LSP Health Psychology & Behavioral Medicine 3 — Questions and Answers
Question 1: Which psychological factor has the strongest evidence as a predictor of poor post-surgical recovery outcomes?
- Trait neuroticism measured preoperatively
- Preoperative depression and anxiety (Correct answer)
- Low conscientiousness on personality inventories
- External locus of control regarding health
Correct answer: Preoperative depression and anxiety
Preoperative depression and anxiety consistently predict longer hospital stays, greater pain, poorer wound healing, and slower functional recovery across surgical populations.
Question 2: The gate control theory of pain (Melzack & Wall) introduced which key concept to pain psychology?
- Pain is purely a peripheral nerve conduction phenomenon
- Psychological and cognitive factors modulate pain signals in the spinal dorsal horn (Correct answer)
- Chronic pain always indicates ongoing tissue damage
- Central sensitization occurs exclusively in the brain's limbic system
Correct answer: Psychological and cognitive factors modulate pain signals in the spinal dorsal horn
Gate control theory proposed that a spinal 'gate' in the dorsal horn can be opened or closed by peripheral signals and descending cognitive-emotional influences, explaining psychological effects on pain.
Question 3: A patient with fibromyalgia catastrophizes about pain, saying 'This will never get better and I can't do anything.' Which CBT technique directly targets this pattern?
- Relaxation training to reduce muscle tension
- Cognitive restructuring to identify and challenge maladaptive pain cognitions (Correct answer)
- Graded task assignment to increase physical activity tolerance
- Biofeedback to improve autonomic self-regulation
Correct answer: Cognitive restructuring to identify and challenge maladaptive pain cognitions
Cognitive restructuring directly challenges pain catastrophizing by helping patients identify cognitive distortions (helplessness, magnification, rumination) and develop more balanced appraisals.
Question 4: Which health behavior theory emphasizes the role of self-efficacy, outcome expectancies, and behavioral goals in maintaining health behaviors?
- Health Belief Model
- Transtheoretical Model
- Social Cognitive Theory (Correct answer)
- Theory of Planned Behavior
Correct answer: Social Cognitive Theory
Bandura's Social Cognitive Theory places self-efficacy—confidence in one's ability to perform a behavior—as the central driver alongside expected outcomes and personal goal-setting.
Question 5: In the context of chronic illness management, illness perceptions are best assessed using which validated instrument?
- Illness Perception Questionnaire (IPQ-R) (Correct answer)
- Sickness Impact Profile (SIP)
- Medical Outcomes Study Short Form (SF-36)
- McGill Pain Questionnaire (MPQ)
Correct answer: Illness Perception Questionnaire (IPQ-R)
The IPQ-R measures patients' cognitive and emotional representations of their illness across dimensions including identity, timeline, consequences, control, and coherence.
Question 6: Psychoneuroimmunology research demonstrates that chronic stress most reliably affects immunity by:
- Permanently increasing NK cell cytotoxicity against tumors
- Suppressing cellular immunity while upregulating certain inflammatory markers (Correct answer)
- Eliminating humoral immunity through B-cell apoptosis
- Triggering autoimmune responses via molecular mimicry
Correct answer: Suppressing cellular immunity while upregulating certain inflammatory markers
Chronic stress shifts immune function toward suppressed cell-mediated responses (reduced NK and T-cell activity) and elevated pro-inflammatory cytokines, increasing susceptibility to infection and chronic disease.
Question 7: Which approach to pain management is characterized by accepting pain without judgment and committing to valued life activities despite its presence?
- Cognitive Behavioral Therapy for pain
- Acceptance and Commitment Therapy (ACT) (Correct answer)
- Mindfulness-Based Stress Reduction (MBSR)
- Dialectical Behavior Therapy pain modules
Correct answer: Acceptance and Commitment Therapy (ACT)
ACT for chronic pain targets psychological flexibility, encouraging patients to accept pain experiences and pursue meaningful activities rather than struggling to eliminate pain.
LSP Health Psychology & Behavioral Medicine 3
Which psychological factor has the strongest evidence as a predictor of poor post-surgical recovery outcomes?