PSC 126 Midterm 1

Lecture 1 –Introduction to Health Psychology (chapter 1)

o What is the definition of health psychology? Understanding psychological influences on how people stay healthy, why they become ill, and how they respond when they do get ill

o How have the causes of mortality changed since the 1900s compared to recent trends? More preventable disease  

o What are non-communicable diseases (NCDs), and can you provide some examples? What are communicable diseases and can you provide some examples? NCDs are not transferable from one person to another and include things like heart disease, stroke, and cancer

o What is an experiment? How is it different from correlational research? Experiment looks at causality, manipulate IV to get DV, correlational research is non causal

o What is a randomized clinical trial (also known as a randomized controlled trial) or RCT? Why is it considered the “gold standard” of evidence? It is an experiment with randomized participants and trials, gold standard because of strong causality and validity

o What is correlational research? Does one change correspond with a change in another variable 

o What is a prospective research design? Looks forward in time, change over time

o What is a retrospective research design? Looks backwards in time to attempt to reconstruct the conditions that led to a current situation

o Can you define these terms from the field of epidemiology: morbidity, mortality (how are morbidity and mortality different?), prevalence, incidence (how are prevalence and incidence different?), quality of life. Epidemiology: study of frequency, distribution, and causes of infectious and noninfectious disease in a population 

Morbidity: the number of cases that exist of that disease

Mortality: the number of deaths from that disease

Prevalence: the proportion of the population that has the disease

Incidence: the number of new cases per population percentage of a percentage

Quality of Life: measures bodily integrity, feelings of safety, self worth, structure, belonging, social participation, meaningful activities, and inner contentment

o What is epidemiology? What does the term “etiology” mean? Differentiate epidemiology from etiology. Etiology: the origin or cause of an illness

Lecture 2 -Systems of the Body (chapter 2)

o What are the main divisions of the nervous system (central versus peripheral, and subdivisions of the central and peripheral nervous systems). Central: brain and spinal cord 

Peripheral: Autonomic and somatic 

Autonomic: Sympathetic and parasympathetic

o Differentiate between the sympathetic and parasympathetic nervous systems and describe their primary functions.

Sympathetic: fight or flight

Parasympathetic: rest and digest

o Name and locate the four lobes that make up the cerebral cortex (frontal, parietal, temporal, occipital).

o What are some of the most common disorders of the nervous system we discussed in class, and can you match their names to their definitions? Epilepsy, Parkinson’s 

o What is the endocrine system? What is its primary role? Secrete hormones into blood to stimulate change in organs

o Where are the adrenal glands located in the body and what hormones do they produce? Adrenal glands located on the kidneys and produce epinephrine and norepinephrine and cortisol 

o What is diabetes (definition and main symptoms), and what is the difference between Type 1 and Type 2 diabetes? Body cannot able to manufacture or properly use insulin, type 1 is born with, type 2 is acquired  

o Describe the structure of the heart (name the four chambers of the heart) and identify three common disorders of the cardiovascular system (need to know definitions for atherosclerosis, myocardial infarction, and ischemia). 

Right atrium, left atrium, right ventricle, left ventricle 

atherosclerosis: deposits of cholesterol on the arterial walls which form plaques that narrow the arteries which reduces blood flow and interferes with the passage of nutrients from the capillaries into the cells which can lead to tissue damage

Myocardial infarction: heart attack

Ischemia: lack of blood flow and oxygen to the heart

o What is blood composed of? What is plasma? Blood is composed of plasma and red and white blood cells. Plasma is made of plasma proteins and plasma electrolytes

o Describe the structure and function of the respiratory system and identify definitions of common respiratory system disorders discussed in class (asthma, viral and bacterial infections, COPD, pneumonia, tuberculosis, lung cancer). 

Three main functions: take in oxygen, excrete carbon dioxide, and regulate the composition of the blood

Asthma attack: muscles surrounding air tubes constrict and swell, increased mucus is produced, obstructing the airway 

Viral Infections: common cold, bronchitis, influenza

Bacterial Infections: strep throat, whooping cough, diphtheria 

Chronic Obstructive Pulmonary Disease (COPD): lung disease the obstructs airflow, not curable but preventable 

Pneumonia: two types Lobar - primary infection of the entire lung lobe Bronchial - confined to the bronchi, typically a secondary infection that may occur after other disorders like cold or flu

TB: infectious disease that invades lung tissues and can produce cavities in the lung

