Exam 3

Question 1

Alcohol

Answer 1

A depressant that acts on the central nervous system and produces a variety of sensations that many people experience as pleasurable including relaxation, euphoria and loss of inhibitions among others

Question 2

A standard drink in the United States

Answer 2

12 g pure alcohol

Question 3

Safe drinking limits

Answer 3

No more than 4 standard drinks in a day for men (14 weekly) and no more than 3 standard drinks per day for women (7 weekly).
Drinking levels in excess of these limits place individuals at risk for negative health effects and problem drinking.

Question 4

Problem drinking

Answer 4

Encompasses a wide range of drinking behaviors from at-risk drinking to binge drinking to alcohol dependence.

Question 5

Binge drinking

Answer 5

Defined by blood-alcohol content (BAC) but is generally considered 5+ drinks in one setting for men and 4+ drinks for women

Question 6

At-risk drinking

Answer 6

Drinking in excess of the limits defined above by NIAAA

Question 7

Alcohol abuse and alcohol dependence are what type of disorder?

Answer 7

Substance abuse disorders

Question 8

Alcohol abuse

Answer 8

Maladaptive pattern of alcohol use causing impairment or distress as manifested by at least one of the following criteria in a 12-month period:
Recurrent use resulting in failure to fulfill major role obligations at home, work or school
Recurrent use in situations in which it is physically hazardous
Recurrent alcohol-related legal problems
Continued use despite persistent or recurrent social or interpersonal problems known to have been caused or exacerbated by the alcohol use

Question 9

Alcohol dependence

Answer 9

Three or more of the following criteria in a 12-month period:
Tolerance
Withdrawal
Alcohol taken in larger amounts or over longer periods than intended
Persistent desire or unsuccessful efforts to cut down or control alcohol use
Great deal of time spent in activities necessary to obtain, use or recover from effects of alcohol
Social, occupational or recreational activities are given up or greatly reduced because of alcohol use
Alcohol use is continued despite knowledge of persistent physical or psychological problems that are known to be caused or exacerbated by alcohol use

Question 10

Tolerance

Answer 10

Need for more alcohol to achieve the same effect, or reduced effect from the same amount of alcohol

Question 11

Withdrawal

Answer 11

Characteristic alcohol withdrawal syndrome in absence of alcohol or consumption of alcohol to avoid withdrawal symptoms

Question 12

List two factors that are associated with effective alcohol treatment programs.

Answer 12

Factors include six to eight weeks of participation, identification of triggers and skills to cope with them, provision of aftercare and involvement of significant others in treatment.

Question 13

Leading cause of preventable death in the United States

Answer 13

Smoking

There is no safe level of cigarette smoking like alcohol.

Question 14

Illicit drugs

Answer 14

Marijuana, cocaine, heroin, methamphetamine and methylenedioxymethamphetamine (MDMA), or ecstasy, among others

Question 15

Prescription medications

Answer 15

Can also be abused and lead to addiction.

Primary among these medications are narcotics or opioids

Question 16

Marijuana

Answer 16

Most commonly abused drug in the world, with the highest rates of use in the United States, Canada and Australia
Achieves its effects on the body by mimicking the neurotransmitter dopamine in the brain.
One of the functions of dopamine is to regulate sensations of pleasure. The rewarding features of dopamine are the prolonged sensations of pleasure as it floods the brain, which is what causes many people to want to use it repeatedly
NOT a harmless drug
Health effects of repeated use of marijuana include short-term memory deficits, increased blood pressure and consequent risk of heart attack, sexual dysfunction, weakened immune functioning and increased risk of cancer.
Contains 50–70 percent more carcinogens than tobacco cigarettes

Question 17

Cocaine

Answer 17

Cocaine and its less-refined version, crack, are derived from the coca plant most prominently found in South America.
Both forms are extremely addictive.
Acts on the dopaminergic system of the brain; blocks the ability of neurons to reuptake dopamine, thereby producing prolonged feelings of elation and euphoria.
Negative health effects: increased body temperature, heart rate, blood pressure and irregular heartbeats; increased risk of heart attack or cardiac arrest, can cause seizures, abdominal pain, nausea, nosebleeds and other gastrointestinal problems.

