencies are correlated with chronic pain?

• personality traits of neuroticism, introversion,

• Tendencies: use passive coping approaches, suppression of anger 

What is the neurotic triad?

• Hypochondriasis: abnormal anxiety about ones health with an unwarned fear that one has a serious disease

• - Hysteria: disorder of neurlogical systems accompanied by exaggerated/ inappropriate emotional behavior

• - Depression

What are the three types of results pain control techniques can achieve?

• Pain control can mean:

  • Complete numbing

  • Sensation without pain

  • Pain remaining but becoming less concerning or intolerable

How do local anesthetics vs. opiates or antidepressants act to reduce pain perception?

• Local anesthetics: reduce the transmission of pain impulses to the spinal cord

• Opiates: act on the downward pathways from the brain to reduce pain

What are endogenous opioid peptides?

Naturally occurring pain-relieving compounds, endorphins

What is the most commonly prescribed pain medication?

morphine

How long does pain relief from surgery tend to last?

short term, temporary

How well do relaxation and distraction work to reduce pain?

Relaxation like PMR and mindfulness mediation are moderately helpful for reducing acute and chronic pain

- Distraction works moderately well but only for mild acute pain