Pleurisy: inflammation of the pleura, the membrane that surrounds the organs in the thoracic cavity, produces a sticky fluid that is usually a consequence of pneumonia or tb

Lung Cancer: uncontrolled growth in tissues of the lungs, producing rapid and unrestricted cell growth that forms a tumor, may lead to metastasis - the invasion of of adjacent tissue and infiltration beyond the lungs

o Describe the structure and function of the digestive system and identify definition of common digestive system disorders.

food is converted into heat and energy by the process of metabolism, this supplies nutrients for growth and the repair of tissues, but before that, it is converted through the process of digestion into a form suitable for absorption into the blood

Food is lubricated by saliva where it forms a lump called a bolus, moves thru esophagus into stomach, stomach digests food, moves to duodenum, where proteins, carbs and fats are broken down by the pancreas, then moves to the large intestine which stores it

Disorders include: gastroesophageal reflux disease - acid reflux 

gastroenteritis, diarrhea, and dysentery, Ulcers, appendicitis, hepatitis - inflammation of the liver, Dysbiosis - microbial imbalance of the gut

o What are the main components of the renal system? What are the definitions of the discussed disorders of the renal system (urinary tract infections, glomerular nephritis, tubular necrosis, and kidney failure)?

consists of the kidneys, uterus, urinary bladder, and urethra

Glomerular Nephritis - inflammation of the glomeruli in the nephrons of the kidneys that filter blood

Tubular Necrosis - causes acute renal failure, destroys epithelial cells in the tubules of the kidneys, caused by poisons

Kidney failure - the inability the produce an adequate amount of urine will cause the waste products of metabolism to be retained by the body

o What are the main anatomical components of the male and female reproductive systems? Ovaries, fallopian tubes, uterus. Penis, Testes

o What is the main role of the immune system? To resist pathogens 

o How are nonspecific immune mechanisms different from specific immune mechanisms? Nonspecific immune mechanisms are a general set of responses to any kind of infection or disorder. Specific immune mechanisms are acquired after birth and fight particle microoganisms and their toxins 

o Define and differentiate common disorders of the immune system (AIDS, lupus, tonsilitis, infectious mononucleosis, and lymphoma). 

Lupus: skin rash, inflammation, pain

Tonsilitis: inflammation of the tonsils that interferes with the ability to filter out bacteria 

Lymphoma: progressive, chronic enlargement of the lymph nodes, spleen, and other lymphatic organs, nodes cannot effectively produce antibodies

Infectious mononucleosis: a viral disorder marked by an unusually large number of monocytes; it can cause fever, sore throat, and general lack of energy.

AIDS - acquired immunodeficiency syndrome

Lecture 3 –Health Behavior Interventions (chapter 3)

o How are health behaviors and health habits defined and how are they different from each other? 

Habits: health behavior that is firmly established and usually performed automatically

Behavior: behaviors undertaken by people to enhance or maintain their health

o What are the seven positive health habits from the Alameda County Study, and what is their relationship to mortality? 

3) Eating breakfast every day 

4) Having no more than one or two alcoholic drinks each day 

5) Getting regular exercise 

6) Not eating between meals 

7) Being no more than 10% overweight

Reduces mortality

o Define and differentiate primary versus secondary versus tertiary prevention.

Primary prevention: altering problematic behaviors before people develop poor health habits

Secondary prevention: efforts that aim to reduce the impact of a disease or injury that has already occurred 

Tertiary prevention: strategy that aims to soften the impact of an ongoing illness or injury that has lasting effects

o What are some examples of the determinants of health behaviors discussed in class?

Demographic factors, age, personal control, social influence, personal values, perceived symptoms, knowledge and cognition, access to health care

o Define educational appeals and fear appeals to change behavior. 

Educational appeal: appealing to people to change their behavior through education

Fear appeal: appealing people to change their behavior through fear

o Define the health belief model. 

Whether a person practices a health behavior depends on whether the person perceives a personal health threat and whether the person believes that particular health practice will be effective in reducing that threat

o What is self-determination theory? What are autonomous motivation and perceived competence? 

A theory that builds on the idea that people are actively motivated to pursue their own goals

Autonomous motivation: people are autonomously motivated when they experience free will

Perceived competence: the belief that one is capable of making the health behavior change

o Describe cognitive-behavioral approaches to behavior change, what are the self-control of behavior and cognitive restructuring? 

Cognitive behavioral therapy: focuses on the target behavior itself using several methods

Cognitive Restructuring: training people to recognize and modify their internal monologues to promote health behavior change 

o What is self-reinforcement? Differentiate positive self-reward, negative self-reward, positive self-punishment and negative self-punishment. 