Question 18

Heroin

Answer 18

Heroin produces an initial feeling of euphoria, followed by an extremely sedated period that alternates between low-level wakefulness and drowsiness.
Negative health consequences: collapsed veins from repeated injections, increased risk of infectious diseases such as HIV/AIDS and hepatitis, liver disease, infection of the heart lining and risk of death from depressed respiratory system when users stop breathing.

Question 19

Methamphetamine

Answer 19

Stimulant that is exceptionally addictive and produces many sensations similar to those of cocaine
Acts on the dopamine receptors of the nervous system.
Health risks: damage to the central nervous system, increased heart rate, blood pressure and irregular heartbeats. Hyperthermia, convulsions, anxiety, irritability, insomnia and confusion.

Question 20

MDMA (ecstasy)

Answer 20

Produces an intense high and stimulation.
Negative health effects: interference with the body’s ability to regulate its temperature, extreme thirst, liver, kidney and cardiovascular complication

Question 21

Prescription Drugs

Answer 21

3 main classes of prescription medication that are commonly abused: opioids, depressants and stimulants

Question 22

Opioids

Answer 22

Aka narcotics; are prescribed to treat pain and include morphine-based and codeine-based medicines.
Common opioids: hydrocodone (Vicodin) and oxycodone (OxyContin, Percocet).
Inhibit the experience of pain by blocking opioid receptors in the brain. Also produce a sedative effect and when taken in higher doses than prescribed can lead to respiratory depression, cognitive problems, drowsiness, constipation and even death

Question 23

Depressants

Answer 23

Medications that are commonly used to treat anxiety and include barbiturates (phenobarbital) and benzodiazepines.
Barbiturates are prescribed much more rarely than benzodiazepines because of the dangers associated with overdose.
Common benzodiazepines: alprazolam (Xanax), diazepam (Valium), and lorazepam (Ativan).
Benzodiazepines work by enhancing the function of the neurotransmitter GABA in the brain and produce a sedative, hypnotic effect as well as muscle relaxation.
Run a high risk of addiction and can produce tolerance and withdrawal.
Other negative effects when misused include lowered blood pressure, dizziness and disorientation as well as unconsciousness and death.

Question 24

Stimulants

Answer 24

Prescribed to enhance energy and increase attention and are often prescribed for individuals with attention-deficit/hyperactivity disorder (ADHD).
When misused, they can produce feelings of increased motivation, wakefulness and productivity as well as improving mood and inducing feelings of euphoria. Common stimulants: amphetamine (Adderall) and methylphenidate (Ritalin).
Can increase blood pressure and heart rate as well as body temperature and feelings of irritability and paranoia.

Question 25

Theories of Addiction

Answer 25

``` Cognitive-Affective Social Learning Conventional Commitment Personality Trait Integration ```

Question 26

Cognitive-Affective theory of addiction

Answer 26

Three factors that increase likelihood of substance use: 1. Positive attitudes about substance use 2. Endorsement of use by others 3. Perception that benefits outweigh costs

Question 27

Social learning theory of addiction

Answer 27

Role models, such as friends, parents and so on, who model use of substances

Question 28

Conventional commitment theory of addiction

Answer 28

Commitment to conventional social institutions (school, family, etc.) buffer against substance use. Weak ties increase likelihood of use.

Question 29

Personality Trait theory of addiction

Answer 29

Stress and low self-esteem increase likelihood of substance use as means of coping.

Question 30

Integration theory of addiction

Answer 30

Includes elements of all of the above theories as well as problem-behavior theory which states involvement in one problem behavior (e.g., truancy) increases likelihood of other problem behaviors such as substance use.

Question 31

Cardiovascular disease

Answer 31

Aka coronary heart disease or heart disease General term that refers to illnesses caused by atherosclerosis, the narrow- ing of the coronary arteries, the vessels that supply the heart with blood Leading cause of death in the US Many of the risk factors are preventable and in some cases reversible (high cholesterol, BP, obesity)

Question 32

Cardiovascular reactivity

Answer 32

The tendency of the cardiovascular system to react in the presence of stress Contributing factor in development of heart disease Hard to control, but can control stress

Question 33

How does stress play an indirect role in the development of heart disease?

Answer 33

In presence of stress, cardiovascular system may respond with increased HR and BP which is triggered by sympathetic nervous system People vary in reactivity and latency back to normal

Question 34

Leading causes of death in US

Answer 34

