Sample Chapter


Health Psychology 3rd Canadian Edition By Shelley Taylor – Test Bank
Sample  Questions       


Student: ___________________________________________________________________________

1. The 1948 World Health Organization’s definition of health is analogous to a state of wellness.

True    False


2. Early cultures took a dualistic approach to the mind and the body.

True    False


3. The ancient Greeks believed in a humoral theory of illness.

True    False


4. In conversion hysteria, the patient converts psychological conflict into a symptom which then relieves the patient of anxiety.

True    False


5. The biomedical model emphasizes both health and illness.

True    False


6. The biopsychosocial model emphasizes the importance of an effective patient-practitioner relationship.

True    False


7. The most important factor giving rise to health psychology has been the expansion of health care services.

True    False


8. Morbidity may be expressed in two ways: as the number of new cases or as the total number of existing cases of an illness.

True    False


9. Although health psychologists have been employed in health settings for many years, they have difficulty establishing their credibility with physicians and other health care professionals.

True    False


10. Public health researchers inform policymakers about changes that would benefit communities.

True    False


11. The field within psychology devoted to understanding all psychological influences on health and illness across the life span is called

A. psychosomatic medicine.


B. health psychology.


C. medical psychology.


D. epidemiology.


E. immunology.


12. A health psychologist who designs a media campaign to get people to improve their diets focuses on

A. health promotion and maintenance.


B. prevention and treatment of illness.


C. etiology and correlations of health, illness, and dysfunction.


D. the health care system and the formulation of health policy.


E. the philosophy of the mind-body relationship.


13. A health psychologist who works with people who are already ill focuses on

A. health promotion and maintenance.


B. prevention and treatment of illness.


C. etiology and correlations of health, illness, and dysfunction.


D. the health care system and the formulation of health policy.


E. the philosophy of the mind-body relationship.


14. What does etiology refer to?

A. causes of illness


B. a special kind of disease state


C. healthy behaviour


D. stress effects


E. the prevalence of disease in a population


15. A health psychologist who is interested in the behavioural and social factors that contribute to disease focuses on

A. health promotion and maintenance.


B. prevention and treatment of illness.


C. etiology and correlations of health, illness, and dysfunction.


D. the health care system and the formulation of health policy.


E. the biopsychosocial model.


16. A health psychologist who studies the impact of hospitals and physicians on people’s behaviour focuses on

A. health promotion and maintenance.


B. prevention and treatment of illness.


C. etiology and correlations of health, illness, and dysfunction.


D. the health care system and the formulation of health policy.


E. social psychology.


17. Ancient cultures viewed the mind and the body as

A. ultimately unknowable.


B. somewhat interdependent.


C. separate and autonomous systems.


D. part of the same system.


E. not much differently than we do today.


18. According to the humoral theory of Hippocrates and Galen, disease is the result of

A. trephination.


B. evil spirits.


C. an imbalance of bodily fluids.


D. cellular disorders.


E. God’s punishment.


19. The idea that one’s biochemistry may be associated with certain personality characteristics can be traced to the

A. Stone Age.


B. ancient Greeks.


C. Middle Ages.


D. Renaissance.


E. ancient Romans.


20. In ____________________, the Church was the guardian of medical knowledge.

A. ancient Greece


B. the Middle Ages


C. the Renaissance


D. Freud’s era


E. the Stone Age


21. Conversion hysteria

A. is now even more frequent than in Freud’s time.


B. occurs when unconscious conflict is manifested in a symbolic physical symptom.


C. occurs when an individual develops several minor symptoms to avoid interpersonal conflict.


D. is strongly associated with hypochondria.


E. occurs more often in men than in woman.


22. The field of behavioural medicine

A. focuses on objective and clinically relevant interventions.


B. relies on subjective, verbal interventions.


C. does not recognize biofeedback as a treatment intervention.


D. focuses mainly on behavior modification interventions.


E. was the basis for the field of psychosomatic medicine.


23. _______________ linked specific personality patterns to specific illnesses.

A. Dunbar and Alexander


B. Galen


C. Hippocrates


D. Freud


E. Cattell


24. Which of the following statements best reflects a current perspective of the mind-body relationship?

A. Repressed psychological conflicts can manifest as physical symptoms and illness.


B. Health and healing involves the interrelation of all of the body’s systems, and illness arises as a disharmony between these systems.


C. Illness is largely a product of one’s temperament.


D. Healing relies most heavily on the patient’s belief in the physician.


E. Illness results only from a breakdown of organic and cellular changes within the body.


25. According to your text, all conditions of health and illness are influenced by

A. one’s personality type.


B. psychodynamics.


C. lifestyle factors.


D. psychological and social factors.


E. the deterioration of cells.


26. The fundamental assumption of the _______________ model is that health and illness are consequences of the interplay of biological, psychological, and social factors.

A. biomedical


B. psychoemotional


C. psychoneuroimmunology


D. psychosocial


E. biopsychosocial


27. The _______________ model maintains that all illness can be explained on the basis of aberrant somatic processes.

A. biomedical


B. psychoemotional


C. biopsychosocial


D. psychosocial


E. psychosomatic


28. Josh is feeling achy, has a stuffed up nose and a cough, and is feeling very tired. On the basis of these symptoms Josh’s doctor tells him he has been infected with a cold virus. This diagnosis is an example of

A. dualism.


B. systems theory.


C. homeostasis.


D. reductionism.


E. mechanism.


29. The notion that cancer can be cured simply by excising a tumour, most closely resembles the

A. biomedical model.


B. biopsychosocial model.


C. psychosomatic model.


D. pathological model.


E. mind-body model.


30. A single-factor model of illness assumes that

A. there is one ultimate cause of all illnesses.


B. health should be emphasized over illness.


C. illness can be explained in terms of a biological disorder.


D. only one factor of an illness can be dealt with at one time.


E. there is only one correct treatment for the illness.


31. The idea that health is the absence of disease most closely resembles the

A. biomedical model.


B. biopsychosocial model.


C. psychosomatic model.


D. pathological model.


E. holistic model.


32. The biopsychosocial model of health

A. emphasizes the social and psychological factors in health.


B. views the body as a system of organs that work holistically together.


C. proposes that complex phenomenon can be reduced down to their simpler components.


D. considers both macro and micro level factors.


E. proposes body-mind unity.


33. According to the biopsychosocial model, state of health and illness are produced by

A. microlevel processes.


B. macrolevel processes.


C. the interaction of microlevel and macrolevel processes.


D. environment.


E. microlevel processes and the environment.


34. The _______________ maintains that health and illness are caused by multiple factors and produce multiple effects.

A. biopsychosocial model


B. psychosomatic model


C. reductionistic model


D. biomedical model


E. dualistic approach


35. Systems theory assumes a principle of hierarchical organization. This implies that

A. changes in any one level will affect all other levels of the system.


B. only changes in the highest level will affect all levels of the system.


C. changes in one level will affect only lower levels of the system.


D. changes in intermediate levels have the most profound impacts.


E. an aberration in one level will cause a demise of the system.


36. According to the biopsychosocial model,

A. an interdisciplinary team approach may lead to the best diagnoses.


B. treatment must focus on biological, psychological, and social factors.


C. patients and practitioner play an important role in their diagnosis and treatment.


D. one can understand health habits only in their psychological and social contexts.


E. All of these answers are correct.


37. Until the turn of the 20th century, _______________ were among the major causes of illness and death in Canada.

A. acute disorders


B. chronic illnesses


C. hereditary disorders


D. accidents and homicides


E. waterborne parasites


38. Acute disorders are

A. short-term medical illnesses that are usually responsive to cure.


B. typically diseases that are co-managed by patients and their practitioners.


C. the major causes of death and illness in Canada.


D. serious disorders such as heart disease, cancer, and diabetes.


E. usually deadly disorders that are difficult to cure.


39. Currently, in industrialized countries, _______________ is/are the major contributor/s to disability and death.

A. acute disorders


B. chronic illnesses


C. hereditary disorders


D. accidents and homicides


E. suicide


40. Chronic illnesses

A. are illnesses that are psychosomatic in origin.


B. are difficult for patients to manage, but seldom contribute to disability or death.


C. can be cured only if the patient and the practitioner work together as a team.


D. are illnesses in which psychological and social factors play an important role in both cause and management.


E. are rare in industrialized countries.


41. _______________ is the study of the frequency, distribution, and causes of infectious and non-infectious disease in a population, based on an investigation of the physical and social environment.

A. Health psychology


B. Etiology


C. Morbidity


D. Epidemiology


E. Immunology


42. _______________ refers to the number of cases of a disease that exist at some given point in time. _______________ refers to numbers of deaths due to particular causes.

A. Morbidity; Mortality


B. Mortality; Etiology


C. Epidemiology; Pathology


D. Etiology; Epidemiology


E. Prevalence; Mortality


43. Which of the following is NOT considered a determinant of health according to a population health approach?

A. Social support networks


B. Health services


C. Biology and genetic endowment


D. Employment/working conditions


E. All of these answers are correct.


44. Health psychologists typically are employed

A. in academic settings, where they conduct research programs in health psychology.


B. in industrial or occupational health settings.


C. as clinicians who work with medical patients.


D. with individuals who are emotionally and physically disabled.


E. All of these answers are correct.


45. Which of the following is not an allied health professional?

A. Physiotherapist


B. Physician


C. Dietitian


D. Occupational therapist


E. Social worker


46. As an allied health professional Susan has the opportunity to apply the principles of health psychology with her clients. For example, she helps patients with ongoing health issues, help them learn to use adaptive devices and become accustomed to new ways of performing old tasks. Susan most likely works as a(n)

A. Physiotherapist.


B. Physician.


C. Dietitian.


D. Occupational therapist.


E. Social worker.


47. Explain the factors that contributed to the development of behavioural medicine. In what ways has the field of behavioural medicine influenced the practice of health psychology?





48. Explain how current views of the mind-body relationship have been influenced by the growing interest in holistic health and healing.





49. Compare and contrast the biopsychosocial and biomedical models. Include in your explanation the advantages of the biopsychosocial model over the biomedical model.





50. Explain how the changing patterns of illness have contributed to the rise of health psychology.





51. Training in health psychology can lead to opportunities to work in a variety of different fields. Name three of these fields and provide examples of the roles associated with each.





Student: ___________________________________________________________________________

1. Health promotion is defined as helping people at risk for particular health problems by making healthy lifestyle changes.

True    False


2. By the age of 11 or 12, most children have fairly stable health beliefs that resemble those of adults.

True    False


3. Instilling good health habits and changing poor ones is the task of primary prevention.

True    False


4. The concept of the window of vulnerability refers to the fact that certain times are better for teaching particular health practices than others.

True    False


5. Health message communicators are more persuasive if they are likable and similar to the audience.

True    False


6. Research has established that the more fear that a persuasive message elicits, the more effective it is for changing behaviour.

True    False


7. Social cognition models of health behaviour change suggest that the beliefs that people hold about particular health behaviour motivate their decision to change that behaviour.

True    False


8. Cognitive-behaviour therapy approaches to health habit modification target behaviour itself, the conditions that elicit and maintain it and the factors that reinforce it.

True    False


9. Social engineering approaches to health behaviour change are active.

True    False


10. Health risk assessments identify employees’ specific risks based on current age, family history, and lifestyle factors.

True    False


11. Which of the following is the best definition of health promotion?

A. A general philosophy that good health is a personal and collective achievement.


B. The practice of good health behaviours.


C. The avoidance of health-compromising behaviours.


D. Medical interventions designed to enhance and maximize good health.


E. A collection of behavioural management techniques for good health behaviours.


12. According to the text, changing health behaviours may be beneficial because it

A. may reduce the number of deaths due to diseases related to lifestyle.


B. may increase individual longevity and life expectancy.


C. may delay the onset of chronic disease and enhance quality of life.


D. it will reduce spending on health services.


E. All of these answers are correct.


13. Health habits

A. are highly resistant to change, because they are continually reinforced by specific positive outcomes.


B. are unrelated to health behaviours.


C. require access to the health care delivery system.


D. are often performed without conscious awareness.


E. are something people are consciously aware of but choose to deny.


14. According to the text, cancer deaths could be reduced by more than 50 percent simply by getting people to

A. avoid smoking.


B. increase their physical activity.


C. tell their doctor when their health changes.


D. eat more fruits and vegetables.


E. decrease their alcohol intake.


15. According to the demographic factors discussed in the text, which of the following individuals is most likely to practice good health behaviours?

