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BS Online Examination July-August, 2020

Govt. Postgraduate College for Women, Gulberg, Lahore

Roll No: 011621046 Name: Wajiha Yamin

Date: 27th July, 2020 Session: 2016-2020

Class: BS Applied Psychology Semester: 8th

Course Code: Subject: Health Psychology

Credit Hours: 04 Time Allowed: 3 hrs.

Max Marks: 65 Paper Title: Psychology of Health

Question 1: Explain the cardiovascular system and coronary heart diseases? Relate the heart

diseases with hereditary and environmental influence?

Answer:

Cardiovascular System

The cardiovascular system comprises of the heart, blood vessels, and blood and acts

as the transport system of the body. Blood carries oxygen from the lungs to the tissues

and carbon dioxide from the tissues to the lungs. Blood carries nutrients from the digestive

tract to the individual cells so that the cells may extract nutrients for growth and energy.

The blood carries waste products from the cells to the kidneys, from which the waste

is excreted in the urine. It also carries hormones from the endocrine glands to other organs of

the body and transports heat to the surface of the skin to control body temperature.

Heart

The heart functions as a pump, and its pumping action causes the blood to circulate

throughout the body. The left side of the heart, consisting of the left atrium and

left ventricle, takes in oxygenated blood from the lungs and pumps it out into the aorta from

which the blood passes into the smaller vessels to reach the cell tissues.
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The blood exchanges its oxygen and nutrients for the waste materials of the cells and

is then returned to the right side of the heart (right atrium and right ventricle), which pumps it

back to the lungs via the pulmonary artery. Once oxygenated, the blood returns to the left side

of the heart through the pulmonary veins.

Cardiac cycle

The heart performs these functions through regular rhythmic phases of contraction

and relaxation which is known as the cardiac cycle. There are two phases in the cardiac

cycle:

• Systole

• Diastole

During systole, blood is pumped out of the heart, and blood pressure in the blood vessels

increases.

The muscle relaxes during diastole, blood pressure drops, and blood is taken into the

heart. The flow of blood into and out of the heart is controlled by valves.

Coronary heart diseases

Coronary heart disease, or coronary artery disease, develops when the coronary

arteries become too narrow. The coronary arteries are the blood vessels that supply oxygen

and blood to the heart. It develops when cholesterol builds up on the artery walls, creating

plaques. These plaques cause the arteries to narrow, reducing blood flow to the heart. A clot

can sometimes obstruct the blood flow, causing serious health problems. Coronary arteries

form the network of blood vessels on the surface of the heart that feed it oxygen. If these

arteries narrow, the heart may not receive enough oxygen rich blood, especially during

physical activity.
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Blood Pressure. High blood pressure is harmful to the arteries and increases the risk

of heart attack, heart failure and stroke. The condition tends to run in families, but blood

pressure is also influenced by lifestyle. To prevent blood pressure from rising, it is important

to achieve and maintain a healthy body weight, keep alcohol intake moderate, reduce salt

intake, manage and reduce stress and be physically active. Furthermore, certain medicines are

available to reduce elevated blood pressure.

Blood cholesterol. The accumulation of cholesterol can become troublesome when it

gets deposited in the walls of arteries, which might damage and blocked the arteries. If this

happens, a heart attack could result. Many people make too much cholesterol when their diet

is rich in saturated fats, so it should be kept in view.

Diabetes. Diabetic patients are at a much higher risk of coronary heart disease. They

might experience high blood sugar, high blood pressure and raised blood lipids. People with

diabetes and a raised cholesterol level experience an even greater risk of heart diseases.

Obesity. Being overweight increases the chance of having a heart attack. This is in

part because people who are overweight are more likely to have high blood pressure, diabetes

and high blood fats. Reducing fat, sugar and alcohol, reducing portion sizes, being more

physically active and adequate support to enable behavioral change are recognized ways of

losing weight.

Alcohol. Consuming too much alcohol places health at risk in a number of ways.

Excessive intake or consumption of alcohol is harmful to the heart and other organs. It can

directly damage the heart muscle and cause irregular beating of the heart. Alcohol also

contributes to weight gain, high blood pressure, strokes and cancer.

Stress. A certain amount of stress may be desirable, in that it keeps people alert and

motivated. However, as the stress level builds, especially if prolonged, it can be harmful to
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health. Stress can contribute to pre-existing heart disease and to trigger high blood pressure.

Thus, it is important to find time for relaxation. Simple breathing exercises, sports, music,

meditation etc. There are many ways to reduce stress.

Hereditary and environmental influences

Blood pressure, diabetes, obesity and stress tends to run in families, but all of these

conditions are also influenced by lifestyle. As if a person doesn’t maintain healthy body

weight, manage stress and keeping active, alcohol and salt intake is left unchecked, the

condition can get triggered. If the conditions run in families a person has the chances of

experiencing certain symptoms and is at risk but maintaining healthy habits can help the

person to avoid any kind of serious health issue. Several environmental factors influence

these conditions as cigarette smoking, even a few a day, increases the risk of heart disease.

There are thus many health benefits from being a non-smoker. In the same way not taking

stress of the environmental conditions might help a person reduce the rate of risk.