``` Heart disease Cancer Chronic respiratory disease Cerebrovascular disease Accidents Alzheimer's Diabetes Kidney disease Influenza and pneumonia Suicide ```

Question 35

Metabolic syndrome

Answer 35

Cluster of risk factors that are precursor to heart disease Strong risk factor for many health problems like heart disease, heart attack, stroke, and diabetes Components are abdominal obesity, raised triglycerides, hypertension, insulin resistance and glucose intolerance, proinflammatory state, and prothrombotic state

Question 36

How can atherosclerosis be described as a mediator in stress-heart attack relationship?

Answer 36

Stress can lead to negative health behaviors such as eating a diet high in fat and becoming less active physically. These behaviors can lead to the development of atherosclerosis, which can result in temporary blocking of oxygen to the heart resulting in heart attack.

Question 37

What major systems of the body are involved in the effect of cardiovascular reactivity on heart disease?

Answer 37

Cardiovascular and nervous systems

Question 38

What are three sources of stress that have been linked to heart disease?

Answer 38

Job stress, low SES, negative emotionality, imbalance between control and life demands, social instability

Question 39

Hostility has received a great deal of attention for its role in heart disease. Describe the sources of hostility and when would be a good time to intervene in this development.

Answer 39

Hostility seems to develop in childhood and may result from insecurity about self. Hostility may be partially a result of genetic influences and abusive or punitive parenting as well as conflicted early environments. It makes most sense to intervene early before these risk factors can develop into a hostile orientation in the child.

Question 40

Type 1 diabetes

Answer 40

Typically genetic Affects 5-15% of Americans Typically 1st diagnosed in late childhood or adolescence Failure of pancreas to produce sufficient insulin Can lead to hypertension, heart disease, heart attack, stroke, kidney failure, neuropathy, amputations, and blindness

Question 41

Insulin

Answer 41

Hormone secreted by the pancreas that is used to convert the sugars and starches form food to usable energy for the body

Question 42

Type 2 diabetes

Answer 42

Disorder of lifestyle Onset in adulthood or late adolescents Over 90% of diabetes Pancreas may not produce enough insulin or body may be insensitive to insulin Rates have increased dramatically in recent decades Obesity is strong risk factor Treatment adherence especially difficult for adolescents and children

Question 43

Why is obesity a strong risk factor for type 2 diabetes?

Answer 43

Possibly due to the greater number of fat cells within obese people. Fat cells may be more resistant to insulin than muscle cells, making insulin generally less effective in obese individuals than those with healthy weights.

Question 44

Barriers to effective treatment of diabetes

Answer 44

Changing eating and exercise habits Treatment adherence Low SES, harder to find and afford healthy food

Question 45

Prediabetes

Answer 45

Presence of elevated blood glucose levels that have not yet risen so high as to meet diagnostic criteria for diabetes Critical moment for intervention efforts