A. Joe, a 45-year-old high school dropout who works two jobs in order to support his family


B. Dan, a 30-year-old high school graduate who works as a file clerk in a small insurance agency who expects to be married next month


C. Bill, a divorced 50-year-old corporate attorney


D. Sam, a 30-year-old assistant professor who has just celebrated his fifth wedding anniversary


E. Barbara, a high school senior in a small farming community


16. One aspect of health habits that makes them difficult to modify is that

A. the exact point for intervention is seldom clear.


B. they are interdependent—a change in one habit is often reflected in changes in others.


C. factors controlling health behaviour are generally consistent across the life span.


D. unhealthy habits do not develop until adulthood, when they have no apparent effect on health.


E. stable personalities make change difficult.


17. Considering the relationship of chronological age to health behaviours, health habits

A. are good in childhood.


B. deteriorate in adolescence and early adulthood.


C. improve among retired adults under 73.


D. deteriorate among adults 73 and older.


E. are relatively stable throughout the lifespan.


18. Which of the following is considered a “teachable moment”?

A. a child’s first dental visit


B. pregnancy


C. an adult with newly diagnosed coronary artery disease


D. a crucial point at which a person is ready to modify a health behaviour


E. All of these answers are correct.


19. Research suggests that most people’s perceptions of their own health risks are

A. unrealistically optimistic.


B. unrealistically pessimistic.


C. insensitive to feedback.


D. generally accurate.


E. that their poor health behaviours are distinctive.


20. You are designing a health-promotion program for a retirement community. According to the text, which of the following behaviours would be the most important to target in your intervention?

A. Eliminating smoking.


B. Developing a regular exercise program.


C. Maintaining a healthy diet.


D. Getting regular vaccinations for influenza.


E. Learning meditation and relaxation techniques.


21. Which of the following is the best description of Prospect theory?

A. different presentations of risk information will change people’s perspectives and actions.


B. messages that emphasize potential problems should work better for behaviours that have uncertain outcomes.


C. messages that stress benefits may be more persuasive for behaviours with certain low risk outcomes.


D. matching the framing of the message with the health behaviour can impact the effectiveness of the message.


E. messages that emphasize statistics tend to be regarded as most important.


22. Julia is designing a public service message designed to encourage adults to engage in moderate exercise. To be most effective, her message should address

A. weight gain experienced by sedentary adults as they age.


B. decreased flexibility associated with lack of exercise.


C. positive mood and enhanced well-being associated with aerobic exercise.


D. decreased bone density as they age.


E. the strongest arguments in the middle of her message.


23. The health belief model states that the practice of a particular health behaviour is a function of

A. an individual’s beliefs that he or she, rather than powerful others or chance, is in control of his or her own health.


B. an individual’s attitudes about a health behaviour, subjective normative beliefs, and self-efficacy.


C. an individual’s beliefs in a specific health threat and beliefs that a specific health behaviour can reduce that threat.


D. perceived self-efficacy and perceived invulnerability.


E. the fact that messages that emphasize potential problems should work better for behaviours that have uncertain outcomes.


24. _______________ is the belief that one is able to control one’s practice of a particular behaviour.

A. Health locus-of-control


B. Self-esteem


C. Self-control


D. Self-efficacy


E. Self-confidence


25. According to the theory of planned behaviour, behavioural intentions are a function of

A. attitude to a specific action, subjective norms, and perceptions of control.


B. general health attitudes, normative beliefs, and perceptions of control.


C. specific health attitudes and normative beliefs.


D. perceptions of vulnerability, magnitude of health threat, and self-efficacy.


E. planning and self-esteem.


26. Julian has decided that he needs to lose 15 pounds. He is concerned about the amount of fat he consumes and suspects that his cholesterol count is high. He has purchased a popular book on low-fat diets and has decided that he will begin walking three times a week after he buys a new pair of walking shoes next week. According to Prochaska et al.’s (1992) transtheoretical model of behavioural change, Julian is in the _______________ stage of health behaviour change.

A. precontemplation


B. contemplation


C. preparation


D. action


E. maintenance


27. Studies evaluating the effectiveness of Prochaska et al.’s (1992) transtheoretical model of behavioural change indicate that

A. interventions matched to the stage that an individual is in are more successful than those more appropriate for other stages.


B. interventions that teach skills relevant to action and behaviour maintenance have little effect on individual motivation.


C. the media has even less of an effect on an individual’s health behaviours than previously thought.


D. its applications have shown mixed success.


E. its applications have been shown to be extremely useful.


28. Which of the following is NOT the best example of an implementation intention to increase exercise behaviour?

A. I want to exercise more.


B. I will go buy some new running shoes so that I can start running.


C. I will jog for 30 minutes in my neighbourhood every Tuesday and Thursday evening.


D. I will exercise 2 hours per week for the next 3 months.


E. I will complete three sets of 10 squats every day.


29. _______________ focuses on the target behaviour and on the beliefs that people hold about their health habits.

A. Attitudinal therapy


B. Operant conditioning


C. Cognitive-behaviour therapy


D. Modelling


E. Classical conditioning.


30. _________________ trains individuals to recognize and modify negative internal monologues to promote health behaviour change.

A. Covert self-control


B. Self-efficacy


C. Contingency contracting


D. Assertiveness training


E. Behavioural assignment


31. The use of Antabuse in the treatment of alcoholism involves having the client sip his or her favourite drink while ingesting Antabuse. After several pairings, alcohol becomes associated with the Antabuse and elicits a(n) _______________.

A. conditioned response


B. conditioned stimulus


C. unconditioned response


D. unconditioned stimulus


E. extinction response


32. Classical conditioning modifies the _______________ of behaviour; operant conditioning modifies the _______________ of behaviour.

A. consequences; consequences


B. consequences; antecedents


C. antecedents; consequences


D. antecedents; antecedents


E. stimuli; responses


33. A behavioural response is most resistant to extinction if it is subject to a _______________ schedule of reinforcement.

A. continuous


B. variable


C. random


D. maintenance


E. positive


34. The use of rewards for weight loss (e.g., money or new clothing) in the treatment of obesity is an example of

A. shaping.


B. modelling.


C. operant conditioning.


D. classical conditioning.


E. conditioned response.


35. The use of ex-addicts as peer counsellors in drug treatment programs is an example of

A. shaping.


B. modelling.


C. operant conditioning.


D. classical conditioning.


E. mentoring.


36. A discriminative stimulus

A. is a central component of therapies based on classical conditioning.


B. becomes reinforcing through pairing with the unconditioned stimulus.


C. serves as a cue that positive reinforcement will occur.


D. involves systematically rewarding the self to increase or decrease the occurrence of a target behaviour.


E. is often associated with shaping behavior.


37. Brenda has been trying to lose weight and control her seemingly insatiable sweet tooth. To meet her goal, she has removed all cookies, candy, and ice cream from the kitchen cabinets and refrigerator. She also has begun keeping a bowl of fresh fruit on the kitchen counter from which she may nibble freely. Brenda is practicing

A. vicarious self-control.


B. self-punishment.


C. stimulus control.


D. self-reinforcement.


E. discriminating stimuli.


38. Fred wants to lose 20 pounds. He places 20 one-pound boxes of lard in the refrigerator. As his weight-loss program proceeds, he removes one box of lard each time he succeeds in losing a pound. In this instance, Fred is using

A. positive self-punishment.


B. negative self-punishment.


C. positive self-reward.


D. negative self-reward.


E. positive self-punishment and negative self-reward.


39. Self-punishment

A. is as effective in changing behaviour as self-reward.


B. is most effective in changing behaviour when it is also coupled with self-reward.


C. is effective in behaviour change even when individuals stop performing the target behaviour.


D. becomes increasingly effective as the punishment becomes increasingly aversive.


E. is not usually recommended due to the lasting emotional problems associated with it.


40. Rhonda entered into an agreement with her friend, Nancy, in an attempt to establish a regular exercise program. According to their agreement, Nancy pays Rhonda $1 every day that she exercises for at least 30 minutes after work. If she fails to do so, Rhonda must pay Nancy $1. This is an example of

A. shaping.


B. a token economy.


C. a contingency contract.


D. vicarious reinforcement.


E. negative reinforcement.


41. Internal monologues

A. are always positive and adaptive.


B. can function as antecedents and as consequences of target behaviour.


C. are resistant to change through standard techniques of reinforcement.


D. can function as antecedents but not as consequences of target behaviour.


E. are always negative and maladaptive.


42. Wanda’s weight loss counsellor has observed that she has a self-defeating pattern of beliefs and cognitions about her ability to control her overeating. Specifically, when she eats something that is not allowed on her diet, she thinks “I have no willpower; I’ll always be fat” and binges the rest of the day. Wanda’s counsellor now is encouraging her to think “Well, I slipped on my diet at lunch. Relax, one slip isn’t that bad. I’ll get back on my diet right away!” The therapist is utilizing a technique called

A. cognitive restructuring.


B. positive reinforcement.


C. self-monitoring.


D. self-punishment.


E. theory of reasoned behaviour.


43. How can modelling can be used to teach the client cognitive restructuring?

A. Model maladaptive behaviours first.


B. Model classical conditioning.


C. Model adaptive self-talk.


D. Model effective breathing techniques.


E. Model motivational learning.


44. The goal of social skills training is to

A. reduce the anxiety associated with social situations.


B. get the client to think through and express some of his or her own reasons for and against change.


C. learn relaxation procedures to cope more effectively with their anxiety.


D. learn to relax all the muscles in the body to discharge tension or stress.


E. increase motivation.


45. Motivational interviewing

A. is designed to reduce anxiety that occurs in social situations.


B. is used to train a client in cognitive restructuring


C. helps rid the environment of discriminative stimuli that evoke the problem of health behaviour.


D. is a client-centred counselling style designed to get people to work through ambivalence they may be experiencing about changing their health behaviours.


E. sets the stage for enlisting the patient’s joint participation early in the effort to modify health behaviours.


46. Relapse

A. is more likely to be observed in instances of declining motivation and lack of goals.


B. appears to be unrelated to situational factors; it is almost exclusively an individual problem.


C. has been found to have similar rates and patterns for alcohol and drug addiction, but relapse rates for smokers increase with the passage of time.


D. is unrelated to levels of perceived stress and social support.


E. usually occurs after a three month period of abstinence.


47. An abstinence violation effect is associated with

A. psychological reactance and an increased feeling of perceived control.


B. an increased feeling of perceived control and decreased likelihood of relapse.


C. a loss of perceived control and increased likelihood of relapse.


D. increased vigilance.


E. suppressed hypervigilance.


48. Relapse prevention techniques often adopt cue exposure techniques, which

A. extinguish the craving typically evoked by a cue, such as an alcoholic beverage.


B. increase feelings of self-efficacy.


C. reduce positive expectations associated with the addictive behaviour.


D. provides the opportunity to practise coping responses.


E. All of these answers are correct.


49. _______________ involves modifying the environment to affect one’s ability to practise a particular behaviour.

