Exam 2

Question 1

Moderator

Answer 1

A variable that changes the relationship between two other variables
Ex: Exercise is a moderator for stress

Question 2

Coping

Answer 2

The process of trying to manage demands that are appraised as taxing or exceeding one’s resources
Active and changing process, affected by personality

Question 3

Negative affectivity

Answer 3

A personality variable marked by a pervasive negative mood, including anxiety, depression, and hostility; believed to be implicated in the experience of symptoms, the seeking of medical treatment, and possibly illness.
AKA: Neuroticism
On a sliding scale
Associated with a wide variety of negative psychological outcomes including depression, anxiety, substance abuse
Has modest heritability

Question 4

Optimism

Answer 4

Tendency to expect positive outcomes rather than negative outcomes

Question 5

Psychological control

Answer 5

The perception that one has at one’s disposal a response that will reduce, minimize, eliminate, or offset the adverse effects of an unpleasant event, such as a medical procedure.

Question 6

Conscientiousness

Answer 6

The propensity to follow socially-prescribed norms for impulse control, to be task- and goal-directed, to be planful, to delay gratification, and to follow norms and rules
Higher levels of conscientiousness were found to be significantly associated with higher physical activity and lower levels of excessive alcohol use, drug use, unhealthy eating, risky driving, risky sex, suicide, tobacco use and violence

Question 7

4 major coping styles

Answer 7

Approach/Avoidant
Problem focused
Emotion focused
Rumination

Question 8

Approach Coping Style

Answer 8

Aka confrontative, vigilant
The tendency to cope with stressful events by tackling them directly and attempting to develop solutions; may ultimately be an especially effective method of coping, although it may produce accompanying distress.

Question 9

Avoidant Coping Style

Answer 9

Aka minimizing
The tendency to cope with threatening events by withdrawing, minimizing, or avoiding them; believed to be an effective short-term, though not an effective long-term, response to stress

Question 10

Problem-focused coping

Answer 10

Attempts to do something constructive about the stressful situations that are harming, threatening, or challenging an individual.
Beneficial if something can be done about the problem

Question 11

Emotion-focused coping

Answer 11

Efforts to regulate emotions associated with a stressful encounter; can be associated with distress.
Beneficial if nothing can be done about the problem

Question 12

Rumination

Answer 12

Tendency to focus on the negative aspect of the stressor, or the negative emotions experienced as a result of the stressor, in a passive and repetitive way
Decidedly not beneficial to health
Holds one in an ongoing state of negative thoughts and emotions and does nothing to help an individual cope with or move past a stressor.

Question 13

Co-rumination

Answer 13

Sharing negative thoughts and emotions with others who also foster and support those negative thoughts and emotions
Associated with increased symptoms of depression

Question 14

SES and Coping

Answer 14

Those who perceive themselves as having higher SES cope more effectively and have better health outcomes
Several reasons for this; may have more resources than those with lower SES and have less daily stressors

Question 15

Successful coping

Answer 15

Successfully addressing tasks in several domains:

1) reduce stressful environmental conditions
2) maximize the chance of recovery, if relevant
3) adjust to or tolerate negative events
4) maintain a positive self-image
5) maintain emotional equilibrium
6) continue satisfying relationships with others

Question 16

Social support

Answer 16

Information from other people that one is loved and cared for, esteemed and valued, and part of a network of communication and mutual obligation.
Types include: Esteem support, Informational support, Social companionship, Instrumental support
Positive effects on psychological functioning, health behaviors and illness, as well as the ability to cope successfully with stress.
Not measured by number of friends

Question 17

Esteem support

Answer 17

Other people increase one’s self-esteem

Question 18

Informational support

Answer 18

Other people are available to offer advice

Question 19

Social companionship

Answer 19

Support through activities

Question 20

Instrumental support

Answer 20

Physical help

Question 21

2 main hypotheses on how social support influences health

Answer 21

Direct/Main Effect Hypothesis

Buffering Hypothesis

Question 22

Direct/Main Effect Hypothesis

Answer 22

The theory that coping resources, such as social support, have direct beneficial psychological and health effects under conditions of both high stress and low stress
Absence of social support is itself a stressor that can lead to illness

Question 23

Buffering Hypothesis

Answer 23

The hypothesis that coping resources are useful primarily under conditions of high stress and not necessarily under conditions of low stress.
Described using social comparison theory and role theory

Question 24

Social comparison theory

Answer 24

Individuals are able to select appropriate coping strategies by comparing themselves to those around them

Question 25

Role theory

Answer 25

As individuals experience differing stressors, they can change their roles to deal most appropriately with the stressor as friend, CEO, mother, wife and so on. Having other people in one's network allows one to select roles as appropriate to meet the demands of the stressor.