Question 46

The deadly quartet

Answer 46

Type 2 diabetes Hypertension Dyslipidemia Obesity

Question 47

Common risk factors for cardiovascular and endocrine disorders

Answer 47

``` Smoking Alcohol consumption Obesity Lack of physical exercise Tend to cluster Modifiable and cheap to fix ```

Question 48

Given the strong link between type 2 diabetes and lifestyle factors, how would you design an intervention targeting adolescents with prediabetes? What would your message be and how would you deliver it? What aspects of health promotion do you think would be relevant and what model of health behavior might apply?

Answer 48

Consider teachable moments in designing your intervention. If you are focusing on exercise, you may want to incorporate your message into a physical education class. If your intervention includes a diet component, you may want to deliver your message around mealtimes or in areas where adolescents tend to eat. I suspect you would want to incorporate both diet and exercise in your intervention as both are linked with improved health and outcomes among prediabetics. Be cautious of using scare tactics as these are known to not be particularly effective, especially among adolescents. Focusing on empowerment (how adolescents have the power and ability to make these changes) is likely an important component of a successful intervention.

Question 49

Given the strong link between type 2 diabetes and lifestyle factors, how would you design an intervention targeting adolescents with prediabetes? What would your message be and how would you deliver it? What aspects of health promotion do you think would be relevant and what model of health behavior might apply?

Answer 49

More generic form of immunity in that the functions of the cells that comprise natural immunity are to attack foreign invaders in the body generally. Granulocytes, including macrophages, are part of natural immunity, as are natural killer cells

Question 50

Specific immunity

Answer 50

Targets specific pathogens in the body. Lymphocytes including B and T lymphocytes are part of the specific immunity system. Further subdivided into humoral and cell-mediated immunity.

Question 51

Humoral immunity

Answer 51

B cells that produce antibodies

Question 52

Cell-mediated immunity

Answer 52

T cells that produce cytokines

Question 53

Immune response to Immediate short-term stress

Answer 53

Increased natural immunity Decreased specific immunity Ex: bad grade, car accident

Question 54

Immune response to short-term stress

Answer 54

No change in blood cell coutnt Decreased cellular immunity Increased humoral immunity Ex: studying, new job, doctor appointment

Question 55

Immune response to chronic stress

Answer 55

Global negative immune response Decreased cellular immunity and humoral immunity Ex: poverty, unemployment, chronic illness, caregiving

Question 56

Inflammation

Answer 56

One of the first functions of the immune system in response to infection or pathogens Increased blood flow and cytokines

Question 57

Measurement of immune system functioning in studies of stress and immunology

Answer 57

``` # WBCs, NK cells, and lymphocytes Inflammation ```

Question 58

Correlates of improved immune functioning

Answer 58

``` Positive affect Social support Optimism Active coping strategies Emotional disclosure Positive behavior during conflict Personal control Exercise Relaxation Mindfulness meditation Finding benefits of stress ```

Question 59

Correlates of impaired immune functioning

Answer 59

``` Insecure attachments Avoidant coping strategies Pessimism Caregiving Chronic interpersonal stress Martial disruption/conflict Bereavement Loneliness Depression ```

Question 60

Sleep

Answer 60

May be important for consolidating and organizing memory, rehearsing new learning or behaviors, preventing unproductive energy expenditure, conserving energy, and enabling psychological adaptation through dreams 7 hours per night associated with best health benefits Promotes function of immune system Stress=poorer sleep

Question 61

Sleep deprivation

Answer 61

Lower T helper cells and NK cells Reduced response of lymphocytes to mitogens Chronic sleep deprivation has more harmful effects than acute

Question 62

Parsimonious hypothesis

Answer 62

Explains multiple phenomena in the simplest terms possible For example, the associations of cardiovascular problems, negative affect, and immune disorders in the face of stress may be explained by a more general psychobiological reactivity Supports biopsychosocial approach to health

Question 63

HIV/AIDS symptoms

Answer 63

Developed in the 70s HIV: headache, fever, diarrhea, sore throat, yeast infections, muscle aches, fatigue, rash, mouth sores, swollen lymph glands AIDS: chills, fever, rash, weakness, night sweats, swollen lymph glands, weight loss

Question 64

HIV/AIDS rates

Answer 64

Higher among lower SES and minorities | Rise among minority women

Question 65

Two explanations for rise of AIDS among women in the US

Answer 65

1. Initially AIDS was just between homosexual men and eventually women become infected also 2. Involvement in sex trade or prostitution

Question 66

Four main categories of cancer

Answer 66

Carcinomas Sarcomas Leukemia Lymphomas

Question 67

Carcinomas

Answer 67

Cancers of the epithelial cells which are found in skin, glands, and organs including the bladder, liver, prostate, and breasts

Question 68

Sarcomas

Answer 68

Cancers of soft tissues such as muscle, nerves, fat and tendons

Question 69

Leukemia

Answer 69

Cancer that derives from tissues that produce blood, such as bone marrow, including uncontrolled proliferation of white blood cells.