Self reinforcement: systematically rewarding oneself to increase or decrease the occurrence of a target behavior

positive self reward - adding a positive stimulus to reward oneself 

negative self reward - removing a negative stimulus to reward oneself 

positive self punishment - adding a negative stimulus to punish oneself

negative self punishment - removing a positive stimulus to punish oneself

o What is motivational interviewing? 

Client centered counseling designed to get people to work through changing their health behaviors, the interviewer is nonjudgmental and encouraging, no advice is given 

o How can relapse be prevented? 

Ask people to identify situations that might lead to relapse, use self talk, cue elimination, exposure therapy

o What is the abstinence violation effect, and how does it relate to relapse? 

Feeling loss of control that results when a person has violated self imposed rules, can lead to serious relapse

o Transtheoretical model of behavior change –what are the main stages of change?

Precontemplation, contemplation, preparation, action, maintenance

o What is social engineering? What are some examples of social engineering? (please see lecture and textbook) 

Modifying the environment in ways that affect people’s abilities to practice a particular health behavior

examples: mandated vaccines, speed limits, seatbelt laws

Lecture 4 –Health-Promoting Behaviors (chapter 4)

o What are the health benefits of regular exercise? 

Can speed up recovery from stress, accelerates wound healing, decreases the risk of chronic diseases such as heart disease, diabetes, and cancer, beneficial for cognitive functioning.

o What are the effects of exercise on psychological wellbeing? 

Improves mood and wellbeing, used as a prescription for depression

o What is the minimum exercise prescription for adults? 

2.5-5 hrs a week of moderate intensity or 1.25-2.5 hrs a week of vigorous intensity

o Describe exercise interventions discussed in class. 

Family based interventions (include whole family) relapse prevention techniques, wearable tech (Fitbit)

o What is the effectiveness of wearable activity trackers? 

Step count is accurate, but calorie burning may not be

o Mammography –what are the pros and cons of recommending its usage, based on breast cancer prevalence statistics?

1 in 8 women get breast cancer, compliance is low, mammography doesn’t prove to be super useful

o What is the primary risk factor for skin cancer? 

Excessive exposure to UV radiation

o What are sun safety practices? (see especially textbook section on this) 

SPF, covering up, no tanning beds

o What are the links between stress and changes in diet? 

Pleasure driven eating - hedonic eating

People may eat more when they are stressed, diets causes stress, leading to relapse

o What are some common interventions to change diet? (see lecture and textbook) 

Family intervention, self affirmation, social support, motivational interviewing

o What are the primary theories for why we sleep?

Energy conservation theory, bodily restoration theory, cerebral restitution theory

o What are the effects of lack of sleep on health? (see lecture and textbook) 

Lack of sleep can affect cognitive functioning, mood, job performance, and quality of life, insomnia can compromise the ability to secrete and respond to insulin and increases the risk of coronary heart disease

o How does the amount of sleep needed per night change across the lifespan? 

Babies need the most sleep, you need less as you get older

o Describe strategies for a good night’s sleep (see lecture and textbook).

Avoid exposure to bright lights an hour before bed, maintain regular sleep and wake schedules, avoid caffeine, don't drink or smoke  

Lecture 5 –Health-Compromising Behaviors (chapter 5)

o Describe alcohol dependence statistics discussed in class: 

o Mortality statistics 

Increase in alcohol related deaths in pandemic, over 108,000 deaths in 2021

o Costs to society  

249 billion dollars annually 

o What is substance dependence? 

Repeatedly self administering substance, resulting in tolerance, withdrawal, and compulsive behavior

o Can you differentiate problem drinking from alcoholism?

Problem Drinking: alcohol consumption that results in social, psychological and medical problems

Alcoholism: physical dependence and inability to control drinking

o What is the connection between alcohol consumption and stress? 

Drinking can occur, in part, to reduce the effects of stress

o What are some treatment programs for alcoholism?

Detoxification in a monitored medical setting

stress management  

abstinence 

controlled drinking 

o How often do people with alcoholism experience relapse? 

As many as 60% of people treated through alcohol programs may return to alcohol abuse

o Is mild alcohol consumption (one drink per day) beneficial for health or not? What is the main controversy surrounding alcohol consumption recommendations? 

Maybe. Some studies show it does, others do not

o What are some chronic diseases associated with smoking cigarettes? 