A. Social engineering


B. Reconstruction


C. Adaptive environmental change


D. Passive retraining


E. Occupational therapy


50. Which of the following is NOT an example of social engineering to change health-related behaviours?

A. Legislating smoke-free indoor work environments.


B. Lowering the speed limit.


C. Interventions designed to get parents to reduce accidents in the home.


D. Legislation to eliminate the amount of trans fats allowed in foods.


E. Requiring immunizations for children before school entry.


51. The work site has typically dealt with employees’ health habits by

A. providing on-the-job health-promotion programs.


B. using a health risk assessment to identify employees’ specific risks.


C. structuring the environment to help people engage in healthy activities.


D. providing reduced insurance premiums for individuals who successfully modify their health habits.


E. All of these answers are correct.


52. The family physician may be a particularly effective agent in promoting health-related attitudes and behaviour because

A. individuals are more likely to follow a suggested treatment if they pay for professional advice.


B. few social engineering solutions to health problems have been successful.


C. a one-to-one approach is the least expensive and most efficient vehicle for changing health habits.


D. a physician is a highly credible communicator and agent of health-habit change.


E. a physician can reduce the risk status of many people at one time.


53. Evaluations of the efficacy of mass media health appeals suggest that

A. messages are often too concrete and specific, and thus it is difficult to glean useful information from mass media appeals.


B. including specific recommendations about health-related behaviours diminishes individual perceptions of self-efficacy.


C. mass media messages are unrelated to shifts in cultural climate.


D. media appeals are often important sources of information for alerting the public to unknown health risks.


E. mass media campaigns are successful at bringing about long-term change.


54. Which of the following is NOT one of the main messages conveyed by the ParticipACTION media campaign?

A. eat well


B. avoid illness


C. be physically active


D. feel good about yourself


E. have fun while being physically active


55. Compare and contrast what health promotion means to individuals, medical practitioners, psychologists, and community and national policy makers.





56. How have patterns of disease in Canada changed since the turn of the 20th century? Considering these trends, explain the importance of efforts to modify health behaviours and lifestyle rebalancing.





57. Explain why the instability of health habits makes them difficult to change.





58. Charles is a college student who smokes cigarettes. Use the health belief model and the theory of planned behaviour to explain why Charles continues to smoke even though he is aware of the Surgeon General’s warning about the relationship between cigarettes and cancer and heart disease.





59. Describe the problem of relapse. Explain how relapse prevention might be incorporated into a broad-spectrum cognitive-behaviour therapy treatment plan for (choose one) alcoholism, smoking, or obesity. Be sure to include in your answer specific cognitive-behaviour techniques and their role in the therapeutic plan.





60. List three types of venues used for health behaviour change and describe how each deals with health behaviour change. What are the advantages and disadvantages of each venue?





Student: ___________________________________________________________________________

1. Adolescence is a particularly vulnerable time for health compromising behaviours.

True    False


2. Many health compromising behaviours are more common in individuals from higher social classes.

True    False


3. Harm reduction focuses on completely eliminating substance use.

True    False


4. There are four main classes of illicit drugs.

True    False


5. Psychological and social rewards associated with drinking include reduced anxiety and depression.

True    False


6. Research supports the idea that most alcoholics eventually receive some form of inpatient or outpatient treatment.

True    False


7. Trying cigarettes makes a person significantly more likely to use other drugs in the future.

True    False


8. Smokers have more accidents and injuries at work,

True    False


9. Anorexia nervosa is classified as an obsessive disorder.

True    False


10. Individuals with bulimia are often thinner than those with anorexia nervosa.

True    False


11. Alcohol abuse and smoking share a window of vulnerability in

A. adolescence.


B. young adulthood.


C. middle age.


D. old age.


E. stressful times.


12. Since he stopped smoking last week, John complains about fighting the urge for a cigarette, especially when he is around other smokers. This is an example of

A. addiction.


B. tolerance.


C. craving.


D. withdrawal.


E. All of these answers are correct.


13. Psychoactive substances

A. impact cognitive and affective processes and alter the way a person behaves when ingested.


B. include illicit drugs.


C. include alcohol.


D. include prescription drugs.


E. All of these answers are correct.


14. According to a recent international study on substance abuse in industrialized countries by the United Nations, Canada is one of the world leaders in

A. injection drug use


B. marijuana use


C. binge drinking


D. treatment programs for alcohol abuse


E. cocaine use


15. Which of the following individuals would be MOST at risk for developing alcoholism?

A. Shirley, whose identical twin, Fran, is an alcoholic


B. George, whose fraternal twin, Sam, is an alcoholic


C. Linda, whose adoptive mother, Gail, is an alcoholic


D. Adam, whose father, Ben, is an alcoholic


E. Sheila, whose mother, Sally, is a problem drinker


16. Individuals who experience _______________ are more likely to become problem drinkers than those without these risk factors.

A. negative life events


B. chronic stressors


C. deficits in social support


D. chronic stressors and deficits in social support


E. All of these answers are correct.


17. Compared to persons with more long-term drinking problems, people who become problem drinkers in late middle age are

A. less likely to control their drinking on their own.


B. less likely to be successfully treated.


C. more likely to use problem drinking as a coping method.


D. more likely to have a higher tolerance for alcohol.


E. more likely to develop lung cancer.


18. The goals of broad-spectrum cognitive-behavioural therapy of alcohol abuse include

A. reducing the reinforcement associated with alcohol.


B. teaching new behaviours inconsistent with alcohol abuse.


C. introducing reinforcement for activities that do not involve alcohol.


D. treating the biological and environmental factors involved simultaneously.


E. All of the these are goals of broad-spectrum cognitive-behavioural therapy of alcohol abuse.


19. Naltrexone, a medication, is used to

A. modify the action of GABA, a neurotransmitter.


B. prevent alcoholics from drinking by causing the body to negatively react to alcohol.


C. prevent relapse among alcoholics.


D. give alcohol a foul taste.


E. trick the brain into thinking that it is consuming alcohol when mixed with water.


20. Many successful treatment programs have attempted to provide alcoholics with

A. relaxation training.


B. assertiveness training.


C. social skills training.


D. stress management techniques.


E. relaxation, assertiveness, and social skills training, as well as general stress management techniques.


21. Surveys of alcohol treatment programs suggest that programs are most successful when participants remain in treatment for

A. one to two weeks.


B. six to eight weeks.


C. two to three months.


D. at least four months.


E. 28 days.


22. As many as ____________ of Canadian undergraduate university students engage in harmful drinking.

A. 2%


B. 10%


C. 16%


D. 22%


E. 32%


23. With increased media attention on the problem of drunk driving, drinkers seem to be __________________ to avoid driving while drunk.

A. limiting drinks to a prescribed number


B. arranging for a designated driver


C. getting taxis


D. delaying or avoiding driving after consuming alcohol


E. All of these answers are correct.


24. Moderate alcohol intake has been associated with

A. increased risk from coronary artery disease.


B. increased risk for cardiovascular disease.


C. elevated levels of high-density lipoprotein cholesterol (HDLC).


D. elevated levels of low-density lipoprotein cholesterol (LDLC).


E. increased cancer risk.


25. For Aboriginal peoples, leaving the community for a residential addictions facility can

A. increase the chance of healing alcoholism and problem drinking.


B. reduce community triggers for problem drinking.


C. decrease the chance of relapse.


D. increase the chance of alcoholism and problem drinking.


E. increase risky sexual behaviours.


26. _______________ is/are the single greatest cause of preventable death.

A. Obesity


B. Alcoholism


C. Vehicular accidents


D. Smoking


E. Risky sexual behaviours


27. In Canada, approximately _______________ deaths per year are related to smoking.

A. 10,000


B. 25,000


C. 45,000


D. 50,000


E. 65,000


28. Smoking and serum cholesterol interact to produce higher rates of morbidity and mortality by

A. decreasing high-density lipoprotein (HDL) production.


B. increasing low-density lipoprotein (LDL) production.


C. inhibiting the blood’s ability to coagulate.


D. reducing blood oxygen capacity and increasing carbon monoxide levels.


E. increasing high-density lipoprotein (HDL) production.


29. Following the publication of the Surgeon General’s report on smoking in 1964, in Canada

A. smoking in all groups has continued to increase.


B. smoking in all groups has continued to increase, but the rate of increase has slowed.


C. men’s smoking has declined, but women’s has remained stable.


D. smoking among older people was relatively unaffected, but the percentage of teenage smokers has declined.


E. All of these answers are correct.


30. Smoking among adolescents is

A. independent of other health-compromising behaviours.


B. likely to occur in the presence of peers.


C. an effort to maintain a positive mood.


D. unrelated to individual differences in personality.


E. likely to occur in relation to drinking behaviour.


31. “Chippers”

A. is a term used to describe usually light smokers.


B. do not have the same risk factors as other smokers.


C. are declining in number.


D. are individuals who consume more than 20 cigarettes a day.


E. are more likely to eat while consuming cigarettes.


32. Fiissel and Lafreniere (2006) suggested that women who report that they smoke to control their appetite and weight

A. internalized the prescribed cultural standards of thinness.


B. are overweight or obese.


C. have eating disorders.


D. have a family history of eating disorders.


E. are more likely to come from single parent households.


33. Adolescents are more likely to smoke if

A. their parents smoke.


B. they have a lower SES.


C. there has been a major stressor in the family.


D. they feel social pressure to smoke.


E. All of these answers are correct.


34. The two “windows of opportunity” for beginning smoking are

A. late elementary and high school.


B. high school and beginning university.


C. late elementary school and beginning university.


D. high school and the ages 23-28.


E. there is only one window of opportunity.


35. Nicotine alters levels of active neuroregulators which

A. enhances memory.


B. reduces anxiety and tension.


C. improves mood.


D. improves psychomotor performance.


E. All of these answers are correct.


36. Evaluations of the effect of mass media anti-smoking messages suggest that they

A. provide information to smokers about health habits but have little effect on attitudes about smoking.


B. provide information about health habits to the general population but have little effect on anyone’s behaviour.


C. provide information about health habits and discouraging youth from beginning to smoke.


D. provide information about health habits and discourage adult non-smokers from beginning to smoke.


E. provide information about health habits and discouraging youth and adult non-smokers from beginning to smoke.


37. The use of transdermal nicotine patches

A. produces a sharper rise in nicotine level than does cigarette smoking.


B. does not produce significant gains in smoking cessation.


C. produces significant smoking cessation.


D. is more strongly associated with cardiovascular risk than is smoking.


E. was the first tool used for smoke cessation.


38. In which stage of Prochaska’s transtheoretical model of behaviour change would information about the adverse health consequences of smoking would be the most effective to provide to smokers?

A. precontemplation


B. contemplation


C. action


D. preparation


E. maintenance


39. Ex-smokers are more likely to be successful over the short term if they have

A. a supportive partner.


B. non-smoking supportive friends.


C. smoking supportive friends.


D. a supportive partner and non-smoking supportive friends.


E. a regular exercise routine.


40. The best predictor of long-term abstinence among smokers is

A. social support.


B. environmental support.


C. self-efficacy.


D. remaining vigilant about not smoking.


E. strength of intention to quit.


41. Physicians and other health care professionals are less helpful in controlling smoking as could be expected because

A. many smokers do not listen to them.


B. they rarely give advice to smokers.


C. they do not always have a negative attitude towards smoking.


D. almost all believe they would not be able to motivate people.


E. there is no time to discuss this on a routine visit.


42. Programs that provide materials to smokers so that they can quit on their own

A. are too haphazard in nature to be successful.


B. have been found to have higher initial quit rates than cognitive-behavioural interventions.


C. have been found to be as successful as cognitive-behavioural interventions in terms of long-term maintenance.


D. have the same impact as cognitive-behavioural interventions but are not as cost effective.


E. have been found to have high long-term relapse rates.


43. More than _______________ Canadians successfully quit smoking each year.

A. fifty thousand


B. one hundred thousand


C. two hundred thousand


D. half a million


E. one million


44. Those who quit smoking on their own

A. appear to be more successful in maintaining abstinence than participants in smoking cessation programs.


B. have high levels of self-control that is related to low relapse rates.


C. are more likely to have a socially supportive network that smokes.


D. have strong beliefs in the health benefits of stopping smoking.


E. are more likely to be women.


45. Social influence intervention programs often use the principle of behavioural inoculation. According to this principle, exposing individuals to a(an)

A. strong persuasive message ensures that they will internalize the message.


B. boring, repetitive persuasive message ensures that they will become desensitized to the message.


C. one-sided message ensures that uncommitted individuals will more likely be persuaded by the message.


D. weak version of a persuasive message ensures that they will develop counterarguments to resist a stronger version of the message.


