Health Psych Midterm 2

Lecture 10 –Coping 

o What is the definition of coping? What are the stages of the coping process?

Coping - the thoughts and behaviors used to manage the internal and external demands of situations that are appraised as stressful

Stressful event -> appraisal and interpretation -> coping responses and strategies -> coping tasks -> coping outcome

o Personality and coping –differentiate negative affectivity versus positive affectivity 

Negative affectivity - a pervasive negative mood marked by anxiety, depression, and hostility 

Positive affectivity - a pervasive positive mood

o Psychosocial resources –list examples. 

Positive affectivity, self esteem, conscientiousness, self confidence, being smart, emotional stability

o What is the definition of resilience and examples of resources that promote resilience?

Resilience - ability to bounce back and adapt

resources that promote resilience include, sense of coherence and purpose in life, sense of humor, trust in others, sense that life is worth living, religious beliefs

o What is the relationship between religious beliefs and health?  

Religion may prohibit unhealthy behaviors, increase social support, can promote self esteem, can reduce anxiety about death, and can increase sense of control

o What is coping style? Make the distinction between avoidant and approach coping style 

Coping style is a propensity to deal with stressful events in a particular way

avoidant coping avoids the problem 

approach coping faces the problem head on

o Define and distinguish problem-focused and emotion-focused coping.

Problem focused coping: involves attempts to do something constructive about stressful situations 

Emotion focused coping: involves efforts to regulate emotions 

o What are some examples of external resources for coping? 

Time, money, education, job, friends, family 

o What the main stages of collective coping with tragedy? 

1. Emergency stage - talk and think about the event

2. Inhibition stage - reduced discussion but continued thinking

3. Adaptation stage - both talking and thinking is diminished

o What is John Henryism?

A coping mechanism where individuals, particularly African Americans, work harder and longer (high effort) to prove their worth to meet perceived expectations (psychosocial environmental stressors)

o Provide examples of successful coping outcomes.  

Reducing or eliminating stressors, tolerating or adjusting to negative events or realities, maintaining positive self image, maintaining emotional equilibrium, and more

o Describe mindfulness meditation.

A state of mind marked by heightened awareness of the present moment 

o Describe Acceptance and Commitment Therapy (please see lecture and textbook).

An intervention that incorporates mindful awareness and acceptance that says pain, grief, and illness are inevitable

o Describe expressive writing.

Writing about your emotions can help improve stress

o Describe self-affirmation.

Self affirmation is a technique through which people affirm values that are importantly to them and it can reduce defensiveness about personally relevant risk information and consequently make people more receptive to reducing their risk

o Describe progressive muscle relaxation.

Tighten up each muscle one by one and then relax them

o What is coping effectiveness training? (examples of skills taught in coping effectiveness training programs, please see lecture and textbook) 

Training to help teach people how to develop coping skills and stress management 

Lecture 11 –Social Support 

o How is social support defined? Describe types of social support (emotional, instrumental, material). 

Social support is information from others that say one is loved and cared for, esteemed and valued, part of a network of communication, and has mutual obligations

emotional support - providing care, empathy and validation

informational support - providing useful information

material support - providing tangible goods and services to aid the person

o What is the relationship between social relationships/social support and mortality?

Social support reduces the risk of mortality

o Describe the biopsychosocial pathways linking social support and health: 

o a) how social support affects cortisol responses

Social support lowers cortisol responses to stress

o b) how social networks affect immune function

Social support improves immune response

o c) how social support affects neural activity (examples of neural regions activated by social support) 

Social support lowers physiological and neuroendocrine responses to stress

o What types of behaviors have been linked to oxytocin release? 

Envy, xenophobia, mistrust, gloating

o Differentiate the direct effects hypothesis versus the buffering hypothesis of how social support benefits health. 

Direct effects hypothesis - social support has main or direct effects on physical and mental health, even during non stressful times

Buffering hypothesis - social support is linked to physical and mental health benefits because it buffers against stress

o What are some examples of effective and ineffective kinds of social support? What is the matching hypothesis?

Effective kinds of social support include familial support, marriage, community support

the matching hypothesis says that support that matches the needs of of a stressful event are the most effective

o Describe beneficial support systems (especially family-based and community-based). 

o How prevalent is loneliness? 

25% of Americans are chronically lonely

o Which chronic loneliness interventions are most effective for adults? 