Question 70

Lymphomas

Answer 70

Cancers of the lymphatic system

Question 71

Patient satisfaction

Answer 71

Becoming increasingly important in the new landscape of healthcare delivery. Patients are increasingly encouraged to be partners in their healthcare

Question 72

Common sense model of illness

Answer 72

Perceived causes of illness of patients are summarized into three dimensions: physical/nonphysical, stable/unstable and controllable/uncontrollable.

Question 73

Factors that affect patient compliance

Answer 73

Patient understanding Patient recall Patient satisfaction Difficulty or complexity of the recommendation

Question 74

Domains of health literacy

Answer 74

``` Fundamental literacy (reading, writing, speaking) Scientific literacy Civic literacy (public health, media) Cultural literacy (customs) ```

Question 75

3 areas of healthcare that health literacy affects

Answer 75

Access and use of healthcare system Interaction between patient and provider Self-care and health behaviors among patients

Question 76

Lay referral network

Answer 76

An informal network of family and friends who offer their own interpretations of symptoms, often well before any medical treatment is sought

Question 77

Characteristics of health compromising behaviors

Answer 77

``` Habitual and sometimes addictive Modifiable Window of vulnerability in adolescence Many tied to peer culture Many are pleasurable Dangerous Risk factors for more than one major chronic disease Develop gradually All substance abuse predicted by same factors (parental conflict, poor self-control) More common in lower social classes ```