Question 26

Coping interventions

Answer 26

Mindfulness CBT Exercise

Question 27

Mindfulness

Answer 27

Involves the ability to be fully present in the current moment and to pay attention to the thoughts, emotions and sensations one is feeling at any given time. Calls on individuals to be free of judgment and to accept things as they are in the moment.

Question 28

Cognitive-Behavioral Therapy

Answer 28

Form of psychotherapy that addresses the thoughts and behaviors that lead to negative emotional states such as depression and anxiety.

Question 29

Exercise

Answer 29

Can be helpful for individuals in terms of putting nervous energy to use, thereby helping to cope with anxiety Can also be activating for individuals who are suffering from depression, thereby improving mood

Question 30

Pain

Answer 30

An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage Cannot be measured objectively; is subjective Includes physical and emotional components Critical feedback system to keep us healthy and safe

Question 31

Theories of pain

Answer 31

Specificity theory Pattern theory Gate-control theory (GCT)

Question 32

Specificity theory

Answer 32

``` Individual nociceptors (pain receptors) deliver pain stimuli directly to specific corresponding areas of the brain via pain pathways known as A-delta fibers and C-fibers, thereby triggering the recognized experience of pain and subsequent pain behaviors. Greater the intensity of stimulus, greater the intensity of pain experienced ```

Question 33

3 problems with specificity theory

Answer 33

1. No evidence supporting notion of specific brain locations for pain 2. Pain fibers do not only respond to pain, but to other sensations as well, including temp. and pressure 3. Does not seem to be a 1:1 relationship between stimulus intensity and intensity of pain experience (differs across individuals and situations)

Question 34

Pattern theory

Answer 34

Stimulation of nociceptors in body generate patterns of impulses that are transmitted to the dorsal horn of the spinal cord. If patterns exceed a given threshold, info about pain is then transmitted to brain and pain is perceived Advantage: allows for stimulation of nociceptors without automatic experience of pain (i.e., sub-threshold stimulation) accounting for the lack of pain in the presence of some stimulation.

Question 35

Problems with pattern theory

Answer 35

1. Some people experience pain in absence of stimulation of nociceptors (phantom limb pain) 2. Some people don't experience pain immediately, but after the event

Question 36

Gate-control theory (GCT)

Answer 36

Pain is a multidimensional perceptive experience that is subjective and includes physiological and psychological components There is a gating mechanism in dorsal horn of spinal cord that inhibits or allows transmission of pain info to the brain. Dorsal horn receives info from nociceptors and brain about psychological state of individual Info from both directions influences conscious experience of pain Advantage: allowance for a role of psychological factors in the experience of pain.

Question 37

Problems with GCT

Answer 37

1. No direct evidence of gating mechanism in dorsal horn. | 2. Not able to account for phantom limb pain

Question 38

Relationship between mood and pain

Answer 38

Bidirectional | Anxiety, depression, and anger all positively associated with perceived intensity of pain

Question 39

Anxiety

Answer 39

Typical consequence of pain | Adaptive response, but increased anxiety can perpetuate itself and increase likelihood of pain

Question 40

Depression

Answer 40

Serotonin and norepinephrine involved in both depression and pain

Question 41

Anger

Answer 41

Can increase muscle reactivity that can contribute to pain | Can overburden endogenous opioid system in brain, inhibiting the body's natural ability to manage pain

Question 42

Substance abuse

Answer 42

Linked with chronic pain, mood and anxiety disorders

Question 43

Catastrophic thinking

Answer 43

Aka catastrophizing Dysfunctional thought or cognitive error Tendency to predict future negatively without consideration of other, more likely outcomes 3 main components: rumination, magnification, and helplessness Linked to incidence of pain and transformation of acute to chronic pain Associated with depression

Question 44

Rumination

Answer 44

Going over and over the same idea or focusing exclusively on one idea, such as pain

Question 45

Magnification

Answer 45

Tendency to overestimate the degree of threat or harm

Question 46

Helplessness

Answer 46

Underestimation of personal and other resources available for coping

Question 47

Perceived control

Answer 47

Refers to both cognitive and behavioral control | Low levels linked to higher disability levels related to chronic pain and depression

Question 48

Cognitive control

Answer 48

Extent to which individuals can control their thoughts to cope with pain Ex: through distraction

Question 49

Behavioral control

Answer 49

Ability to alter behavior in a way that either eases painful stimuli or enhances coping Ex: relaxing tense muscles to ease pain

Question 50

Secondary gain

Answer 50

Benefits of being treated for illness, including the ability to rest, to be freed from unpleasant tasks, and to be taken care of by others. Can be a motivator to engage in illness-related behaviors Not necessarily a conscious, deliberate process

Question 51

Conditioning

Answer 51