Social engagement, social skills training, social support provision, changing social-cognitive bias

Lecture 12 – Health Care Services 

o Define hypochondria and cyberchondria. 

Hypochondria - illness anxiety disorder, the belief that normal bodily symptoms are indicators of illness

Cyberchondria - online diagnosis anxiety

o What is the role of attentional differences in symptom perception? 

People focused on themselves are more likely to recognize symptoms rather that people not focused on themselves 

o What is the role of stress in symptom perception? 

People under stress may believe they are more vulnerable to illness

o What are some of the causes of problems in patient –provider communication?

Providers struggle with inattentiveness, overuse of medical jargon, baby talk, depersonalization, stereotypes of patients

Patients struggle with inattentiveness, poor health literacy, inability to present complaints effectively, under and over reporting symptoms

o What are some recommended strategies for improving patient –provider communication? 

To improve provider communication they must listen, use clear, jargon free explanations, repeat instructions, write down instructions, single out and clarify recommendations, use simple, warm, and supportive behaviors, and watch nonverbal communication

To improve patient communication they must come prepared with descriptions of symptoms, think of questions ahead of time, listen, and ask clarifying questions

o Define and describe the commonsense model of illness. 

A set of beliefs held by people about their symptoms and illnesses that results in organized illness representations including the identity, cause, timeline, consequences, control, and cure of the illness

o What is a lay referral network?

A network of family and friends who offer advice before treatment is sought

o Describe the stages of delay in seeking treatment for symptoms. 

Appraisal delay - time taken to decide if symptoms are serious 

Illness delay - time between recognition and the decision to seek treatment

Behavioral delay - time between deciding to seek treatment and actually doing so

Medical Delay - the time between calling for an appointment and actually receiving medical care

o What are the causes of delay in seeking treatment for symptoms?

o Which criteria can be used to compare healthcare systems? 

Lecture 13 –Management of Chronic Illness 

o How is chronic disease defined? Provide some examples (see lecture and textbook). 

A chronic disease lasts 3 or more months and has no complete prevention or cure

examples: cancer, diabetes, arthritis, asthma, fibromyalgia 

o What are the top two leading causes of death in the U.S.?

Chronic diseases - heart disease and cancer

o Define quality of life measures and describe some of their components. 

Physical functioning, psychological status, social functioning, disease or treatment related symptoms

o What are common emotional responses to chronic illness –denial, depression, anxiety (define each)

Denial - defense mechanisms by which people avoid implications of a disorder

anxiety and depression

o What are the effects of chronic illness on self-concept, self-esteem, and body image (see lecture and textbook)?

Self concept - stable set of beliefs about one’s personal qualities and attributes 

Self esteem - an evaluation of your self concept, good or bad

Body Image - perception and evaluation of one’s physical functioning and appearance

Chronic illness can decrease all of these

o What are some of the coping strategies commonly used by cancer patients (e.g., cognitive versus behavioral escape)?

Cognitive escape - mentally avoiding stressors

Behavioral escape - physically avoiding stressors

o What is flexible coping?

Adjusts to the situation 

o What are some common positive emotional changes in response to chronic illness?

Optimism, inspiration to act now, more empathy and compassion, feeling more self assured

o Provide examples of psychological interventions for patients with chronic illness. 

Pharmacological interventions, individual therapy, relaxation and stress training, ACT, MBSR, exercise 

o How does individual therapy for patients with chronic illness differs from therapy with clients who do not have chronic illness? 

Lecture 14 –Chronic Illness: Heart Disease & Related Conditions 

o Define coronary heart disease and describe some risk factors associated with it. 

Coronary Heart Disease (CHD) - illnesses caused by atherosclerosis 

risk factors - high cholesterol, high blood pressure, elevated inflammation, diabetes

o Define metabolic syndrome, describe its symptoms and what this syndrome is a risk factor for. 

Metabolic syndrome - 3 or more of the following problems: obesity centered around the waist, high blood pressure, low levels of HDL, difficulty metabolizing sugar, high levels of triglycerides

o How does a myocardial infarction (heart attack) happen?

Plaque builds up on walls of arteries, plaque ruptures, blood clot forms and blocks blood flow 

o What is the role of stress in the development of coronary heart disease?

Stress’s cumulative effects lead to damage of endothelial cells

o What are some of the differences between men and women with respect to the development of coronary heart disease?