Question 78

Obesity

Answer 78

``` An excessive accumulation of body fat Risk factor for many disorders like cancer, cardiovascular disease, atherosclerosis, hypertension, Type II diabetes, and heart failure Chief cause of disability Prone to psychiatric conditions Social and economic consequences Childhood is window of vulnerability ```

Question 79

Yo-yo dieting

Answer 79

Successive cycles of dieting and weight gain | Lowers metabolic rate

Question 80

Set point theory of weight

Answer 80

The idea that each individual has an ideal biological weight, which cannot be greatly modified Some people have a higher set point than others, leading to a risk for obesity

Question 81

Anorexia nervosa

Answer 81

An obsessive disorder amount- ing to self-starvation, in which an individual diets and exercises to the point that body weight is grossly below optimum level, threatening health and potentially lead- ing to death. Most sufferers are young women, but gay and bisexual men are also at risk

Question 82

Bulimia

Answer 82

Characterized by alternating cycles of binge eating and purging through such techniques as vomit- ing, laxative abuse, extreme dieting or fasting, and drug or alcohol abuse

Question 83

Physical dependence

Answer 83

When the body has adjusted to the substance and incorporates the use of that substance into the normal functioning of the body’s tissues Often involves tolerance

Question 84

Craving

Answer 84

A strong desire to engage in a behavior or consume a substance. It results from physical dependence and from a conditioning process

Question 85

Addiction

Answer 85

Occurs when a person has become physically or psychologically dependent on a substance following repeated use over time

Question 86

Alcoholism

Answer 86

Includes the need for daily use of alcohol, the inability to cut down on drinking, repeated efforts to control drinking through temporary abstinence or restriction of alcohol to certain times of the day, binge drinking, occasional consumption of large quantities of alcohol, loss of memory while intoxicated, continued drinking despite known health problems, and drinking of non-beverage alcohol, such as cough syrup.

Question 87

Placebo drinking

Answer 87

Consuming nonalcoholic beverages or alternating an alcoholic with a nonalcoholic beverage.

Question 88

Synergistic effects of smoking

Answer 88

Smoking and cholesterol interact to produce higher rates of heart disease Stress and smoking increases BP or reactivity Smoking and low SES Weight and smoking Smoking and depression/anxiety

Question 89

Passive smoking/secondhand smoke

Answer 89

3rd leading cause of preventable death in US

Question 90

Cardiac invalidism

Answer 90

Can be one consequence of MI | Patients and their spouses see the patient’s abilities as lower than they actually are

Question 91

John Henryism

Answer 91

A personality predisposition to cope actively with psychosocial stressors. It becomes a lethal predisposition when active coping efforts are likely to be unsuccessful Tied to hypertension

Question 92

Psychoneuroimmunology

Answer 92

Refers to the interactions among behavioral, neuroendocrine, and immunological processes of adaptation

Question 93

Rheumatoid arthritis

Answer 93

Affects the small joints of the hands and feet, as well as the wrists, knees, ankles, and neck Autoimmune

Question 94

Osteoarthritis

Answer 94

Smooth lining of a joint, known as the articular cartilage, begins to crack or wear away because of overuse, injury, or other causes Tends to affect the weight- bearing joints: the hips, knees, and spine

Question 95

Medical students’ disease

Answer 95

As they study each illness, many medical students imagine that they have it

Question 96

Commonsense model of illness

Answer 96

People hold implicit commonsense beliefs about their symptoms and illnesses that result in organized illness representations or schemas

Question 97

Lay referral network,

Answer 97

An informal network of family and friends who offer their own interpretations of symptoms, often well before any medical treatment is sough

Question 98

Delay behavior

Answer 98

A person may live with one or more potentially serious symptoms for months without seeking care.

Question 99

Appraisal delay

Answer 99

The time it takes an individual to decide that a symptom is serious

Question 100

Illness delay

Answer 100

The time between the recognition that a symptom implies an illness and the decision to seek treatment

Question 101

Behavioral delay

Answer 101

The time between deciding to seek treatment and actually doing so

Question 102

Medical delay

Answer 102

The time that elapses between the person’s calling for an appointment and his or her receiving appropriate medical care

Question 103

Private, fee-for-service care.

Answer 103

Used to be the norm

Question 104

Health maintenance organization (HMO)

Answer 104

An employer or employee pays an agreed-on monthly rate, and the employee can then use services at no additional (or a greatly reduced) cost. This arrangement is called managed care. In some cases, HMOs have their own staff, from which enrollees must seek treatment.

Question 105

Preferred-provider organizations (PPOs)

Answer 105

A network of affiliated practitioners have agreed to charge preestablished rates for services, and enrollees in the PPO must choose from these practitioners when seeking treatment.

Question 106

Colleague orientation

Answer 106

Because the patient no longer pays directly for service, and because the provider’s income is not directly affected by whether the patient is pleased with the service, the provider may not be overly concerned with patient satisfaction. The provider is, however, concerned with what his or her colleagues think, because it is on their recommendations that he or she receives additional cases.

Question 107

Creative nonadherence

Answer 107

Modifying and supplementing a prescribed treatment regimen.

Question 108

Complementary and alternative medicine (CAM)

Answer 108

A diverse group of therapies, products, and medical treatments that include prayer, potions, natural herb products, meditation, yoga, massage, homeopathic medicines, and acupuncture, among other treatments.

Question 109

Holistic medicine

Answer 109

An approach to treatment that deals with the physical, psychological, and spiritual needs of the person

Question 110

Traditional Chinese Medicine

Answer 110

Based on the idea that a vital force, called qi (pronounced “chee”), flows throughout the body through channels called meridians that connect the parts of the body to each other and to the universe

Question 111

Ayurvedic medicine

Answer 111

Although people are born into a state of balance, events in their lives can disrupt it, compromising health, and so bringing these forces back into balance alleviates illness and maintains good health India

Question 112

Homeopathy

Answer 112

Interprets disease and illness as caused by disturbances in a vital life force.

Question 113

Guided imagery

Answer 113

A meditative procedure that has been used to control discomfort related to illness and treatment, especially cancer. Patient is instructed to conjure up a picture that he or she holds in mind during a procedure or during the experience of discomfort.

Question 114

Integrative medicine

Answer 114

The combination of alternative medicine with conventional medicine