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Final Exam Review Guide

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Rutgers University
Richard J.Contrada

Outline of Major Topics and Guide for Review for Final Exam This is a guide for review. It tells you about the material that will and will not be on the exam. It should help you to focus your preparation for the final exam. Sakai: Contains this study guide, sample final exam questions with answers, and an outline of the main points from the readings. Final Exam: This is not a cumulative final exam. It is simply a second exam with multiple-choice questions based on material covered since the Mid-Term. It will have about the same number and type of questions as the Mid-term. Day/Time/Location of Final Exam: See syllabus Photo ID: Aphoto ID must be presented at the door prior to seating for the Final Exam. Pencils: Bring several #2 pencils with sharp points and good erasers Major Topics and Sub-Topics Note that topics and subtopics in bold font are guaranteed to be subject to one or more questions on the final exam Cardiovascular Disease 1. Coronary artery disease, coronary heart disease, stroke, hypertension: Definitions a. Coronary artery disease – when the arteries that supply blood to heart muscle become hardened and narrowed (atherosclerosis): a common form of arteriosclerosis in which fatty substances form a deposit of plaque on the inner lining of arterial walls. b. Coronary heart disease – a narrowing of the small blood vessels that supply blood and oxygen to the heart c. Stroke (Cerebrovascular Disease) – Astroke is a condition in which the brain cells suddenly die because of a lack of oxygen. This can be caused by an obstruction in the blood flow, or the rupture of an artery that feeds the brain. d. Hypertension - Hypertension, also referred to as high blood pressure, is a condition in which the arteries have persistently elevated blood pressure 2. Historical trends: How and why things changed from 1900 to the present a. Why the initial increase??? i. Went up to the 60s b. Why the subsequent decrease? i. Went down after the 60s 3. Risk factors: Traditional/biomedical and psychosocial: The four major traditional risk factors; why the distinction between biomedical and psychosocial risk factors is misleading a. Traditional/Biomedical Risk Factors i. Main Risk Factors: 1. High Cholesterol levels 2. High Blood pressure 3. Diabetes/blood sugar 4. Cigarette smoking ii. Other: 1. Diet/obesity, lack of exercise 2. Older age 3. Being male 4. Family history 5. BeingAfricanAmerican b. Psychosocial Risk Factors i. Psychological Stress ii. TypeABehavior Pattern iii. Hostility and anger iv. Social networks and support v. Gender vi. Low socio-economic status vii. Race and ethnicity viii. Depression ix. Religiousness/spirituality c. Psychosocial risk factors damage the cardiovascular system including the fight or flight response and the d. Traditional risk factors did not account for a large portion of cases so psychosocial factors had to be accounted for e. The distinction between the two can be misleading because factors in each category have the option of being modified and corrected while some in both do not 4. TaxAccountant Study: Purposes, design and methods, results, and significance a. Purpose: early study of stress and heart disease b. Design: Followed tax accountants around for several months c. Methods: measured them with serum cholesterol, how easily blood clotted, and diet d. Results: i. No significant change in diet ii. Job stress caused blood cholesterol to increase iii. Job stress caused blood to clot more easily e. Significance: Demonstrates how stress can cause many risk factors that can lead to cardiovascular disease 5. Reactivity hypothesis: Definition of reactivity, what causes it, it’s significance, how it promotes disease a. Reactivity Hypothesis:Anger leads an individual to have strong physiologic responses to stressors activating the SAM more often leading to an increased risk of coronary disease b. Causes: Having a Type A Behavior c. Significance: Explains the effects of physiologic responses on health d. How it Promotes Disease: increases risk for coronary heart disease i. SAM increases blood pressure and heart rate ii. Increases epinephrine and norepinephrine 6. Hostile Competition Study: Purposes, design and methods, results, and significance a. Purpose: See Effects of behavior type on emotional reactions to stimuli b. Design: TypeA’s and B’s put into No-Harass and Harass groups c. Methods: d. Results: Type A’s had an increased blood pressure and hormone secretion e. Significance: TypeA’s are especially reactive to hostile competition 7. Animal Model of Coronary Disease: Purposes, design and methods, results, and significance a. Purpose: Test if monkeys experience stress like we do b. Design: Manipulated Monkeys environments to chnge their circumstances c. Methods: d. Results: More dominant monkeys experienced more stress than submissive monkeys e. Significance: Cancer 1. Cancer and its metaphors: What the metaphors are and why this is important a. Metaphors have bad effects on people i. Cancer is seen as any evil condition or thing that spread destructively ii. People create beliefs off of figures