E. continued message for at least 6 weeks will ensure they will internalize the message.


46. A popular new method for reducing smoking is referred to as

A. yap patching.


B. nicco-resting.


C. vaping.


D. e-niccorettes.


E. halo smoking.


47. The social influence intervention program highlights

A. the adverse effects of smoking on health.


B. the financial costs of smoking.


C. the negative social consequences of smoking.


D. how advertisers use subtle techniques, hopefully so students will be more able to resist cigarette advertising.


E. All of these answers are correct.


48. Which of the following harm reduction alternatives to smoking provides a promising and safer option to quitting?

A. Nicco-rest patches.


B. Nicotine gum.


C. Visual reality.


D. E-cigarettes.


E. There are no safe alternatives to smoking.


49. Evaluation of social influence programs suggests that

A. adolescent smoking rates are unaffected.


B. fewer adolescents begin smoking after exposure to such programs.


C. adolescent smoking rates are reduced for up to four years.


D. programs are needed that will reach the child destined to become a regular smoker.


E. these programs may delay smoking but do not necessarily reduce overall smoking rates.


50. The life-skills-training approach teaches adolescents

A. social skills.


B. refusal skills.


C. coping enhancement.


D. self-esteem.


E. All of these answers are correct.


51. Passive smoking (second-hand smoke) has been found to be associated with

A. normal blood carbon monoxide levels.


B. increased pulmonary functioning.


C. elevated skin plasticity.


D. childhood obesity.


E. increased rates of lung cancer.


52. Anorexia nervosa

A. is caused by amenorrhea.


B. is characterized by the binge-and-purge syndrome.


C. is characterized by reduced interest in food and restricted physical activity.


D. is characterized by dieting and exercising that results in weight loss that is significantly below optimal levels.


E. has a purely environmental etiology.


53. Anorexia has been found to be correlated with

A. body image disturbance.


B. high blood pressure and heart reactivity to stress.


C. self-esteem.


D. depression and anxiety.


E. All of these answers are correct.


54. Initial therapy for anorexia is focused on weight gain and usually uses a _______________ approach.

A. cognitive


B. family therapy


C. psychodynamic


D. behavioural


E. person-centered


55. Bulimia is correlated with

A. stress.


B. amenorrhea.


C. perfectionism.


D. obsession.


E. alcoholism.


56. Most therapies for anorexia utilize _______________, whereas _______________ appears to be the most effective treatment for bulimia.

A. behavioural therapy; medication and cognitive-behavioural therapy


B. medication; behavioural therapy


C. medication and cognitive-behavioural therapy; inpatient treatment


D. medication and inpatient treatment; cognitive-behavioural therapy


E. person-centered therapy; behavioural therapy


57. Many health-compromising behaviours share several important characteristics. Describe these characteristics and the implications for intervention programs.





58. Explain the consequences of illicit drug use.





59. Identify and describe the biological, psychological, and sociocultural factors implicated in alcohol abuse.





60. Explain the problem of relapse in the treatment of alcohol abuse. Which intervention strategies address this problem most effectively? Substantiate your answer with research from the text.





61. Answer the question posed in the text: “Why do people smoke?”





62. Describe the factors associated with smoking in adolescence. Evaluate the effectiveness of prevention programs targeting adolescents.





63. Describe the similarities and differences of anorexia and bulimia, including causes, symptoms, and treatment.





Student: ___________________________________________________________________________

1. According to the textbook, in the coping process any new event or change in the environment prompts the individual to make secondary appraisals of the significance of the event.

True    False


2. Negative affectivity (or neuroticism) has been related to alcoholism, depression, and suicidal behaviour, but not poor health.

True    False


3. External coping resources may include time, money, education, a decent job and the absence of other life stressors.

True    False


4. Psychological resilience means being able to bounce back from stressful situations relatively quickly.

True    False


5. Refusing to tolerate negative events is an important coping outcome.

True    False


6. Coping efforts are considered successful when they reduce the arousal related to stress.

True    False


7. Poor social relationships, and especially poor social integration, are major risk factors for death.

True    False


8. Whereas social support is associated with physical and psychological well-being, research has failed to establish a relationship between social support and good health habits.

True    False


9. Overall, research investigating the effectiveness of social support fails to support the matching hypothesis.

True    False


10. Ancillary skills of stress management include time management, good health habits, and social skills.

True    False


11. Moderators of the stress experience may have an impact on

A. stress itself.


B. the relationship between stress and illness.


C. the relationship between stress and psychological responses.


D. how much a stressful experience effects other aspects of a person’s life.


E. All of these answers are correct.


12. Coping can be thought of as

A. the thoughts and behaviours used to manage internal and external demands of a situation appraised as stressful.


B. a one-time transaction between a person and their environment.


C. unaffected by the external resources available to an individual.


D. a positive reaction to stress.


E. unrelated to the personality of the individual.


13. Research on the effects of procrastination on health has found that

A. the stress associated with procrastination is tied to more health problems


B. the stress associated with procrastination is tied to fewer health-promoting behaviours


C. procrastinating on going to the doctor is linked to more health problems


D. procrastination is associated with engaging in health-compromising behaviours


E. All of these answers are correct.


14. Current research suggests that perfectionism

A. is associated with high stress.


B. is associated with the practice of fewer wellness-promoting behaviours.


C. increases risk for mortality among older adults.


D. is harmful for health regardless of what form it takes.


E. is associated with high stress, the practice of fewer wellness-promoting behaviours, and increase the risk of mortality among older adults.


15. The process of _______________ involves an individual’s efforts to manage internal or external demands that tax his or her resources.

A. primary appraisal


B. secondary appraisal


C. coping


D. self-pacification


E. meditation


16. The consideration of coping as a dynamic process implies that

A. coping involves a wide range of actions and reactions to stress.


B. coping efforts are moderated by personal resources.


C. coping involves an ongoing set of responses by which the person continues to act on the environment.


D. coping involves an ongoing set of responses by which the person and the environment are involved in a reciprocal interaction.


E. coping is a particular action that can fluctuate depending on mood.


17. Negative affectivity

A. may compromise overall health.


B. can sometimes create a false impression of poor health when none exists.


C. predicts risk for certain chronic health conditions over time.


D. is directly linked to higher risk for mortality in old age.


E. is impacted by gluten sensitivity.


18. Individuals who are high in negative affectivity

A. are less likely to use health services.


B. are more prone to have genetic markers linked to alcohol dependence.


C. suppress symptoms of psychological distress and physical illness.


D. are not prone to anxiety.


E. have a decreased risk of suicide.


19. An individual with a pessimistic explanatory style is more likely to interpret negative events in terms of _______________ factors.

A. external, unstable, specific


B. external, stable, global


C. internal, unstable, global


D. internal, stable, global


E. internal and unstable


20. Wilma has experienced increasing levels of stress due to her deteriorating test scores in psychology. She complains to her friend Betty, “I can’t seem to get the hang of this stuff. I’m just not smart enough. I may have to drop out of the university.” Betty replies, “You’re smart enough, Wilma, but you’re just not spending enough time studying.” Betty is trying to change Wilma’s attributions of

A. internality.


B. stability.


C. globality.


D. externality.


E. All of these answers are correct.


21. A study of post-menopausal women conducted by O’Donovan and colleagues (2009) found that pessimistic explanatory style is associated with

A. reduced cell-mediated immunity.


B. higher rates of physical illness.


C. increased use of health facilities.


D. reduced energy levels.


E. a lack of physical symptoms.


22. Brissette, Scheier, and Carver (2002) found that university students who were optimists coped more effectively with the transition to university because they were more likely to use _______________ as a coping strategy.

A. denial


B. distancing


C. seeking social support


D. accepting personal responsibility


E. perception of social support


23. Treating oneself with kindness, feeling connected with humanity, and being mindfully aware of distressing experiences are qualities of one with

A. optimism


B. personal responsibility


C. self-compassion


D. gratitude


E. perfectionism


24. The belief that one can determine one’s own internal states and behaviour, influence one’s environment, and/or bring about desired outcomes is

A. optimism.


B. perceived control.


C. self-efficacy.


D. hardiness.


E. gratitude.


25. Psychological control has been related to

A. emotional well-being.


B. successful coping.


C. improved immune functioning among children with asthma.


D. increased self-efficacy.


E. All of these answers are correct.


26. High self-esteem has been related to

A. increased longevity.


B. active coping strategies.


C. reducing the harmful effects of high levels of stress.


D. reducing the harmful effects of low levels of stress.


E. genetic markers.


27. Research investigating the effectiveness of avoidant and approach coping strategies suggests that

A. avoidant strategies are effective in dealing with long-term stressors.


B. approach copers may exhibit short-term anxiety but cope well with long-term stressors.


C. the use of approach coping styles may represent a risk factor for negative responses to stressors.


D. both avoidant and approach strategies are equally effective in coping with stress.


E. avoidance strategies are not effective for short-term stressors.


28. Emotion-focused efforts would be most effective in coping with the worry and stress due to

A. having two final exams scheduled for the same day.


B. waiting to hear if your application to graduate school has been accepted.


C. receiving a notice that your taxes will be audited by the Canada Revenue Agency next week.


D. knowing that you haven’t saved enough money to pay your tuition, and it’s due in two weeks.


E. All of these answers are correct.


29. One of the most potent external resources with respect to health is

A. a good social network.


B. money.


C. socio-economic status.


D. genetic factors.


E. optimism.


30. People who are higher in socio-economic status (SES) show

A. lower morbidity for medical and psychiatric disorders.


B. lower mortality from all causes of death.


C. reduced neuroendocrine responses to stress.


D. better access to social support systems in general.


E. All of these are shown in people with a higher level SES.


31. Coping efforts center on

A. maintaining a positive self-image.


B. reducing harmful environmental conditions and enhancing the prospects of recovery.


C. maintaining emotional equilibrium.


D. continuing satisfying relationships with others.


E. All of these answers are correct.


32. When a supportive companion is present during a stressful situation, research has shown a subdued HPA axis response in participants. This is thought to be due to:

A. the release of oxytocin.


B. the release of cortisol.


C. an increased cardiovascular response.


D. the release of exogenous opioids.


E. a suppressed immune system.


33. Information from others that one is loved and cared for, esteemed and valued, and part of a network of communication and mutual obligation is called

A. coping.


B. internal resources.


C. social support.


D. external resources.


E. perceived control.


34. _______________ involves the provision of services, financial assistance, or goods.

A. Visible support


B. Tangible assistance


C. Invisible support


D. Monetary assistance


E. Perceived social support


35. A patient with AIDS decides to enter therapy. He explains that the therapist helps him in ways his friends and family cannot. Specifically, his therapist helps him find ways to cope with the disorder and understand it. This is an example of

A. personal control.


B. informational support.


C. tangible assistance.


D. emotional support.


E. external assistance.


36. The assurance that one is a valuable individual who is cared for is

A. emotional support.


B. tangible assistance.


C. visible support.


D. instrumental support.


E. invisible support.


37. Invisible social support

A. is support provided to you without you being aware of it.


B. is the perception that when you need social support it will be available.


C. often produces a sense of guilt.


D. uses others’ time and resources.


E. leads to a sense of obligation to support others.


38. Implicit social support

A. includes simply knowing that you have a social network that you can rely upon if there were a stressful event.


B. originates from implicit social networks without being directly targeted at a specific problem.


C. is associated with more psychological and biological benefits for Asian Americans compared to explicit social support.