Men get them earlier in life, women die more frequently from their first one

o Why are depression and coronary heart disease linked? 

Depression affects the development, progression, and mortality from CHD

o What are some of the psychosocial aspects involved in the management of heart disease?

o Define hypertension. 

High blood pressure

o Define systolic and diastolic blood pressure. 

Systolic - the greatest force developed during contraction of the heart’s ventricles

Diastolic - pressure in the arteries when the heart is relaxed

o What are the primary risk factors for hypertension? 

Childhood temperament and blood pressure reactivity, gender, genetic factors, emotional factors, family environment, stress

o Define stroke, describe some of its primary causes, warning signs, and risk factors. 

Stroke - disturbance in blood flow to the brain

warning signs include loss of balance, loss of vision in one or both eyes, uneven face, arm weakness, and speech difficulty

o What is type 2 diabetes, and what are its symptoms and risk factors?

Acquired insulin resistance

symptoms include, frequent urination, fatigue, frequent infection of the skin, gums, or urinary system, pain or cramps in legs, feet, or fingers, slow healing of cuts and bruises, intense itching and drowsiness

Risk factors include, being overweight, getting little exercise, having high blood pressure, having a sibling or parent with diabetes, having a baby weighing over 9 pounds at birth.

Lecture 15 –Immune-Related Disorders (Psychoneuroimmunology lecture)

o What is psychoneuroimmunology (PNI)? 

The study of the interactions between psychological experiences, the activity of the brain, and that of the immune system

o What are the main functions of the immune system?

To distinguish between itself and foreign objects and attack and rid the body of the invaders

o Differentiate innate versus acquired immunity. 

Innate - provides generalized defense against pathogens

Acquired - delayed response to a specific invader that is acquired through vaccines or contracting a disease

o What are some examples of immune cells and what are their functions (focus only on macrophages, neutrophils, NK cells, B cells and T helper cells)?

B cells - produce and secrete antibodies

T cells - operate at the cellular level

NK cells - attack tumor cells and virus infected cells

o What is C-reactive protein (CRP)? What is the cutoff for elevated CRP levels? 

C-reactive protein is a protein made by the liver when inflammation is high

3 mg/l is high risk 10 mg/l is either an ongoing infection or incredibly high 

o What are the primary psychological risk factors linked to poor immune functioning?

Stress, depression, insecure attachment, chronic interpersonal stress, marital conflict, partner violence, caregiving for someone ill, loneliness

o What are some of the protective factors (i.e., beneficial factors) for immune functioning?

Social support, finances, optimism, personal control, prioritizing goals, emphasizing relationships, personal growth, meaning in life

o HIV infection –what it is, which immune cells are most under attack, how it progresses

A virus that attacks the T helper cells and macrophages of the immune system, progresses very quickly in the first few weeks, then stabilizes 

o Which psychosocial factors increase or decrease the speed of HIV progression? 

Factors linked to sped up disease progression - negative beliefs about the self and future, depression, stress, trauma, psychological inhibition

Factors linked to slowed down disease progression - optimism, active coping, extraversion, conscientiousness, spirituality

o How is cancer defined? What are some risk factors for cancer? Define carcinogen 

Cancer - a set of more than 100 diseases with different causes and courses

risk factors - family history, race/ethnicity, culture, lifestyle, socioeconomic status, marital status, diet

Carcinogen - a substance or exposure that causes cancer

o Stress and cancer -how are they linked? 

Cancer flourishes when stress hormone levels are high

o What are some common interventions for helping patients adjust to cancer? 

Stress reduction interventions, promoting social support, finding meaning, writing interventions, individual or family therapy 

o Define and differentiate rheumatoid arthritis vs. osteoarthritis. 

Rheumatoid arthritis - affects the small joints of the hands, feet, wrists, knees, ankles, and neck, it is brought about by an autoimmune process

Osteoarthritis - articular cartilage begins to crack or wear away because of overuse, injury or other causes, affects the weight bearing joints 

o What is the definition of type 1 diabetes? What is the main cause for type 1 diabetes, and the most typical age range for its onset? 

Type 1 Diabetes - an autoimmune disorder characterized by the abrupt onset of symptoms resulting from lack of insulin production by the beta cells of the pancreas

likely genetic, can appear following a viral infection or stress

arises usually between ages 5-6 or 10-13