LSP Health Psychology & Behavioral Medicine 2 — Questions and Answers
Question 1: Which psychophysiological mechanism best explains why chronic work stress increases cardiovascular disease risk?
- Repeated HPA axis activation elevates cortisol, promoting inflammation and arterial damage (Correct answer)
- Increased serotonin production thickens arterial walls over time
- Sympathetic suppression reduces cardiac output and causes ischemia
- Elevated melatonin dysregulates circadian blood pressure patterns
Correct answer: Repeated HPA axis activation elevates cortisol, promoting inflammation and arterial damage
Chronic HPA axis activation maintains elevated cortisol, which drives systemic inflammation, endothelial dysfunction, and atherosclerosis.
Question 2: A patient with Type 2 diabetes consistently forgets evening insulin doses. Which behavior change strategy is most evidence-based for this adherence problem?
- Motivational interviewing to explore ambivalence about medication
- Implementation intentions linking the dose to an established evening routine (Correct answer)
- Psychoeducation about the long-term complications of non-adherence
- Self-monitoring diaries to track missed doses retrospectively
Correct answer: Implementation intentions linking the dose to an established evening routine
Implementation intentions ('if-then' plans) reliably bridge the gap between intention and action by coupling new behaviors to existing cues.
Question 3: The biopsychosocial model differs most fundamentally from the biomedical model in that it:
- Rejects biological causes in favor of psychological explanations
- Requires psychological treatment for all physical illnesses
- Recognizes that health and illness result from interacting biological, psychological, and social factors (Correct answer)
- Prioritizes social determinants over individual biology in all cases
Correct answer: Recognizes that health and illness result from interacting biological, psychological, and social factors
Engel's biopsychosocial model holds that health outcomes emerge from the dynamic interaction of biological, psychological, and social systems rather than biology alone.
Question 4: Which conditioning process is most responsible for the nausea a chemotherapy patient experiences upon entering the infusion clinic before treatment begins?
- Operant conditioning via negative reinforcement
- Classical conditioning where clinic cues become conditioned stimuli (Correct answer)
- Observational learning from watching other patients
- Cognitive appraisal of anticipated harm
Correct answer: Classical conditioning where clinic cues become conditioned stimuli
Anticipatory nausea is a classically conditioned response in which neutral clinic cues (CS) become paired with chemotherapy-induced nausea (UCS), eventually eliciting nausea alone.
Question 5: Primary, secondary, and tertiary prevention in behavioral medicine are best distinguished by their:
- Reliance on pharmacological versus psychological interventions
- Temporal relationship to disease onset and severity (Correct answer)
- Use of individual versus group treatment formats
- Focus on acute versus chronic conditions
Correct answer: Temporal relationship to disease onset and severity
Primary prevention targets disease before onset, secondary prevention involves early detection and intervention, and tertiary prevention manages established disease to minimize disability.
Question 6: A health psychologist is using motivational interviewing with a sedentary patient. Which therapist behavior is most inconsistent with MI principles?
- Reflecting the patient's ambivalence about exercise back to them
- Asking open-ended questions about what exercise might look like in their life
- Directly advising the patient that they must exercise or face serious consequences (Correct answer)
- Affirming the patient's past attempts to be more active
Correct answer: Directly advising the patient that they must exercise or face serious consequences
Directing or confronting patients with dire warnings violates MI's spirit of autonomy support and evokes reactance rather than change talk.
Question 7: Allostatic load refers to:
- The maximum stress a person can tolerate before psychological breakdown
- The cumulative physiological cost of chronic stress adaptation across multiple biological systems (Correct answer)
- The mismatch between perceived and actual threat during a stress response
- A person's capacity to return to homeostasis following acute stress
Correct answer: The cumulative physiological cost of chronic stress adaptation across multiple biological systems
Allostatic load (McEwen) describes the wear and tear on multiple physiological systems—cardiovascular, immune, neuroendocrine—from repeated or chronic stress adaptation.
LSP Health Psychology & Behavioral Medicine 2
Which psychophysiological mechanism best explains why chronic work stress increases cardiovascular disease risk?