D. is receiving support from that network without actively having to seek out that support.


E. All of these are related to implicit social support.


39. Social support has beneficial effects on the

A. cardiovascular system.


B. endocrine system.


C. immune system.


D. psychological distress of the individual.


E. All of these answers are correct.


40. According to the buffering hypothesis,

A. the more resources an individual has, the better he or she is able to cope with stress.


B. individual resources augment one’s ability to cope with high or low levels of stress.


C. individual resources improve a person’s ability to cope with only moderate levels of stress.


D. individual resources have little effect on coping with low levels of stress but become important at high levels of stress.


E. the more space an individual places between himself or herself and the situation, the better he or she is able to cope with stress.


41. An important variable in understanding the mechanism by which stress is moderated by social support appears to be the manner in which social support is assessed. When social support has been measured in terms of social integration, _______________ have been found. When subjective levels of social support have been assessed, however, _______________ have been found.

A. direct effects; few effects


B. buffering effects; few effects


C. buffering effects; direct effects


D. direct effects; buffering effects


E. few effects; direct effects


42. According to research on gender, marriage, and social support,

A. support from a partner, usually a spouse, is very protective of health for men.


B. women’s health is only slightly benefited by marriage.


C. being in an unsatisfying marriage confers health risks.


D. exiting a marriage entails health risks.


E. All of these statements relating to marriage and health are true.


43. The interplay of the stress experienced and expressed by one partner and the coping reactions of the other, is referred to as

A. the matching hypothesis.


B. dyadic coping.


C. implicit social support.


D. the coping response.


E. invisible coping support.


44. The idea that the effectiveness of social support is determined by the ability of an individual’s social network to provide the particular types of assistance needed in times of stress is the

A. direct effects hypothesis.


B. buffering hypothesis.


C. matching hypothesis.


D. empathetic understanding.


E. dyadic hypothesis.


45. According to Repetti et al., (2002), social support from one’s parents in early life _______________ in later life.

A. leads to more passive coping


B. is related to better health


C. is related to poorer health


D. is not related to health


E. is related to socioeconomic status


46. Mindfulness-based stress reduction

A. is based on the practice of mindfulness of moment or moment awareness.


B. is associated with a significant reduction in cortisol levels, blood pressure, and pro- inflammatory cytokines among cancer patients.


C. is linked to initial improvements in stress levels that are not maintained one year later.


D. has a high incidence of failure.


E. produces no physical results and only treats the psychological symptoms of stress.


47. According to studies by Li and Ferraro (2005) and C. Schwartz, Meisenhelder, Ma, and Reed (2003), evidence suggests that on the whole, people who provide support to others

A. suffer from poor health.


B. enjoy better health overall.


C. have a higher level of self-esteem.


D. receive physiological benefits but suffer in regards to their mental health.


E. have a lower level of self-esteem.


48. Researchers investigating disclosure have found that subjects who freely express their feelings about traumatic events

A. show increased levels of physiological arousal.


B. have difficulty maintaining adequate levels of social support.


C. are no longer upset about the events after expressing themselves.


D. are less likely to have subsequent health problems.


E. All of these answers are correct.


49. Research indicates that exercise may be a useful resource for combating the adverse effects of stress. Your text suggests this may be because exercise

A. appears to suppress the immune system.


B. appears to modulate immune activity during stress.


C. decreases exogenous opioids.


D. always increases cognitive processes.


E. increases endorphin levels, thus masking the effects of stress.


50. Stress management programs

A. are best conducted on an individual basis by a licensed psychotherapist.


B. are effective in relieving psychological distress but are seldom used in the treatment of stress-related illnesses.


C. may be beneficial in controlling stress-related disorders and reducing risk factors associated with coronary heart disease.


D. may be beneficial in controlling stress-related disorders and psychological distress, but have not yet been proven to be cost effective.


E. are best conducted in a support group environment, led by a licensed psychotherapist.


51. Relaxation training therapies include

A. reduces physiological arousal.


B. allows the person to return to pre-stress activities (when appropriate).


C. reduces psychological distress.


D. progressive muscle relaxation training, yoga and hypnosis among other techniques.


E. All of these are included in relaxation training therapies.


52. Stress management programs typically involve _______________ phases.

A. two


B. three


C. four


D. five


E. six


53. Sarah is taking a stress management class. Her instructor provides a variety of ways Sarah can combat her stress. Sarah is instructed to try several of these techniques in order to discover the skills that work best for her. The instructor is using _______________ training.

A. positive self-talk


B. relaxation


C. time management


D. stress inoculation


E. inoculation management


54. Relaxation training is designed to

A. provide cognitive insights into the nature and control of stress.


B. reduce the physiological arousal associated with stress.


C. mitigate the effect of stress carriers.


D. train individuals not to overcommit.


E. reduce negative dyadic support interactions.


55. Individuals that cause you special stress are

A. stress carriers.


B. not important to you.


C. easily ignored.


D. stress aggregators.


E. not to be confronted.


56. Explain what is meant by the term stress moderator. Identify three psychological variables and three social variables that have been found to moderate stress. Citing research from the text, explain the relationship between these variables and the experience of stress.





57. Explain how individual differences in personality are related to coping, and in turn health.





58. Explain how coping styles and coping strategies moderate the experience of stress. Citing research from the text, evaluate the effectiveness of each in terms of the type of stressor with which a person might be faced.





59. What is social support? What are the benefits of having a sufficient amount of social support? What are the costs of being in a dense social network?





60. Your dormitory suitemate is suffering from stress due to final exams. Using the techniques described in the text, design a simple stress management program. Explain the function of each component and why it should be included in the program.





Student: ___________________________________________________________________________

1. The typical physician assistant program lasts two years.

True    False


2. Good communication between patient and provider leads to a vague sense of satisfaction, but does not improve adherence to treatments.

True    False


3. The “gatekeepers” in Canada’s medical system refer to specialists.

True    False


4. The changing philosophy of health care delivery means that many physicians recognize that there are less intrusive alternatives to traditional medical management.

True    False


5. Disclosure of complementary and alternative medicine use to physicians ranges from only 22 to 36 percent.

True    False


6. Unsatisfactory patient-provider interaction has been noted as a reason for using complementary and alternative medicine.

True    False


7. Adherence to treatment is substantially increased when providers are able to draw on their personal authority as high-status figures, as well as their power of medical authority.

True    False


8. Patient-centred communication is an important way to improve the patient-provider dialogue.

True    False


9. When patients do not adopt the behaviours and treatments their providers recommend it is called non-adherence.

True    False


10. The placebo effect is solely caused by psychological expectations of improved health and alleviation of symptoms.

True    False


11. Rita is trained in traditional nursing and also has received special training in primary care. She is affiliated with a group of private practice physicians, sees her own patients, and provides routine medical care, prescribes treatment, and emphasizes health promotion and illness prevention. Rita is a(n)

A. advanced practice nurse.


B. nurse practitioner.


C. physician assistant.


D. clinical nurse specialist.


E. physician.


12. Most patients

A. are good judges of the technical quality of the medical care they receive.


B. consider medical treatment to be of high technical quality if the provider is nice.


C. feel that the technical quality of medical care is somewhat more important than the manner in which it is provided.


D. judge the quality of care by the amount of time they spend with a care provider.


E. do not associate quality of care with the manner it is received.


13. The technical quality of medical care and the manner in which it is provided are

A. critical determinants of patient satisfaction.


B. both important factors in provider-patient communication.


C. important factors in doctor shopping.


D. unrelated.


E. critical determinants of patient satisfaction, despite being unrelated.


14. Telehealth

A. includes a variety of services that use communication technology to connect people with health services


B. helps to connect patients with doctors


C. is useful for advice and consultation but not diagnosing or treatment


D. always requires the patient to follow-up in person with their health care provider


E. is not an effective way to receive advice or treatment for an illness


15. Problems with the structure of health care delivery system in Canada include

A. specialized care requires a referral


B. many Canadians do not have a family physician


C. long wait times


D. specialized care requires a referral, not enough family physicians, and long wait times


E. not enough use of complementary and alternative medicine


16. According to the Canadian Institute for Health Information (2007), which of the following is/are true?

A. compared to five other industrialized nations, access to primary health care in Canada was second to lowest.


B. fewer than 5 percent of family physicians in Ontario are accepting new patients.


C. more than a third of Canadian patients who needed medical attention had to wait six or more days to get an appointment with a doctor.


D. 25 percent of patients felt that a long wait time affected them negatively.


E. over half of all the patients studied said they experienced worry, anxiety, and stress while waiting.


17. According to research cited in the text regarding complementary and alternative medicine (CAM),

A. CAM is considered an integral part of conventional medical practice.


B. there are up to 300 different types of CAM.


C. 25 percent of Canadians have used at least one CAM in their lifetime.


D. the proportion of the general Canadian population that consults CAM providers is higher than those who use CAM on their own.


E. fewer Canadians are relying on CAM because of the prohibitive costs.


18. Why do people use CAM, given that traditional health care is paid for under Canada’s universal health care system, and for the most part CAM is not?

A. The people who use CAM tend to be higher in socio-economic status, making cost less of an issue.


B. Consultations with CAM providers tend to be longer and often take psychosocial aspects of the patient’s life into account.


C. In many cases people are able to avoid the uncomfortable effects that conventional treatments produce.


D. The people who use CAM tend to be higher in socio-economic status, making cost less of an issue and consultations with CAM providers tend to be longer and often take psychosocial aspects of the patient’s life into account.


E. All of these answers are correct.


19. The philosophy that health is a positive state to be actively achieved, not merely the absence of disease,

A. is not prevalent in Western medicine.


B. acknowledges physical and psychological influences but not spiritual influences on health.


C. is holistic health.


D. is a traditional therapy in Western medicine.


E. None of these answers are correct.


20. According to the text, one of the changes in the philosophy of health care delivery that affects patient-provider relationships is

A. Western medicine’s resistance to nontraditional therapies such as meditation and biofeedback.


B. in response to increased consumerism among patients, medical students become less egalitarian in their relationships with patients during the course of medical training.


C. that provider-patient relationships are becoming more egalitarian.


D. that a holistic view of health is not practical in Western society.


E. that a patient should not question or even discuss their care with their provider beyond what is necessary.


21. Which of the following is a provider behaviour that interferes with provider-patient communication?

A. sexism


B. not listening


C. elderspeak


D. use of jargon


E. sexism, not listening, elderspeak, and use of jargon are all behaviours that interfere with provider-patient communication


22. Provider efforts to manage the patient-provider interaction

A. encourages patients to discuss their concerns.


B. can lead to loss of important information.


C. can help to identify when the patient may be experiencing adverse reactions to certain prescribed drugs.


D. can facilitate an accurate assessment of the level of patients’ technical understanding.


E. can lead to malpractice suits in certain circumstances.


23. According to what the text says about the use of jargon, studies reveal that providers

A. accurately report that patients’ knowledge of medical terms is quite low.


B. underestimate the level of their patients’ understanding of medical terms.


C. overestimate the level of their patients’ understanding of medical terms.


D. tend to blame themselves for their patients’ lack of knowledge of medical terms.


E. tend to blame the internet for the patient’s lack of knowledge of medical terms.


24. When providers oversimplify terms for elderly patients, the result is

A. disturbing to patients and can have a significant effect on the quality of the patient-provider relationship.


B. the elderly patient is more able to understand.


C. the elderly patient feels like a helpless child.


D. a decrease in the rate of recovery.


25. Elderspeak

A. is similar to baby talk.


B. is an overly caring and infantilizing communication issue that sends the message that elderly people are incompetent.


C. have long-range health consequences for the person using elderspeak.


D. creates barriers between patient and provider.


E. All of these answers are correct.


26. Which of the following are often stereotyped as being quiet and passive?

A. First Nations patients.


B. acutely ill patients.


C. sicker patients.


D. patients with psychological disorders.


E. chronically ill patients.


27. Satisfaction with treatment tends to be higher when

A. a person is seen by a provider of the same race or ethnicity.


B. the physician acts worried about the patient’s health.


C. the physician takes an authoritative stance.


D. the physician is older than the patient.


E. the physician is shy and reserved.


28. The study by N’ Chróin’n and colleagues (2011) found that although 72 percent of patients being discharged felt that they had a good understanding of their diagnoses,