Process by which individuals learn to respond to cues or stimuli in their environments. Can increase frequency or severity of pain behavior and possibly also perception of pain intensity

Question 52

Analgesic drugs

Answer 52

Painkillers | Range from OTC like Tylenol to more intense narcotics like Vicodin

Question 53

Opioid

Answer 53

Narcotics Act on opioid receptors in brain- endogenous pain control system High potential for abuse and addiction

Question 54

Nonsteroidal anti-inflammatory drugs (NSAIDS)

Answer 54

Ibuprofen, Naproxen, Meloxicam, Fenoprofen Not addictive Can be prescribed in conjunction with opioids

Question 55

Muscle relaxants

Answer 55

Help control musculoskeletal pain | Valium, Flexeril

Question 56

Antidepressants

Answer 56

Cymbalta | Have some efficacy in treating chronic pain

Question 57

Epidural steroid injections

Answer 57

Sometimes used to reduce inflammation in an attempt to reduce pain

Question 58

Transcutaneous electric nerve stimulation (TENS)

Answer 58

Electrical stimulation of nerve endings to reduce pain

Question 59

Acceptance and commitment therapy (ACT)

Answer 59

Blend of cognitive behavioral therapy and mindfulness that seeks not to control or help individuals avoid pain, but to learn to cope with it and live a productive, rewarding life worth living with the pain There is a difference between pain and suffering Pain cannot always be avoided, but suffering is something an individual can choose to engage in or not

Question 60

Pain behaviors

Answer 60

Behaviors that arise from chronic pain, such as distortions in posture or gait, facial and audible expressions of distress, and avoidance of activities

Question 61

Pain-prone personality hypothesis

Answer 61

A constellation of personality traits that predispose a person to experience chronic pain Ex: Neuroticism, introversion, and the use of passive coping strategies

Question 62

Counterirritation

Answer 62

Inhibiting pain in one part of the body by stimulating or mildly irritating another area.

Question 63

Biofeedback

Answer 63

Method of achieving control over a bodily process | Providing biophysiological feedback to a patient about some bodily process of which the patient is usually un- aware.

Question 64

Health literacy

Answer 64

The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions

Question 65

Palliative care

Answer 65

Medical care designed to help patients feel more comfortable, rather than to cure disease Involves not merely pain relief, but attending to the emotional and spiritual needs of the patient in addition to physical needs Takes a team of people

Question 66

6 aspects of a good death

Answer 66

1. pain and symptom management 2. clear decision-making 3. preparation for death 4. completion (spiritual) 5. contributing to others 6. affirmation of the whole person

Question 67

Quality of life

Answer 67

The degree to which a person is able to maximize his or her physical, psychological, vocational, and social functioning; an important indicator of recovery from or adjustment to chronic illness.

Question 68

Major depressive disorder (Depression)

Answer 68

A neurotic or psychotic mood disorder marked especially by sadness, inactivity, difficulty with thinking and concentration, a significant increase or decrease in appetite and time spent sleeping, feelings of dejection and hopelessness, and sometimes suicidal thoughts or an attempt to commit suicide. 10–25 percent among women and 5–12 percent among men Common and can range from mild to extremely debilitating. Strong links between depression and cardiac illnesses, and between depression and chronic pain Significantly positively associated with smoking and drinking problems, as well as reduced physical activity Individuals with depression have more frequent and more intense reports of physical pain

Question 69

Mood disorders

Answer 69

Depression Bipolar disorder Dysthymia

Question 70

Bipolar disorder

Answer 70

Depressive episodes and manic or hypomanic episodes

Question 71

Dysthymia

Answer 71

A milder, more chronic version of depression

Question 72

Major Criteria for Depression

Answer 72

1. Depressed mood most of the day, nearly every day 2. Diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day 3. Significant weight loss (when not dieting) or significant weight gain or decrease or increase in appetite 4. Insomnia or hypersomnia nearly every day 5. Psychomotor agitation or retardation nearly every day 6. Fatigue or loss of energy nearly every day 7. Feelings of worthlessness or excessive or inappropriate guilt 8. Diminished ability to think or concentrate, or indecisiveness nearly every day 9. Recurrent thoughts of death, recurrent suicidal ideation or a suicide attempt or plan *Must experience at least 5 over a 2 week period

Question 73

Anxiety disorders

Answer 73

Approximately 29 percent of people suffer from at least one anxiety disorder Comorbid with other anxiety disorders, as well as with mood disorders. Physical symptoms including tight chest, heart palpitations, physical restlessness and muscle tension Associated with a variety of physical illnesses including cardiac disorders, hypertension, gastrointestinal problems, genitourinary disorders and migraine Can exacerbate the experience of pain and chronic pain has been linked to anxiety disorders. Association of anxiety with respiratory illnesses is significant Cognitive behavioral therapy and relaxation therapy can be very helpful

Question 74

Types of Anxiety Disorders

Answer 74

