SHORT ANSWER

6. 110 It has been three years since Miguela participated in the Stanford Heart Disease Ans. B Prevention Program. If she received the dual-focus intervention, what would App you expect to discover about her?

p. 208 a. She has returned to the level of risky behaviors she exhibited prior to the M program.

b. She has maintained a reduction in her cigarette smoking for the last 3 years.

c. She is similar to the average person from either of the other two cities in regard to her level of knowledge and risk.

d. She is more likely to exercise on a regular basis and monitor her diet.

SHORT ANSWER

6. 111 Explain how the biopsychosocial model applies to health psychology's understanding of illness, giving several examples of the latter two components of that model. Why does adoption of this model encourage the deletion of "psychosomatic disorders" as a separate DSM category?

An illness does not have a sole cause but is affected by biological vulnerability, psychological factors, and social conditions. These could include the following:

1) psychological factors -- risky behaviors such as cigarette smoking, alcohol & other drug use, unsafe sexual behavior; lack of exercise; negative emotions (hostility, anger, competitiveness)

& lack of conscientiousness; poor diet; lack of a sense of control over environment (related to interpretation of stressors); inadequate problem-solving skills.

2) social conditions -- unstable, stress-producing environments such as crowded, urban areas; lack of education; racism and discrimination; inadequate access to health care; lack of social support; gender-role related stresses.

The DSM deleted the psychosomatic disorders category because it is recognized that psychological factors have a role to play in virtually all diseases and that most diseases can be prevented or substantially ameliorated by psychological interventions.

6. 112 Why are Aristotle, Sir William Osier, Franz Alexander, and Friedman & Rosenman important in the history of health psychology?

Aristotle: encouraged a monistic approach to understanding the relationship between mind (soul) and body, supporting what would become the biopsychosocial model for the modem field.

Osier: considered the father of behavioral medicine, insisted that psychological factors were important in understanding physical illness; 1910 lecture set forth ideas about heart disease that have been supported by modem researchers.

Alexander: in his 1950 text, Psychosomatic Medicine, suggested that specific unconscious conflicts caused certain illnesses; while his original ideas are not empirically supported, the role of certain negative emotional states have been connected to various illnesses.

Friedman & Rosenman: identified the Type A behavior pattern that has become the most extensively studied psychological risk factor for cardiovascular disease.

6. 113 When data regarding negative emotion is combined with research on the physiology of Type A vs. Type B individuals, what pattern emerges?

When encountering a stressor, Type A's demonstrate physiological reactivity in terms of faster heart rate and higher diastolic and systolic blood pressure than Type B's do. When these stressors are related to interpersonal conflict, generate competitiveness, or involve criticism, this reactivity is most evident. Given that these situations also tend to generate hostility and anger, a chronic pattern of hostility can engender higher levels of cardiovascular reactivity; thus, a mutually-reinforcing pattern of negative emotions and reactivity may account for some of the CHD risk exhibited by Type A persons.

6. 114 In regard to the AIDS epidemic, a) which two groups have the highest risk of AIDS in the U. S. ? b) which three groups in the U. S. have AIDS cases growing at a particularly fast pace?

c) what two modes of transmission are most common in African and Asian countries? d) what four high-risk behaviors increase exposure to the disease?

a) gay males and intravenous d r u g users

b) low-income Black Americans, Hispanic adolescents, and heterosexual women c) heterosexual contact and mother-child transmission

d) excessive use of alcohol/other drags prior to sexual activity; sex with multiple partners and/or partners with unknown sexual histories; failure to use a condom; sharing of needles 6. 115 Given the alarming increase in the incidence of HIV and AIDS in heterosexual women in many developing nations, what intervention strategies have been proposed to reduce their risk?

Education regarding HIV, its transmission, and related risk behaviors; reduction in sexual abuse victimization and support for women to take greater control over their sexual lives, including greater access to female condoms and vaginal microbicides; support for greater economic independence to reduce subjection to sexual coercion or commercialized sex

6. 116 Describe a hypothetical intervention for ovarian cancer that includes each of the components necessary for a successful program. Give at least two examples of each of those components.

No specific modal response predictable -- answer should address each of the three components below, with at least two applications of the associated techniques:

1. stress-reduction: cognitive and/or muscle relaxation training, biofeedback, hypnosis (including self-hypnosis), or meditation.

2. cognitive restructuring: training in effective problem-solving, development of a greater sense of control over the disease as well as control related to treatment compliance, provision of realistic information about prognosis and effects and side-effects of treatment, role modeling via interaction with patients who have undergone prescribed treatment.

3. social support: offer 1 & 2 above in a group setting, provide tangible aid if needed, encourage interactions with family and friends.

6. 117 What are the six behavioral risk factors that, if substantially changed, might prevent half of the deaths in the U. S. each year?

use of tobacco, abuse of alcohol & other drugs, unhealthy eating habits, infrequent use of seatbelts, failure to obtain or comply with necessary medical treatment, and risky sexual practices 6. 118 Dr. Bate is a new family practice physician. She was told in medical school that patients would often be noncompliant with treatment, but she is surprised that so many of her patients also seem uninterested in maintaining healthy behaviors. Offer her some ideas that might help her understand her patients' apparent lack of concern.

Changes in lifestyle make long-term adherence difficult due to its inconvenience and to changes in day-to-day priorities.

The delayed consequences for unhealthy behaviors are essentially meaningless to many individuals; the longer the delays, the less the impact, and thus while outcomes may eventually be extremely aversive, they are psychologically irrelevant in the present moment.

Many people with unhealthy behaviors do not develop a related disease or illness;

reductions in risky behaviors, then, only slightly affect a given individual's morbidity risk.

An individual's beliefs about their own susceptibility, the severity of a potential illness, her/his view toward treatment, and level of discomfort caused by internal and external cues are also factors in whether people change their risky behaviors [with these components comprising the health belief model].

6. 119 In your life now or in the future, what unhealthy behaviors might increase your risk of cardiovascular illness? How could you apply the health belief model to the probability that you might change these behaviors?

No modal response available for the first question. The response to the second question should demonstrate that the student has addressed the following issues:

degree to which they believe they personally are susceptible to the disease; how severe they think the disease would be for them; what they think about the treatment for the disease, i. e., the nature of its cost and effectiveness; whether they are bothered by internal cues; whether they are motivated by external cues/pressures