A. one-half did not follow-through with their doctor’s recommendations.


B. older patients and those with cognitive impairments were less likely to have a clear understanding.


C. younger patients were more likely to falsely report their level of comprehension.


D. compared to women, men were less likely to follow-through with their doctor’s recommendation.


E. more than half of the patients studied sought a second opinion to clarify the original diagnosis.


29. One factor in patients’ contribution to faulty communication is because patients

A. often respond to different cues than do providers and provide faulty cues about their true concerns.


B. are more concerned with their underlying illness than its symptoms than are providers.


C. present their most distressing symptoms clearly and precisely; most faulty communication occurs with minor symptoms.


D. have little difficulty interpreting and reporting their symptoms.


E. rely too heavily on misinformation on the internet.


30. Qualities of the medical interaction that exacerbate communication problems include the fact that

A. providers receive little feedback from their patients.


B. patients are more likely to provide negative rather than positive feedback.


C. patients seldom provide feedback about the effectiveness of providers’ communication.


D. many patients are relatively cautious with providers.


E. All of these answers are qualities of the medical interaction that exacerbate communication problems.


31. Patients do not disclose their use of complementary and alternative medicine CAM to their physicians because they

A. do not feel comfortable enough to discuss this with their physician.


B. believe that their physician does not need to know about their use of CAM.


C. because their physician did not explicitly ask them about CAM use.


D. expect a negative response from their physician.


E. All of the these are potential reasons why a patient may chose not to disclose the use of CAM to their physician.


32. The study of 20 randomly chosen hospitals in Quebec found that patients with communication problems in the delivery of their care

A. were at greater risk for experiencing multiple preventable adverse events


B. were less likely to complain to the ministry


C. were more dissatisfied with the hospital staff


D. tended to suffer from relatively minor health problems


E. All of these answers are correct.


33. When patients do not adopt the recommended medical treatment, the result is termed

A. malingering.


B. reactance.


C. doctor shopping.


D. non-adherence.


E. transference.


34. For short-term antibiotic regimens, an estimated _______________ fail to comply adequately.

A. one-quarter


B. one-third


C. one-fifth


D. three-quarters


E. one-eighth


35. The greatest cause of non-adherence to treatment is

A. the patient’s unsupportive home environment.


B. the patient’s uncooperative personality.


C. faulty patient-provider communication.


D. the decreasing use of traditional health plans.


E. distrust of the medical system.


36. For the most part, patients’ estimates of their rates of adherence are

A. accurate.


B. artificially high.


C. artificially low.


D. reliable.


E. creative.


37. Adherence is higher in patients who are

A. anxious and vigilant.


B. satisfied with their provider.


C. younger, white, and female.


D. asked to change personal habits.


E. older


38. Which of the following medical suggestions would be MOST likely to show high rates of non-adherence?

A. “Take three tablets per day for five days.”


B. “Please stop by the lab on your way out and have some blood drawn for a complete battery.”


C. “Make sure you schedule a mammogram before your next appointment.”


D. “Try to rest and take some annual leave from your job.”


E. “Please bring a stool sample back to our office at your earliest convenience”.


39. Overall adherence rates are poorest

A. for obtaining medical tests.


B. with complex self-care regimens.


C. when the advice is perceived as medical.


D. when the advice is vocational.


E. when patients have young children.


40. Avoidant coping strategies on the part of patients are

A. associated with good adherence to treatment regimens.


B. associated with poor adherence to treatment regimens.


C. associated with creative non-adherence.


D. unrelated with adherence to treatment regimens.


E. are not related to non-adherence to treatment regimens.


41. Creative non-adherence

A. seriously undermines a patient’s health.


B. is unrelated to disease prototypes.


C. may be a patient’s attempt to reassert control over their illness and its treatment.


D. is essentially when a patient lies to a doctor to avoid unpleasant treatments.


E. is an effective coping strategy.


42. Which of the following is NOT one of the three steps your text lists as critical in adherence?

A. understanding the treatment regimen


B. satisfaction with the relationship and treatment regimen


C. deciding to adhere


D. self-efficacy


E. these are all critical in adherence


43. The best predictor of physician sensitivity is

A. extraversion.


B. technical competence.


C. an interest in people.


D. idealism.


E. gender.


44. Which of the following is NOT associated with patient-centred communication?

A. it is an important way to improve the patient outcomes.


B. it enlists the patient directly in decisions about medical care.


C. it is especially effective with “difficult” patients, such as those who are high in anxiety.


D. it is well-suited for working with patients with more advanced communication deficits such as stroke survivors.


E. it is more dependent on the physician’s gender.


45. Communication skills training for physicians should include

A. a focus on patient-centred dialogue.


B. the effective use of nonverbal behaviours.


C. the use of simple rules of courtesy.


D. simple tactics that should become second nature.


E. patient-centred dialogue, the effective use of nonverbal behaviours, the simple rules of courtesy should all be included in communication skills training for physicians so that these things can become second nature.


46. According to a study of patient-provider communication skills conducted by Thompson, Nanni, and Schwankovsky (1990), patient satisfaction, perceptions of personal control, and patient question asking was highest in

A. women who listed questions before the visit.


B. women whose physicians encouraged the asking of questions.


C. women who listed questions before the visit and women whose physicians encouraged the asking of questions.


D. women who had done research on the internet before the visit.


E. women who had stronger personalities.


47. Efforts to identify the personalities of physicians who communicate effectively have revealed that

A. there is no one reliable characteristic that predicts good communication skills.


B. interest in people is the only reliable indicator of physician sensitivity.


C. physicians scoring high on extraversion are effective communicators.


D. there are multiple reliable indicators of physician sensitivity.


E. physicians scoring high on extraversion are effective communicators and there are multiple reliable indicators of physician sensitivity.


48. Adherence to treatment is improved when providers

A. provide verbal rather than written instructions about treatment, dosage, and side effects.


B. ask patients about potential barriers to adherence.


C. use their personal authority to prescribe treatments rather than to simply urge patients to adhere.


D. involve the patient’s spouse or partner.


E. take empathy training.


49. Of the following, which is NOT an important factor in increasing adherence to treatment?

A. modifying institutional procedures for following patients


B. presenting the treatment regimen clearly


C. increasing the skill of the practitioner in communicating with the patient


D. following up with the patient by phone or postcard


E. None of these answers are correct.


50. The placebo effect

A. accounted for much of the success of early medical treatments but is seldom an important aspect of modern medical care.


B. accounts for improvements in the patient’s psychological state but is unrelated to actual physiological changes.


C. has been observed in both patients and providers.


D. is powerful but of short duration.


E. accounts for about 15 percent of a drug’s effect.


51. Placebo effects may be associated with

A. improvements in patients’ medical conditions.


B. reductions in patients’ anxiety.


C. increased release of endogenous opioids.


D. some of the same biological pathways that account for the effects of “real” treatments.


E. All of these are associated with the placebo effect.


52. Placebo effects vary according to

A. how a provider interacts with the patient.


B. how much a provider believes in the power of the placebo.


C. a provider’s warmth, confidence, and empathy.


D. how a provider interacts with the patient, the provider’s belief in the power of the placebo, and the provider’s warmth, confidence, and empathy.


E. gender of the patient.


53. Researchers examining the links between the Big Five Factors and placebo responding has found that

A. people scoring low in agreeableness were more likely to experience placebo effects.


B. people scoring low in openness were more likely to experience placebo effects.


C. people scoring high in extraversion were more likely to experience placebo effects.


D. people scoring high in conscientiousness were more likely to experience placebo effects.


E. people scoring high in neuroticism were more likely to experience the placebo effects.


54. If both treatments are considered equally effective, in which of the following scenarios are you most likely to see a larger placebo response for Patient A over Patient B?

A. Patient A receives a vitamin pill; Patient B receives a vitamin injection


B. Patient A receives treatment from a new doctor at a clinic; Patient B receives treatment from her shaman (traditional healer)


C. Patient A takes a green stimulant pill; Patient B takes a red stimulant capsule


D. Patient A takes Buckley’s Mixture cough syrup; Patient B takes a no name brand cough syrup


E. In none of these scenarios would patient A experience a larger placebo response over Patient B


55. The presence of a placebo effect is reflected in the importance placed by the medical community on

A. double-blind studies.


B. prospective studies.


C. retrospective studies.


D. drug studies.


E. pilot studies.


56. Explain the various types of health care providers.





57. Discuss the factors that have contributed to patient consumerism and how patient consumerism has affected the patient-provider relationship.





58. How can patient-provider communication be improved?





59. Explain the causes of adherence and treatment non-adherence and discuss how non-adherence can be reduced.





60. Explain the ways in which interventions that target health care providers’ communication skills may be related to increased patient satisfaction and increased adherence.





61. A friend is laughing about another friend’s self-prescribed herbal remedies. He scoffs that the placebo effect is purely psychological, thus “all in your head.” Explain the nature and effect of placebos, and why this statement is inaccurate.





62. Explain how health care providers might use the placebo effect to its best advantage.





Student: ___________________________________________________________________________

1. Medical measures are only weakly related to patients’ or relatives’ assessments of quality of life.

True    False


2. There is evidence that depression may occur somewhat earlier in the adjustment process than denial or severe anxiety.

True    False


3. Whereas disease severity and the presence of debilitating symptoms affect quality of life, they are unrelated to body image.

True    False


4. Illness duration influences which types of coping strategies are used.

True    False


5. Self-blame for chronic illness is widespread.

True    False


6. Functional somatic disorders are more common in men than in women.

True    False


7. Due to the chronic strain involved, the divorce rate among families with a chronic illness is higher than that for the general population.

True    False


8. Many chronic illnesses lead to a decrease in sexual activity.

True    False


9. The Internet is a good source of information about skills for coping with common illness-related problems.

True    False


10. Simply telling patients that anxiety is a normal response to the stress of chronic illness does not alleviate their concerns about how they are reacting.

True    False


11. Self-reports of health status

A. are an important aspect of quality of life


B. have found to predict morbidity beyond medical and psychological factors


C. have found to predict mortality beyond medical and psychological factors


D. are an important aspect of quality of life, have found to predict morbidity and mortality beyond medical and psychological factors


E. are unreliable


12. ________ is a component of quality of life.

A. Physical functioning


B. Psychological status


C. Social functioning


D. Disease-related symptomatology


E. All of these answers are correct.


13. Medical measures of quality of life are

A. seldom based on objective criteria.


B. poorly correlated with patients’ and relatives’ assessments.


C. poorly correlated with patients’ assessments but are moderately correlated with relatives’ assessments.


D. moderately correlated with health psychologists’ assessments.


E. None of these answers are correct.


14. Assessment of quality of life considers

A. how much the disease and its treatment interferes with the activities of daily living.


B. the functional aspects of daily living.


C. the extent to which a patient’s normal life activities have been compromised by disease and treatment.


D. differences depending on whether the chronic illness is in an acute phase or when symptoms are less active.


E. All of these answers are correct.


15. Studying quality of life

A. makes it possible to determine what kinds of interventions may be needed.


B. is an unnecessary intrusion into patients’ lives.


C. cannot be used to compare therapies.


D. tells us little that the diagnosis does not provide.


E. has always been a top priority in medicine.


16. Immediately after a chronic illness is diagnosed,

A. patients are in a state of crisis.


B. patients find their habitual ways of coping with problems do not work.


C. anxiety, fear, and depression often take over.


D. patients are in a state of crisis where they find their habitual ways of coping do not work and anxiety, fear, and depression take over.


E. patients begin to develop a sense of how the chronic illness will alter their lives right away.


17. Denial

A. is a defense mechanism that allows the patient to avoid the immediate implications of an illness.


B. may help the patient control her or his emotional reaction.


C. can mask the fear associated with a chronic disease.


D. is a defense mechanism that allows a patient to avoid the immediate implications, and can mask the fear associated with a chronic disease, however it may help the patient control his or her emotional reaction.