``` Agoraphobia Panic Disorder Specific Phobia Social Phobia OCD PTSD Generalized Anxiety Disorder ```

Question 75

Agoraphobia

Answer 75

Anxiety about being in places/situations from which escape might be difficult/embarrassing should a panic attack happen

Question 76

Panic Disorder

Answer 76

Presence of one or more panic attacks: | Discrete period of intense fear/discomfort with 4+ of the following that start abruptly and peak within ten minutes

Question 77

Specific Phobia

Answer 77

Persistent fear that is excessive or unreasonable, cued by presence or anticipation of specific object or situation. Subtypes: animal, natural environment (e.g,. storms), blood-injection, situational (e.g., bridges, tunnels)

Question 78

Social Phobia

Answer 78

Persistent fear of 1+ social or performance situations where one is exposed to unfamiliar people or possible scrutiny Exposure to the situation provokes anxiety Recognition that the fear is excessive/unreasonable Feared situations are avoided or endured w/ intense distress

Question 79

OCD

Answer 79

Obsessions Recurrent and persistent thoughts/impulses/images experienced as intrusive and inappropriate, causing anxiety Attempts are made to ignore or suppress them Recognition that these are a product of one's own mind Compulsions Repetitive behaviors or mental acts that one feels driven to perform in response to an obsession according to rigid rules Behaviors or mental acts aimed at preventing or reducing distress

Question 80

PTSD

Answer 80

Exposure to a traumatic event involving actual or threatened death or injury and responded to w/ fear, helplessness or horror Persistent re-experiencing of event (dreams, intrusive thoughts, flashbacks) Persistent avoidance of reminders of the trauma and numbing of responsiveness Persistent increased arousal (hypervigilance, increased startle response)

Question 81

Generalized Anxiety Disorder

Answer 81

Excessive worry and anxiety more days than not for at least six months about a number of events or activities Worry is difficult to control Accompanied by 3+ physical symptoms (restlessness, fatigue, difficulty concentrating, irritability muscle tension, sleep disturbance)

Question 82

Somatoform Disorders

Answer 82

Characterized by the presence of physical symptoms that have no known or identifiable physical/organic cause. Physical symptoms are not intentionally produced or faked Hypersensitivity combined with a tendency toward catastrophic thinking could provide one explanatory model for somatization symptoms

Question 83

Types of Somatoform Disorders

Answer 83

``` Somatization Disorder Conversion Disorder Pain Disorder Hypochondriasis Body Dysmorphic Disorder ```

Question 84

Somatization Disorder

Answer 84

Many physical complaints over several years: 4 pain symptoms (pain in four different sites/functions) 2 gastrointestinal symptoms 1 sexual symptom 1 pseudoneurological symptom Symptoms are not due to a known medical condition or are in excess of what would be expected from a medical condition Often results in feelings of rejection and distress at not being believed or being dismissed.

Question 85

Conversion Disorder

Answer 85

One or more deficits in voluntary motor or sensory function Psychological factors are associated with the symptom, preceded by conflict or stressor Symptom cannot be explained by a medical condition

Question 86

Pain Disorder

Answer 86

Pain in 1+ anatomical sites | Psychological factors are associated with the onset, severity, exacerbation or maintenance of the pain

Question 87

Hypochondriasis

Answer 87

Preoccupation with having, or belief one has, a serious disease Preoccupation persists despite medical evaluation and reassurance Duration is at least 6 months

Question 88

Body Dysmorphic Disorder

Answer 88

Preoccupation with an imagined defect in appearance

Question 89

Cognitive Behavior Therapy

Answer 89

The use of principles from learning theory to modify the cognitions and behaviors associated with a behavior to be modified; cognitive-behavioral approaches are used to modify poor health habits, such as smoking, poor diet, and alcoholism. Best for depression and anxiety Identifying dysfunctional thoughts that cause or maintain the symptoms Behaviors that may be exacerbating or continuing the symptoms are identified and replaced with more adaptive behaviors.