of speech that are not accurate b. Susan Sontag – critical of some of the c. You have to have a cheerful attitude toward it d. Even though some diseases like cancer have lost their threat value folk beliefs remain strong 2. Nature: The major components of carcinogenesis a. Age contributes overtime to an increasing probability of acquiring cancer b. As age increases cells are more likely to make reproductive errors and cause a mutation c. Weak immune system could allow viruses to make cancer 3. Historical trends: How and why things changed from 1990 to the present; high incidence versus most deadly cancers a. Lifestyle changes where people stopped smoking and took up diets reduced incidence of diseases as well as improved detection and treatment b. Large increases in the medical field c. Most common for women is breast cancer d. Most common for men is prostate cancer e. Most lethal is lung cancer 4. Risk factors: behavioral, environmental, genetic, psychosocial a. Genetics plays a limited role in predicting cancer b. Stress may not be too involved, only theories so far i. Type C personality can lead to progression of cancer ii. over activated SAM may cause body to miss cancerous cells c. Behavioral: i. Environmental Exposures 1. Tobacco 2. Diet 3. Alcohol 4. Physical inactivity 5. Overweight/obesity 6. Self-exposure to the sunlight 7. Sexually transmitted viruses d. Environmental: i. Ozone depletion and the sun ii. Man-made sources of ionizing radiation iii. Environmental Carcinogens 1. Radon gas 2. Radiation 3. Asbestos 4. industrial chemicals e. Race/ethnicity, SES f. Psychosocial: i. Self-Concept – how we see ourselves and our possible other selves ii. Self-Identity – images and groups we identify with 1. Taking on risky behaviors trying to meet a social image 2. Gender role expectations 5. Self Concept/Social Identity and cancer risk factors 6. Psychological adaptation to cancer: Forms of coping, self-concept and social a. People are encouraging others to fight cancer and are raising awareness of it i. Diagnosis/treatment threaten self/identity 1. Disfigurement 2. Loss of function 3. Loss of “actual” and “possible” selves ii. Adaptive coping sustains self/identity 1. Meaning and purpose 2. Self-esteem a. maintained by downward social comparisons 3. Mastery 4. Personal growth/benefits 7. David Spiegel study of metastatic breast cancer: Purposes, design and methods, results, and significance a. Purpose: Evaluate effects of psychosocial treatment on pain, quality of life (not death) b. Subjects: 86 metastatic breast cancer patients c. Design: Treatment/Control Groups (Randomized) d. Treatment: 1 year of weekly supportive group therapy with self-hypnosis for pain e. Found that group therapy increases one quality of life. f. Hard to replicate, does not have much significance HIV/AIDS 1. Nature of HIV/AIDS a. 2. HIV/AIDS as compared to other diseases, both acute and chronic a. HIV resembled infectious diseases of 1900’s b. Now it more resembles heart disease c. Has become a chronic condition d. Resembles cancer in being stigmatizing 3. Historical trends and current scope of the problem a. Was on the rise in the 1900s until the definition of it was changed and more people were covered for it by insurance b. Now its prevalence has increased and people are living longer with it c. Leading cause of death in 1994 4. HIV testing a. HIV antibody tests i. ELISA - a widely used technique for determining the presence or amount of protein in a biological sample, using an enzyme that bonds to an antibody or antigen and causes a color change ii. Western Blot (more accurate, for confirmation) - a technique that analyzes mixtures of proteins by separating them and then binding them to specific antibodies b. Home test kits now available c. Direct measures of viral load (amount of virus) d. Problems i. In early stages of infection, test may be negative (solution is to eliminate exposure and repeat testing) 5. Transmission of HIV a. Requires exposure to bodily fluid: i. Blood ii. Semen iii. Vaginal secretions iv. Saliva, urine, tears, breast milk b. Transmitted by: i. Male-male sexual contact ii. Injection drug use iii. Heterosexual contact iv. Birth to HIV+ mother v. Transfusion of blood/blood products (virtually eliminated) 6. Distribution of the problem: Who gets HIV/AIDS and why? a. Disproportionately affects minority group members b. Larger portion of males than females c. Males usually get it from sex with other males while females usually get it from sex with other males d. Leading causes is male-male sexual contact, second leading cause is injection drug use 7. Prevention a. Safer sex b. Sexual abstinence c. Testing d. monogamy 8. Psychosocial influences on the course of HIV/AIDS a. Pain 1. Definition and relevance to health and to psychology a. Major symptom leading to health care b. Inherently psychological process c. Pain is what is feared most about illness/treatment d. Psychological intervention methods can control and prevent pain 2. Adaptive value a. Provides us with a danger signal and is a motivator 3. Measuring pain and its features a. Visual Analog Scale – scale from point on line b. Box Scale – scale from 1 to 10 c. Verbal Rating Scale – statement on severity of pain 4. Early pain