E. inhibits the success of medical treatments for chronic illness.


18. Denial may serve a protective function

A. before the patient seeks medical treatment.


B. in the acute phase of the illness.


C. when patients must play an active role in the treatment regimen.


D. during the rehabilitative phase of the illness.


E. if the illness is chronic.


19. Denial is useful in helping patients

A. control their emotional reaction to illness.


B. monitor their physical condition.


C. seek treatment.


D. become active in their treatment regimen.


E. denial is never helpful.


20. Anxiety

A. is especially prevalent among people with asthma.


B. is associated with poor glucose control and increased symptoms in diabetic patients.


C. interferes with assessments of severity of the disease and its treatment.


D. can increase the risk of subsequent heart attacks among patients with heart disease.


E. All of these answers are correct.


21. According to Clarke and Currie (2009), anxiety is more common in

A. women.


B. men.


C. children with life threatening illnesses.


D. people with stroke, heart disease, and cancer.


E. people who are not in a significant relationship.


22. Depression in chronically ill patients is

A. independent of illness severity.


B. most commonly found in the acute phase of illness.


C. easily and reliably assessed.


D. related to long-term rehabilitation and recovery.


E. All of these answers are correct.


23. Unlike anxiety and denial, depression

A. may be a long-term reaction to chronic illness.


B. is at a steady state during the course of chronic illness.


C. is the first response to chronic illness.


D. may be intermittent and unrelenting.


E. is usually a short-term reaction to chronic illness.


24. Which of the following is NOT a predictor of depression among chronically ill patients?

A. the severity of the illness


B. chronic pain


C. marital status


D. becoming disabled


E. they are all predictors of depression among chronically ill patients


25. The perception and evaluation of one’s physical functioning and appearance comprises one’s

A. physical self.


B. self-concept.


C. body image.


D. self-evaluation.


E. All of these answers are correct.


26. Body image can be improved by

A. ignoring the area of disfigurement.


B. reconstructive surgery.


C. medication.


D. stressing other aspects of appearance and health.


E. biofeedback.


27. ___________ are visions of the self for the future, which can help to motivate, organize, and direct an individual’s current goals and aspirations.

A. Social selves


B. Achieving selves


C. Possible selves


D. Physical selves


E. Potential selves


28. According to a study of cancer patients conducted by Dunkel-Schetter and her colleagues (1988), the most frequently cited stressor was

A. fear and uncertainty about the future.


B. limitations in physical abilities.


C. pain management.


D. altered physical appearance and lifestyle.


E. financial worries.


29. Analyses of the effectiveness of coping strategies in managing the stress associated with chronic illness conclude that

A. the coping strategies used by chronically ill patients are significantly different from the strategies observed in healthy samples.


B. avoidant coping is associated with reduced psychological distress and better psychological adjustment.


C. confrontative coping is associated with better adjustment than the use of multiple coping strategies.


D. active coping is more consistently associated with good adjustment.


E. vigilant coping is associated with reduced psychological distress over the long-term.


30. Successful adjustment to chronic illness is NOT associated with

A. having an appropriate or accurate illness schema about the nature of one’s illness.


B. developing an acute model of one’s disorder.


C. blaming others for one’s illness and thus minimizing self-blame.


D. having a personal sense of control, even in medical situations, in which little personal control is possible.


E. avoidant coping.


31. Blaming another person for one’s disorder

A. is maladaptive.


B. may be tied to unresolved hostility.


C. can interfere with adjustment to the disease.


D. is most effective when the person being blamed is not a close friend or family member.


E. is maladaptive, may be tied to unresolved hostility, and can interfere with adjustment to the disease.


32. In general, high levels of perceived control facilitate adjustment, EXCEPT in cases where

A. patients are seriously debilitated, both physically and psychosocially.


B. patients must cope with long-term chronic illness.


C. patients must cope with acute disorders and treatment.


D. where actual control is low.


E. patients are seriously debilitated and must cope with long-term chronic illness.


33. According to researchers at the University of British Columbia, children with asthma benefit most from

A. perceived control.


B. self-esteem.


C. parental support.


D. emotion focused coping.


E. self-efficacy.


34. Which of the following is NOT one of the goals of rehabilitation discussed in your text?

A. redefining oneself as being chronically ill


B. adherence to one’s treatment regimen


C. the control of energy expenditure


D. the ability to identify and respond to the onset of a medical crisis


E. they are all goals of rehabilitation discussed in your text.


35. Fibromyalgia

A. affects almost 400,000 Canadians.


B. is associated with sleep apnea.


C. is associated with increased parasympathetic system stress responses.


D. is more common among men than women.


E. is not a real disease.


36. Which of the following is NOT a symptom of chronic, low-level inflammatory processes that characterize functional somatic syndromes?

A. fatigue


B. pain


C. sick-role behaviour


D. negative affect


E. All of these answers are symptoms.


37. Adherence to treatment regimens in chronically ill patients is

A. significantly higher than in patients being treated for acute disorders.


B. significantly lower than in patients being treated for acute disorders.


C. unaffected by the side effects of treatment.


D. especially problematic in complex and long-term treatment regimens.


E. significantly lower in women than in men.


38. Creative non-adherence to treatment regimens among people with chronic illness

A. is rare.


B. may occur because they know their disease extremely well.


C. occurs because they are not tuned into their internal feedback.


D. is recommended by doctors when there are no traditional methods left to try.


E. is not an issue that health psychologists are concerned with.


39. The study by Lacaille and colleagues (2007) on the work-related problems of people with arthritis found that

A. fatigue was the most limiting symptom of arthritis that created problems at work.


B. co-workers’ relationships were supportive.


C. job satisfaction, aspirations for advancement, and salary were unaffected by their arthritis.


D. they avoided working too hard so they could save their energy for their home lives.


E. ergonomic solutions in the office were not helpful.


40. With respect to the vocational issues in chronic illness

A. job counselling, retraining programs, and advice on how to avoid or combat discrimination should be assessed later in the recovery process so as to not interrupt the healing process.


B. some people may have to find ways to cope with working conditions that are not ideal but necessary to stay employed.


C. cancer patients are rarely fired or laid off.


D. employers will often allow for a patient to take more sick days than an average employee.


E. many people who suffer from chronic illness are able to keep their jobs with no complications.


41. Negative reactions to chronically ill patients include

A. discrimination.


B. distress.


C. feeling worn down.


D. stereotypes.


E. shunning.


42. Physical rehabilitation of patients with chronic illness involves learning

A. how to use one’s body as much as possible.


B. new physical management skills.


C. how to control the expenditure of energy.


D. a necessary treatment regimen.


E. All of these answers are goals of physical rehabilitation.


43. Divorce rates for families with a chronic illness are

A. higher when the patriarch is sick because they are the primary breadwinner.


B. lower than families without a chronic illness.


C. higher than families without a chronic illness.


D. no different than families without a chronic illness.


E. lower in families with children because they take on new roles to help out.


44. Regarding caregiving for people with chronic illness,

A. care for people with chronic illness is notoriously irregular.


B. the care-giving role more commonly falls to the oldest child.


C. caregiving is usually more rewarding for men than women.


D. the caregiver should only help with the psychological care of a patient.


E. the caregiving role requires a vast amount of medical knowledge or research in order to be effective.


45. Most caregiving for the chronically ill is provided by

A. formal services such as home health nurses or nursing homes.


B. men.


C. family members.


D. friends.


E. hospices.


46. Researchers investigating gender and the impact of chronic illness have found that

A. women with chronic illness also experience less distress than men.


B. women have a higher burden of disease than men.


C. married women spend fewer days in nursing homes than married men.


D. men with chronic illness are less likely to be married than disabled women.


E. hospitalization of one’s spouse does not increase risk of death for husbands or wives.


47. Collins et al. (1990) reported that more than _______________ of the cancer patients in their study reported at least some beneficial changes in their life as a result of the cancer.

A. 20 percent


B. 45 percent


C. 75 percent


D. 90 percent


E. 50 percent


48. Which of the following is NOT a result of caring for those with chronic illness

A. strains the relationship between patient and caregiver.


B. increases risk for depression.


C. compromises the health of the caregiver.


D. is linked to alterations in immune functioning.


E. increases resiliency in most people.


49. Research on the positive changes in response to chronic illness has found

A. that achieving a high quality of life is linked to having positive self-perceptions.


B. more than 90 percent of cancer patients reported at least some beneficial changes in their lives as a result of the cancer.


C. finding benefits in illness is not always associated with good adjustment.


D. All of these answers are correct.


E. None of these answers are correct.


50. Which one of the following would hamper a child’s ability to cope effectively with a chronic illness?

A. The parents do not appear distressed.


B. The child continues to attend school throughout their illness.


C. The parents have a history of depression or other mental illness.


D. The child takes part in physical activities.


E. The parents giving them some control over their treatment.


51. Patient education programs that include coping skills training

A. can increase knowledge about the disease.


B. increase patients’ feelings of purpose and meaning in life.


C. increase adherence to treatment.


D. can increase knowledge about the disease and increase feelings of purpose and meaning in life but does not address adherence to treatment.


E. can increase knowledge about the disease and increase feelings of purpose and meaning in life, all the while addressing adherence to treatment.


52. Family support of patients with a chronic illness is especially important because

A. they encourage the patient to be cheerful.


B. they are the only ones available when friends cannot be counted on.


C. they promote adherence to treatment.


D. they help the patient cope with the stigma associated with certain disorders.


E. they allow the patient to make his or her own choices.


53. A social support group is most likely to help

A. Fred, an insurance company executive who is recovering from a myocardial infarction (MI).


B. Mar’a, a recent immigrant from the Philippines who suffers from rheumatoid arthritis.


C. Sybil, a high-school dropout with three children who is recovering from a mastectomy.


D. All of them, because support groups have shown efficacy for cancer, rheumatoid arthritis, and myocardial infarction.


E. None of these people, as support groups are comforting but otherwise unhelpful.


54. Discuss the components of quality of life.





55. What are the common emotional responses to chronic illness? How do these responses impact care and adjustment?





56. Answer the question posed in the text: “How is the self changed by chronic disease?”





57. What are the coping strategies are commonly used to cope with chronic illness? Which ones are more adaptive and which ones are less adaptive and what factors influence which strategies are used?





58. Studies have found that the quality of life reported by cancer patients is higher than healthy community samples. Explain how chronically ill patients cope with their illnesses and maintain a positive self-concept.





59. Explain the role of social support in coping with chronic illness. In your answer, consider both the benefits and the costs of social support, and the different forms that it can take.



Student: ___________________________________________________________________________

1. One of the most significant aspects of CHD is that a number of the deaths that occur each year are premature deaths.

True    False


2. Across the life span, women seem to be protected against coronary heart disease relative to men.

True    False


3. A type of proinflammatory cytokine is implicated in the development of atherosclerosis.

True    False


4. Cognitive behavioural interventions may reduce the drug requirements for the treatment of hypertension.

True    False


5. Mild hypertension is defined by a diastolic pressure consistently between 105 and 119.

True    False


6. National campaigns to educate Canadians about hypertension have not been very successful in getting people diagnosed and treated.

True    False


7. Stroke occurs more often in women than in men.

True    False


8. In terms of emotional response, patients with left-brain damage from a stroke seem indifferent to their situation.

True    False


9. Whereas stress adversely affects adherence to treatment and diet, stress has not been found to directly affect Type I and Type II diabetes.

