Ch.7 Exam Questions Health Anxiety & Body Symptoms

Chapter 7

Health Anxiety and Other Psychological Responses to Bodily Symptoms

Multiple Choice Questions

1. ________ is a physical sign of bodily change.
   1. Pain
   2. Dizziness
   3. Itching
   4. Erythema

Pages: 143-144

1. ________ is a physical symptom of bodily change.
   1. Edema
   2. Pallor
   3. Itching
   4. Jaundice

Pages: 143-144

1. Surveys that examine the prevalence of physical signs and symptoms suggest that the vast majority of people experience ________ per day.
   1. at least one physical symptom or sign
   2. less than one physical symptom or sign
   3. at least five physical symptoms or signs
   4. more than five physical symptoms or signs

Page: 144

1. Central to the common-sense model (CSM) of illness representation/self-regulation is the interaction between our ________ of physical sensations and our ________ to the physical sensations.
   1. lack; desensitized response
   2. disregard; lack of response
   3. diagnosis; medical response
   4. perceptions; emotional response

Page: 144

1. According to the common-sense model (CSM) of illness representation/self-regulation, ________ refers to how we label the signs and symptoms we experience.
   1. identity
   2. cause
   3. consequences
   4. timeline

Page: 145

1. According to the Illness Perceptions Questionnaire-Revised (IPQ-R), belief in the “controllability” of our signs and symptoms can be further subdivided into subscales. For example, that of personal control measures the belief that ________.
   1. one can manage signs and symptoms of illness
   2. treatment will be efficacious
   3. illness will be of short duration
   4. one can manage one’s emotions

Page: 145

1. According to the Illness Perceptions Questionnaire-Revised (IPQ-R), the subscale of treatment control measures the belief that ________.
   1. treatment will be of short duration
   2. treatment will be efficacious
   3. illness will be of short duration
   4. treatment will be adequately monitored

Page: 145

1. People who perceive their symptoms as multiple, chronic, and/or disabling are more likely to cope by ________.
   1. seeking medical help frequently
   2. stringently adhering to the treatment prescribed
   3. moderately adhering to the treatment prescribed
   4. avoiding medical help

Page: 146

1. Viewing an illness as ________ is associated with greater psychological well-being and social functioning.
   1. having multiple symptoms
   2. within our control
   3. being chronic
   4. disabling

Page: 146

1. Patients who suffered their first myocardial infarction (MI) were assigned to a professional intervention group aimed at enhancing their perception that their medical condition could be controlled. Another group was not assigned to this intervention. The intervention group reported ________.
   1. fewer angina symptoms and went back to work earlier than the control group
   2. fewer angina symptoms but went back to work at the same rate as the control group
   3. the same number of angina symptoms as the control group but went back to work earlier
   4. the same number of angina symptoms as the control group and went back to work at the same rate

Page: 147

1. Illness appraisals are not influenced by ________.
   1. coping strategies
   2. physical stimuli
   3. cultural factors
   4. heuristics

Page: 147

1. The statement that most closely obeys the prevalence rule of heuristic approaches in the common-sense model is ________.
   1. “Many people get the flu; I will get it for sure”
   2. “I am worried about Ebola—who cares if I get the flu?”
   3. “Most people get a mild form of flu; I am sure it will be the same for me”
   4. “I am worried about the common cold—who cares if I get the flu?”

Page: 148

1. The statement that most closely obeys the symmetry rule of heuristic approaches in the common-sense model is ________.
   1. “When I feel sick I can tell, so now that I don’t feel anything I must be in good shape”
   2. “I get the flu every winter, so I will definitely get it this year as well”
   3. “Statistically, illnesses strike equally on the left side of the body and on the right”
   4. “Statistically, certain illnesses strike men and women equally”

Page: 148

1. The statement that most closely obeys the age–illness rule of heuristic approaches in the common-sense model is ________.
   1. “Old people get sick more often”
   2. “My bones are aching; it must be because I’m getting older”
   3. “There are different diseases for each age”
   4. “Young people almost never get sick”

Page: 148

1. ________ is an approach to how others respond to patient illness in which family and friends discuss the illness with the patient, asking how he or she is feeling, and attempting to assist the patient with constructive problem-solving activities.
   1. Active engagement
   2. Protective buffering
   3. Overprotection
   4. Disengagement

Pages: 148-149

1. ________ is the tendency to experience negative emotions and emotional instability.
   1. Anxiety
   2. Neuroticism
   3. Depression
   4. Distress

Page: 149

1. A diagnosis of ________ is given to those who are preoccupied with having or acquiring a serious illness and who have a high level of health anxiety but do not have significant somatic symptoms.
   1. hyperchondriasis
   2. clinical depression
   3. neuroticism
   4. illness anxiety disorder

Page: 150

1. Health anxiety is a dimensional construct characterized by ________.
   1. severe concern about one’s health
   2. lack of concern about one’s health
   3. a lack of concern about one’s health at one end of the continuum and excessive anxiety about health on the other
   4. profound ignorance about emotional health at one end of the continuum and excessive knowledge about emotional health on the other

Page: 150

1. Holding the belief that ________ is not central to the development of health anxiety.
   1. the feared disease is serious and catastrophic
   2. one is immune to disease
   3. inadequate medical resources are available to treat the illness
   4. one is not capable of coping with the feared illness