theories: Specificity theory and pattern theory a. Specificity – Separate pain system b. Pattern theory – pain reflects level/patterning of stimulation through other senses c. Talked about ways to measure pain that were not true d. Physiologically incorrect and do not account for psychosocial factors 5. Gate-control theory a. A neural “gate” exists that modulates pain signals before the reach the brain b. Gate is in the spinal cord c. Control of the gate: i. Opened or closed by brain signals, a pathway for psychosocial influences 6. Endogenous opiates a. Influenced by psychological factors, whether to amplify or dampen pain (depends on perception) b. Involved in pain relief i. Sometimes close the neural gate 7. Cross-cultural factors in pain a. Different orientations reflect expectations 8. Pain, disability, and self-concept a. Viewing pain as a challenge, blessing, punishment b. Using art, spirituality/religion to escape pain Cigarette Smoking 1. Scope of the problem a. Most deadly behavior, half a million people each year, effects on cancer and heart disease b. Started as habit to men who had more than three cigarettes c. Men in 50s 60s d. Women in 60s 70s e. Main risk factor now is through education 2. Health hazards a. Doubles likelihood of premature mortality b. Heart and Blood Vessel Diseases c. Hypertension d. Stroke e. Cancers f. Respiratory Diseases g. Affects pregnancy and infant health h. Impotence i. Wrinkles j. Stress k. Second-Hand Smoking l. Third-hand smoke 3. Historical trends a. Trans theoretical model - assesses an individual's readiness to act on a new healthier behavior, and provides strategies, or processes of change to guide the individual through the stages of change to Action and Maintenance. b. Differences in genetics that make some vulnerable to smoking addiction c. Psychological factors from friends and society d. Nicotine is most addicting drug e. Started rise after entry into first world war f. Hit its peak after surgeon general made health report g. Smoking rates have decreased since the 60s h. Highest percentage of smoker have lowest form of education 4. Risk factors a. 5. Natural history of smoking a. Preparation – initiation – becoming - maintenance 6. Social and biological factors that operate at different stages, e.g., modeling and peer pressure; addiction and regulation of cognition and affect a. Early Stages of Smoking i. Preparation 1. Modeling – learn to expect that smoking will cause reinforcements received by smokers, seeing peers do it 2. Peer pressure – Overt encouragement to smoke, being told to do it 3. Biological – genetics, prenatal exposure 4. Identity formation: major issue in adolescence a. Adolescents often have a positive image of the smoker as rebellious, tough, mature b. Most vulnerable to these influences ii. Initiation – have first few cigarettes 1. Side effects – knowledge discourages act 2. 4 Cigarette – start to become addicted iii. Becoming – now a smoker 1. Regulation of Cognition andAffect a. Smoking can increase alertness/concentration, relaxation, pleasure (positive reinforcement) b. Can decrease anxiety, tension, pain (negative reinforcement) c. All of these effects become condition to social and environmental stimuli 2. PhysicalAddiction to Nicotine a. Develop a tolerance and crave more b. Smoke to maintain a certain level in body c. Lesser amounts cause withdrawal d. Stimulates reward system iv. Maintenance 1. Health Risk – damage to body deters want for more 2. Expense – becomes too costly to keep up b. Dopamine main neurotransmitter in smoking encouragement 7. Cigarette advertising a. Peripheral persuasion, use stimuli that help you form a positive image of smoking Alcohol and Drug Use 1. Historical trends and current scope of the problem a. Has been used since ancient history b. Consumption has gone down since the 1800s 2. Distribution of the problem: Who drinks? a. Small number consume a large amount of alcohol (50% consumed by 10%) b. 63% of pop current drinkers c. Ethnicity: i. Euro-Americans: Higher prevalence ii. Asian Americans: Lower prevalence iii. NativeAmericans: Heavy/bingeing d. Age: i. 25-44: Higher prevalence ii. 18-24: Most heavy/binge drinking iii. 12-17: Reduced by lower drinking age e. Gender: i. Men: Higher prevalence/bingeing f. Education: i. More schooling, more drinkers ii. Dropouts: more heavy/binge 3. Health consequences versus social/psychological consequences a. Disrupts society b. Short term: i. Accidents ii. Injuries iii. Assault iv. Suicide v. Alcohol poisoning vi. Risky sexual behavior c. Long Term: i. Neurological ii. Cardiovascular iii. Psychiatric iv. Cancer 4. Possible health benefits of alcohol with light drinking a. Protection against coronary heart disease i. Increase in high-density lipoprotein ii. Reduced tendency to form blood clots b. Possibly less risk of type 2 diabetes, ulcers, cognitive impairment (Alzheimer’s) 5. Definitions and assessment: Alcoholism, problem drinking, tolerance, withdrawal a. Alcoholism – disease brought about by chemical properties of alcohol b. Problem drinking – having social, psychological, medical problems due to drinking c. Tolerance – when increased dosages are necessary to have the same
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