Lung cancer, breast cancer, depression

o What is the role of pro-smoking media in encouraging smoking? 

‘Cool’ characters who smoke make people more likely to smoke

o Define the “synergistic” effects of smoking. 

Synergy: combined power that is greater than the power achieved by working separately

Smoking boosts the damaging effects of other things like high cholesterol 

o What are some examples of successful interventions to reduce smoking? (please see both lecture and textbook) 

CBT, nicotine replacement, interventions based on transtheoretical model of change, social support, stress management, relapse prevention, interventions with adolescents

o What is the effectiveness of social influence programs to prevent smoking in adolescents?

Reduces experimental smoking, unclear of whether it reduces regular smoking

Lecture 6 –Obesity and Eating Disorders (chapter 5)

o How is obesity defined and what are the prevalence of overweight and obesity in the United States? 

An excessive amount of body fat, 68% overweight 40% obese

o What are some of the biological/health outcomes correlated with obesity?

Poorer cognitive skills, prone to depression, diabetes, hypertension, and heart failure

o What is weight stigma (definition) and how is it related to weight gain? 

Discriminatory attitudes about individuals based on their weight

those who experience weight stigma are less likely to lose weight

o What is an obesogenic environment and how does portion size relate to the prevalence of overweight and obesity in the U.S.? 

Obesogenic environment: environments that promote gaining weight and are not conducive to weight loss

portion sizes have nearly tripled which causes people to eat more food and gain more weight

o Results from NHANES study: how do home-prepared meals compare to fast food andfull-service restaurants in terms of calorie content and nutritional content? 

At home meals total up to less calories and more nutrients than if you eat fast food or full service meals

o What does research show about the effectiveness of dieting and risks for future weight gain? What is yo-yo dieting? 

Dieting doesn’t seem to be very effective, most people who lose weight gain it back within 5 years, causes stress which can undermine dieting

Yo-yo dieting: successive cycles of dieting and weight gain, enhances efficiency of food use and lowers metabolic rate 

o What is the set point theory of weight?

Each individual has an ideal biological weight which cannot be greatly modified

o Define leptin and ghrelin. Identify their role in hunger and satiety. 

Leptin - secreted by fat cells, the satiety hormone, tells you when you’re full

Ghrelin - secreted by specialized cells im the stomach, tells you when you’re hungry

o What are the causes of obesity during childhood?

Adverse social relationships, genetics

o Identify preventative measures for obesity.

Staying active, social engineering, school interventions

o Anorexia vs. bulimia –what are the distinguishing symptoms for each disorder? 

Anorexia - self starvation

Bulimia - alternating cycles of binge eating and purging through vomiting, laxative abuse, extreme dieting, and drug or alcohol use

o What is the U.S. government’s recommendation for the composition of a healthy meal? See https://www.myplate.gov/

50% fruits and vegetables, 50% protein and grains

Lecture 7 –Stress (Part 1) (chapter 6)

o What are the definitions of stress and stressor? 

Stress - negative emotional experience accompanied by predictable biochemical, physiological, cognitive, and behavioral changes that are directed either toward altering the stressful event or accommodating to its effects

Stressor - the stressful event

o Define primary versus secondary appraisal of stressors.

Primary appraisal - occurs as a person is trying to understand what the event is and what it will mean

Secondary Appraisal - assess whether personal resources are sufficient to meet the demands of the environment

o Fight-or-flight response: definition, and which biological systems are activated?

When an organism perceives a threat, the body is rapidly aroused and motivated by the sympathetic nervous system and the endocrine system

o What is the General Adaptation Syndrome and what are the three stages of the stress response?

When a person confronts a stressor, it mobilizes, and regardless of what the threat is, has the same physiological pattern of reactions, but if the person experiences repeated or prolonged stress, there will be wear and tear on the system

Alarm -> Resistance -> Exhaustion

o Describe the main ideas in Taylor’s “tend-and-befriend” theory. 

Theory says that in addition to fight or flight, people respond to stress with social affiliation and nurturant behavior towards offspring

o Describe the function of the HPA axis: which hormones are involved and which glands secrete them?

Hypothalamus releases corticotrophin-releasing hormone (CRH)

Pituitary gland secretes adrenocorticotropic hormone (ACTH)

Adrenal cortex releases glucocorticoids 

o What does the normal diurnal cortisol rhythm look like?

Cortisol should be highest in the morning and go down throughout the day

o Differentiate hypercortisolism (Cushing’s Syndrome) from hypocortisolism (Addison’s Disease). 