True    False


10. Depression often is a complication of diabetes.

True    False


11. The number two killer in Canada, accounting for more than 20 percent of all deaths, is

A. diabetes.


B. coronary heart disease.


C. hypertension.


D. cancer.


E. parainfluenza.


12. One of the most significant aspects of coronary heart disease is that

A. a number of the deaths that occur each year are premature deaths.


B. it is a disease of lifestyle.


C. it involves modifiable risk factors.


D. it is a non-communicable disease.


E. it is not as serious as most people think.


13. The combination of obesity centered around the waist, high levels of triglycerides, low levels of HDL cholesterol, and difficulty metabolizing blood sugar are symptomatic of

A. inflammation due to C-reactive protein.


B. metabolic syndrome.


C. angina pectoris.


D. cardiac arrest.


E. diabetes.


14. Which of the following job factors has been found to be related to increased risk of CHD?

A. high work demands and low control


B. a discrepancy between one’s education level and one’s occupation


C. low job security


D. occupational stress in general


E. All of these job factors have been found to be related to an increase risk of CHD.


15. Coronary heart disease (CHD) is the number _____ killer in Canada.

A. one


B. two


C. three


D. four


E. five


16. Women

A. show greater increases in cardiovascular, neuroendocrine, and some metabolic responses in response to stress than do men.


B. experience an increased risk of myocardial infarction or CHD-related death after menopause.


C. develop CHD on the average about 15 years earlier than do men.


D. seem to be protected at young ages against CHD due to their lower levels of HDL cholesterol.


E. have not been shown to have different risks for CHD than men.


17. The personality quality “agency” is associated with _______________, whereas “communion” is associated with _______________.

A. good physical and mental health outcomes; reduced psychological stress


B. good physical and mental health outcomes; few relations to physical and mental health outcomes


C. few relations to physical and mental health outcomes; good physical and mental health outcomes


D. reduced psychological stress; good physical and mental health outcomes


E. they are both related to good physical and mental health outcomes


18. Besides chronic stress, what other emerging factor may lead to coronary heart disease?

A. socio-economic status




C. ethnicity


D. career choice


E. mobile phone use


19. Hostility

A. is a potential risk factor for the development of heart disease.


B. is a predictor of survival of heart disease.


C. is implicated in diabetes.


D. has a genetic component.


E. All of these answers are correct.


20. Cynical hostility is characterized by

A. suspiciousness.


B. little resentment.


C. infrequent angry episodes.


D. trust in others.


E. paranoid schizophrenia.


21. Higher levels of hostility have been found among

A. men.


B. non-whites.


C. people low in socio-economic status (SES).


D. men, non-whites, and people with low socio-economic status (SES).


E. men and non-whites only, socioeconomic status (SES) does not affect higher hostility levels.


22. Hostile individuals

A. exhibit a weak antagonistic response to sympathetic activity in response to stress


B. have a prolonged reactivity to stress


C. have larger and longer-lasting blood pressure responses to anger-arousing situations


D. show different patterns of immune activation in response to sympathetic activation


E. All of these answers are correct.


23. Which type of hostility is most related to CHD?

A. oppositional defiant hostility


B. familial hostility


C. conflictual hostility


D. cynical hostility


E. major depressive hostility


24. Individuals who are high in hostility

A. have chronically higher blood pressure.


B. show more pronounced heart rate reactivity to laboratory stressors.


C. show more pronounced physiological reactions in response to interpersonal stressors.


D. exhibit a strong antagonistic response to sympathetic activity in response to stress.


E. exhibit higher levels of serotonin.


25. Depression may be a risk factor for CHD due to its relationship with

A. C-reactive protein.


B. the metabolic syndrome.


C. both C-reactive protein and the metabolic syndrome.


D. decreased energy levels.


E. Depression is not a risk factor for CHD.


26. Social dominance is related to



B. all-cause mortality.


C. a pattern of attempting to dominate social interactions.


D. a faster than normal speaking rate.


E. All of these answers are related to social dominance.


27. As a recommended intervention for the modification of coronary-prone behaviour, exercise can

A. reduce CHD risk factors.


B. enhance psychological well-being.


C. reduce CHD morbidity and mortality.


D. help reduce the anxiety associated with CHD following cardiac events.


E. All of these answers are correct.


28. Which of the following has NOT been found to be associated with delay before seeking treatment for myocardial infarction?

A. interpretation of symptoms as mild disorders


B. being young and white


C. history of angina or diabetes


D. experiencing an attack during the daytime


E. they have all found to be associated with delay before seeking treatment for myocardial infarction


29. Beta-blocking agents are used in cardiac rehabilitation

A. to activate the parasympathetic nervous system.


B. to resist the effects of sympathetic nervous system stimulation.


C. to control the pain of angina pectoris.


D. when behavioural stress management interventions fail.


E. to lower levels of LDL cholesterol.


30. ______________ is/are the most common drug treatment for reducing the incidence of death, heart attack, and stroke.

A. Statins


B. Diuretics


C. Beta-blockers


D. Vitamins


E. Aspirin


31. Cardiac rehabilitation programs involve

A. aerobic exercise.


B. smoking cessation.


C. reduced alcohol consumption.


D. aerobic exercise, smoking cessation, and reduced alcohol consumption.


E. aerobic exercise, smoking cessation only.


32. Cardiac invalidism occurs when

A. patients and their spouses underestimate the patient’s physical abilities.


B. spouses underestimate the extent of disability.


C. patients malinger in order to reap secondary gains associated with the sick role.


D. patients feel that they are unable to control the stressors in their daily lives.


E. spouses overestimate the patient’s physical abilities.


33. In a study of cardiac invalidism (Taylor et al., 1985), wives’ perceptions of their husbands’ cardiac and physical efficiency were highest when they had

A. been provided information about their husband’s medical and psychological condition.


B. observed their husband’s performance on a treadmill task.


C. personally experienced the treadmill task themselves.


D. been involved in the decision making process regarding treatment.


E. observed them at home doing everyday tasks.


34. Sudden death from heart attack is most likely to occur

A. at home.


B. at work.


C. on vacation.


D. while the patient is asleep.


E. at a restaurant.


35. Diastolic pressure is related to

A. resistance of the blood vessels to blood flow.


B. the amount of force developed during contraction of the heart.


C. the volume of blood leaving the heart.


D. the arteries’ elasticity.


E. All of these answers are correct.


36. Males are at greater risk for hypertension

A. across the life span.


B. before age 40.


C. before age 50.


D. after age 50.


E. after age 60.


37. According to a study of hypertension risk factors by Ewart (1991), the family environment that fosters _______________ may then contribute to hypertension.

A. negative affectivity


B. chronic anger


C. excessive competitiveness


D. cynical distrust


E. defensiveness


38. The role of stress in the development and exacerbation of hypertension

A. is the same for people at risk for hypertension and those who are not at risk.


B. does not change as hypertension progresses.


C. may be different for people at risk for hypertension.


D. has not been studied enough to determine what the role is.


E. is still unclear.


39. In a study of Canadian-Chinese and American-Chinese women by Satia-Abouta, Patterson, Kristal, Teh, and Tu (2002), the prevalence of hypertension associated with acculturation may be traced to

A. the stress of acculturation.


B. the pressure to change traditional lifestyle practices, including an adopted diet lower in fruit and vegetables.


C. exposure to chronic environmental stressors.


D. anxiety related to learning a new language.


E. There are no health risks associated with acculturation.


40. The longer immigrants have been living in Canada

A. the more levels of hypertension resemble the general population.


B. the incrementally more chance there is of having hypertension.


C. the less researchers can separate hypertension from socioeconomic variables.


D. the incidence of hypertension drops dramatically.


E. has no effect, hypertension can set in at any time during acculturation.


41. One drug treatment for hypertension, beta-adrenergic blockers, work by

A. decreasing cardiac output and decreasing plasma renin activity.


B. decreasing sympathetic outflow from the central nervous system.


C. depleting catecholamines from the brain and the adrenal medulla.


D. reducing blood volume by promoting the excretion of sodium.


E. decreasing cardiac output and increasing plasma renin activity.


42. Caffeine restriction is often included as part of the dietary treatment of hypertension because

A. caffeine elevates blood pressure responses among those at risk for or already diagnosed with hypertension


B. caffeine generally contributes to rising levels of hypertension


C. it is an easy and inexpensive treatment


D. caffeine elevates blood pressure, contributes to rising levels of hypertension


E. caffeine restriction is never a recommended part of a dietary treatment for hypertension


43. Cognitive behavioural techniques

A. may substitute for drug treatments in cases of severe hypertension.


B. aggravate sympathetic nervous system activity.


C. are effective but expensive compared to drug treatments for hypertension.


D. designed to control the expression of anger have been unsuccessful in the treatment of hypertension.


E. are effective because they do not require supervision and they have less side effects


44. The correlation between beliefs about level of blood pressure and actual blood pressure is

A. high.


B. moderate.


C. low.


D. zero.


E. > than.8.


45. The risk factors for stroke

A. are independent of those for heart disease.


B. decrease with age.


C. are not subject to modification by lifestyle changes.


D. include cigarette smoking.


E. None of these answers are correct.


46. Patients with right-brain damage due to stroke typically suffer

A. communication disorders such as aphasia.


B. impaired performance on cognitive tasks that require the use of short-term memory.


C. difficulty in processing visual feedback.


D. extreme anxiety and depression.


E. impaired performance on tasks that require language generation.


47. Small strokes that produce temporary weakness, clumsiness, or loss of feeling in one side or limb are called

A. cerebral hemorrhages.


B. hypertension.




D. transient ischemic attacks.


E. temporary cerebral attacks.


48. Predictors of depression in stroke patients include

A. overprotection by a caregiver.


B. site and severity of stroke.


C. poor relation with a caregiver.


D. a caregiver with a negative viewpoint on the caregiving situation.


E. All of these answers are correct.


49. Which of the following is NOT one of the rehabilitative interventions used for stroke patients?

A. psychotherapy.


B. cognitive remedial training.


C. family counselling.


D. the use of structured, stimulating environments to challenge the stroke patient’s capabilities.


E. training in specific skills development.


50. Type I (insulin-dependent) diabetes

A. develops relatively late in life (after age 40).


B. accounts for 90 percent of all diabetics.


C. is characterized by an abrupt onset of symptoms.


D. usually is inherited.


E. is related to obesity.


51. Type II (noninsulin-dependent) diabetes

A. develops relatively late in life (after age 40), but is becoming more common in children and adolescents.


B. accounts for 70 percent of all diabetics.


C. occurs when insulin action and secretion is regulated.


D. most commonly occur in women.


E. All of these answers are correct.


52. Stress has been implicated in

A. problems in glucose metabolism.


B. disruption of the performance of preventive health behaviours related to diabetes self-management.


C. adverse effects on adherence to diabetic treatment regimens and diet.


D. the aggravation of both Type I and Type II diabetes after diagnosis.


E. All of these answers are correct.


53. Poor adherence to diabetes treatment seems to be due to

A. situational factors.


B. regional factors.


C. personality factors.


D. family background.


E. socio-economic status.


54. Which of the following would BEST predict compliance with a diabetic treatment regimen?

A. the number of persons in the diabetic’s social support network


B. training the diabetic to discriminate when his or her blood glucose level needed to be modified


C. any intervention that focuses on improving a sense of self-efficacy and the ability to independently regulate one’s behaviour


D. stress management and relaxation training


E. having a family member present at diagnosis to take notes


55. Studies of diabetic control and adherence indicate that the best outcomes are found among adolescents who have

A. individual therapy.


B. family therapy.


C. parents who are actively involved in tasks such as monitoring glucose levels.


D. a dense social support network.


E. parents who allow them to monitor their own glucose levels, giving them a sense of independence and accomplishment.


56. Explain the relationship of lifestyle factors to coronary heart disease and cardiac rehabilitation.





57. Discuss what we currently know regarding how women experience coronary heart disease including the factors contributing to its development and the consequences for women in comparison to men.





58. What ethnic differences have been found in the incidence of hypertension? What psychosocial factors may be implicated in these ethnic differences?





59. What are the consequences of stroke? What are the rehabilitative interventions used to manage the consequences of stroke?





60. Explain why adherence to diabetic treatment programs is so difficult for most people to achieve.