Page: 150

1. The cognitive behavioural model of health anxiety is based on the core construct that ________.
   1. health anxiety is due to genetic inheritance
   2. health anxiety is due to a learned set of ideas
   3. more medical knowledge provided by trained professionals will mitigate the symptoms
   4. behaviour can be changed by practising meditation

Page: 152

1. ________ has not been identified as a predisposing trait suspected of increasing vulnerability to health anxiety.
   1. Anxiety sensitivity
   2. Somatization
   3. Neuroticism
   4. Insomnia

Page: 152

1. Individuals with health anxiety may exhibit ________, which refers to the tendency to believe that if they feel anxious, there must be danger present.
   1. ex-consequentia reasoning
   2. confirmatory bias
   3. thought–action–fusion bias
   4. safety behaviour

Page: 153

1. ________ is not a strategy often incorporated into cognitive behavioural treatment of health anxiety.
   1. Focusing on improving the patient’s general life satisfaction
   2. Stress management
   3. Ensuring that the patient’s family is not involved in treatment
   4. Mindfulness

Pages: 154-157

1. ________ is not an example of a safety behaviour associated with extreme health anxiety.
   1. Body monitoring
   2. Reassurance-seeking
   3. Avoidance
   4. Exposure with response prevention

Page: 153

1. The first step of cognitive behavioural therapy for health anxiety is usually ________.
   1. assessment based on the subjective units of discomfort scale (SUDS)
   2. addressing safety behaviours
   3. psycho-education
   4. exposure with response prevention

Pages: 155-157

Short Answer Questions

1. Provide a real-life example of the symmetry rule that influences how we appraise signs and symptoms of illness.

Page: 148

1. Provide a real-life example of the prevalence rule that influences how we appraise signs and symptoms of illness.

Page: 148

1. Explain how culture can influence the way in which we interpret and respond to illness.

Page: 149

1. Explain, with an original example, why applying heuristic rules uncritically can be dangerous for your health.

Page: 148

1. Briefly outline the attractive features of cognitive behavioural therapy in treating health anxiety.

Pages: 154-157

1. Briefly describe how a typical cycle of cognitive behavioural therapy is structured (e.g., duration, etc.) as well as the basic assumptions on the part of the therapist.

Pages: 154-157

1. List and briefly discuss three complicating factors that may delay/prevent success with CBT.

Page: 155

1. The first step in cognitive behavioural therapy is to provide psycho-education. Highlight and then briefly discuss a typical challenge for the patient at this stage.

Page: 155

1. Explain how cognitive behavioural therapy can help patients with health anxiety examine and reduce their safety behaviours.

Page: 157

1. Explain how our views of illness and how we cope with illness can impact our emotional and physical health.

Pages: 147-148

Essay Answer Questions

1. The homework assignment is a central methodological tool in cognitive behavioural therapy (CBT) for health anxiety; it is typically a diary of the patient’s thoughts and ideas. Provide a detailed sample of what a day in a fictional diary might look like, using the same format as that of the “In Focus” box on page 156 of the textbook.

Page: 156

1. The creation of an exposure hierarchy is a second methodological tool in CBT for health anxiety. Provide a detailed sample of what a hierarchy might look like, following up on the fictional example presented in essay question (1) and using the same format as that of the “In Focus” box on page 156 of the text.

Page: 156

1. Describe in detail the dimensions of illness representation.

• Identity: how we label the signs and symptoms we experience (e.g., lupus, cancer, heart disease); often measured by asking individuals about their physical signs and symptoms (e.g., pain, breathlessness, fatigue).
• Cause: refers to our beliefs about what brought on the signs and symptoms; we might consider biological, emotional, environmental, or psychological causes.
• Consequences: the impact of the signs and symptoms on our everyday lives (e.g., self-care, household responsibilities, family, work, emotional well-being).
• Timeline: refers to our beliefs about how long the signs and symptoms will last (e.g., acute versus chronic) and whether they will fluctuate or persist over time.
• Controllability: refers to our beliefs about whether we have control over our signs and symptoms and whether we believe treatment will be efficacious.

These representations of our signs and symptoms are not static but change over time, especially in response to treatment.

Page: 145

1. Discuss the challenges of CBT when delivered to patients with an actual medical condition.

Tip: Read the following paper and comment:

Seivewright, H., Green, J., Salkovskis, P., Barrett, B., Nur, U., & Tyrer, P. (2008). Cognitive-behavioural therapy for health anxiety in a genitourinary medicine clinic: Randomised controlled trial. British Journal of Psychiatry, 193, 332–337.

Page: 158

1. Briefly review the empirical evidence showing that CBT is an efficacious approach to treating health anxiety and evaluate the methodological strength of these data.

Tip: Read and comment on any of the following research papers:

Hagger, M.S., & Orbell, S. (2003). A meta-analytic review of the common-sense model of illness representations. Psychology & Health, 18, 141–184.

Rachman, S. (2012). Health anxiety disorders: A cognitive construal. Behaviour Research and Therapy, 50, 502–512.

Seivewright, H., Green, J., Salkovskis, P., Barrett, B., Nur, U., & Tyrer, P. (2008). Cognitive-behavioural therapy for health anxiety in a genitourinary medicine clinic: Randomised controlled trial. British Journal of Psychiatry, 193, 332–337.

Pages: 152-157