Cushing’s Syndrome - excess cortisol 

Addison’s Disease - not enough cortisol

o What are the effects of sympathetic nervous system activation (examples: pupil dilation, secretion by sweat glands) 

Pupil dilation, decreased salivation, acceleration of heartbeat, relaxes airways, inhibits digestion

o What are the four pathways through which stress is thought to cause illness?

o Define and differentiate acute versus chronic stress. 

Acute stress - short, recoverable stress instances

Chronic stress - long term stress 

o What are some of the effects of chronic stress on the brain?

Can produce neurochemical imbalances that may contribute to the development of psychiatric disorders

o What is allostatic load? Identify some examples of measures of allostatic load. 

 The physiological costs of chronic exposure to the physiological changes that result from repeated or chronic stress

Lecture 8 –Stress Part 2 (chapter 6)

o What is an acute stress paradigm?

When people perform stressful tasks, they become psychologically distressed and show physiological arousal 

o What is the Trier Social Stress Test and how is it conducted? 

Interview, countbackwords, tests cortisol levels

o What are life events? Provide a definition and examples of life events typically measured on life events scales used by psychologists. How are life events different from chronic, long-term stress?

Life events are big event markers in your life

life events are not chronic stress because they are usually short term

o What are perceived stress scales?

Scales that measure how much stress a person perceives they are undergoing

o What are daily hassles and examples of hassles as defined by health psychologists?

Daily hassles are small annoyances that can build up and cause damage over time

o What are the advantages and disadvantages of life stress interviews? 

Include central life domains, allow customization for each person, can capture total stress exposure, can incorporate objective ratings

very time intensive and costly

o Acute versus chronic stress and examples of chronic stress

Examples of chronic stress include work stress and relationship stress

o What is work overload? How is karoshi defined?

Work overload is being overloaded with the amount of work they must complete

Karoshi is death from overwork

o Compare and contrast role ambiguity versus role conflict. 

Role ambiguity - no clear expectations

Role conflict - occurs when one is given conflicting feedback or set of tasks 

o What does the demand-control-support model of work stress state?

When high demands and low control are combined with little social support at work you get stress

o What are the differences in life expectancy for African Americans versus Caucasians in the United States?

African Americans have a 4-5 year shorter life expectancy than Caucasians in the United States

o How have labor market experiments revealed evidence of discrimination?

Stereotypically black names get lower callback rates with the same resume

o What has research shown about the links between relationship hostility and metabolic health?

Having a hostile relationship and a history of a mood disorder makes you less likely to lose weight

Lecture 9 –Early-life Stress (Shonkoff article on Canvas)

o What are Adverse Childhood Experiences (ACEs)? Please provide a definition and some examples. Which ACEs are more prevalent and less prevalent in the population according to the classic study by Kaiser Permanente and the CDC (Centers for Disease Control)? 

Examples of ACEs - abuse (substance, mental, physical) mental illness in house, spousal abuse of parents, incarcerated family member, parental separation

more prevalent are physical abuse and household dysfunction

less prevalent are incarcerated family members and emotional abuse

o What are some of the main results from the ACE Study? 

The more ACEs one has, the higher the chance you develop depression, commit suicide, are obese

o What are the primary pathways from ACEs to poor health?

Allostatic load during a sensitive period of development, prenatal and infancy, structural and functional changes in the brain, immune, and metabolic systems

o Prenatal undernutrition –what is it and which health outcomes is it associated with?

Prenatal undernutrition - when the mother does not consume enough nutrients to support the child in the womb

associated with low birth weight and increased chance of obesity later in life and cardiovascular risks

o What is the new approach to health policy suggested by Shonkoff et al. (2021) in the article you read from Canvas? 

Screening for ACEs

o Please define and differentiate among the following three types of stress: toxic stress, tolerable stress, positive stress (this information can be found in the Shonkoff article) 

Toxic stress - characterized by strong, frequent, and/or prolonged activation of stress response systems which can produce disruptions of brain circuitry and other biological systems and lead to health damaging behaviors

Tolerable stress - physiological responses that have the potential to disrupt developing organ systems but generally occur over a limited period of time that allows for recovery

Positive stress - moderate, short lived, physiological responses that are turned on when needed and turned off when not

o What were the goals of Nurse-Family Partnerships?

Improve prenatal care and support families with children 0-2, prevent child injuries, malnutrition, or abuse, improve school readiness and achievement 

o What are the root causes of stress in society according to neurobiologist Robert Sapolsky?

Hierarchy and competition