Question no 2. Explain any stress model and relate it with current pandemic situation and its

possible management?

Selye defined stress first as a stimulus and then as a response. Whenever the body

encounters a disruptive stimulus, it mobilizes itself in a generalized attempt to adapt to that

stimulus. Selye called this mobilization the general adaptation syndrome.

The GAS has three stages;

• Alarm- the body’s defense against a stressor are mobilized through activation

of the sympathetic nervous system.

• Resistance- in this stage, the organism adapts to the stressor.

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• Exhaustion- the organism’s ability to resist is depleted, and a breakdown

result. This stage is characterized by activation of the parasympathetic division

of the autonomic nervous system.

Selye conceptualized stress using the term stressor to refer to the stimulus and stress for the

response. According to Selye’s model, stress was a nonspecific response, that is, a wide

variety of stressors could prompt the stress response, but the response would always be the

same. He considered the stress response to all events to be similar.

The criticism of Selye’s view is that it ignores the situational and psychological

factors that contribute to stress. These factors include the emotional component and a

person’s interpretation of stressful events, which makes the view of stress incomplete in the

view of most psychologists.

Current pandemic situation and its possible management

Stressor

The stressor may be threatening, and in the case of the pandemic the major stressor is the fear

catching the virus and of eventual death induced in people through the media.

Alarm

The body initially responds to a stressor with changes that lower resistance, in the case people

might be so fearful about the situation, that they would be stressed enough to be sick apart

from catching virus, as they have to face certain issues and their routines are turned upside

down, interpersonal conflicts people are facing at homes, and there are several issues as

people might be dissatisfied with all financial conditions as their source of earning is ceased.

Resistance

If the stressor continues, the body mobilizes to withstand the stress and return to normal, in

the current situation if people find out ways to make the ends meet and help themselves with

the work while staying at home their conditions might improve.

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Exhaustion

Ongoing, extreme stressors eventually deplete the body’s resources so we function at less

than normal. In relation to current pandemic Covid-19, many people are getting exhausted as

per poor health conditions, troubled routines, interpersonal conflicts, difficulty of maintaining

health habits, and financial issues they are facing currently.

Question no 3. Discuss the behaviour modification in detail include its principles and give an

example related to your real life situations?

Answer: Behavioural Modification refers to the techniques used to try and decrease or

increase a particular type of behavior or reaction.

The ultimate goal of behavioral modification is to swipe problematic, undesirable behavior

with more positive and desirable behavior. The techniques are used majorly to treat and

enhance positive behaviors in persons having obsessive compulsive disorder, attention deficit

hyperactivity disorder, irrational fears, generalized anxiety disorder and separation anxiety.

The steps involved in modifying behaviors involve:

• Changing the environment

• Adding incentives to follow the rules

• Being consistent

Step 1: Identifying behaviors that need to be changed

Step 2: Measure the baseline level

Step 3: Analyze its antecedents and Outcomes

Step 4: Intervene

Step 5: Evaluate and Maintain

Some behavioral techniques that might be helpful to modify undesirable behaviors include:

• Reinforcement

• Punishment
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• Systematic De-sensitization

• Contingency Contract

• Shaping

• Prompting

• Token economy

• Assertive Training

• Time out

Reinforcement

Reinforcement refers to the addition or removal of some pleasant or aversive stimulus to

change or enhance certain problematic behaviours. Reinforcement is used to help increase the

probability that a specific behavior will occur in the future by delivering or removing a

stimulus immediately after a behavior.

• Positive Reinforcement

Positive reinforcement is adding a pleasant stimulus to enhance a behavior.

• Negative Reinforcement

Negative reinforcement is the removal of aversive stimulus.

Punishment

Punishment is a concept of operant conditioning, with the main goal of decreasing the rate

of certain undesirable behaviors from occurring again. It involves decreasing or suppressing

behavior. Consequence are considered as punishment, and different people have different

perceptions of what is punishing.

• Positive Punishment

Positive punishment refers to the addition of aversive stimuli to decrease the undesirable

behavior. It works by presenting a negative consequence after an undesirable behavior which

is being exhibited, making the behavior less likely to happen in the future.
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Example; Extra homework, if the student is disturbing other fellows

• Negative Punishment

Negative punishment refers to the removal of pleasant stimulus to decrease behavior. This

technique is highly effective, but there are certain factors that come into play when it comes

to determining the success rate, two are as follows;

• It should be immediately followed by a response.

• It should be applied consistently.

Example; Loses cell phone and privileges when homework is not completed.

Shaping

Shaping refers to gradually molding or training an individual to perform a specific response

(behavior) by reinforcing any response that are similar to the desired responses. The concept

was given by B.F Skinner and it involves reinforcing progressively instead of waiting for

perfection.

Task analysis

Task analysis refers to the chaining or procedurally following certain behaviors to know

what an individual has been achieving over time. The tasks are hierarchically arranged to be

followed by the individuals.

Example; Dolphin training in circus.

Contingency contract

Contracts are verbal or written agreements containing conditions which makes the parties

liable to perform the obligations. This technique involves the teachers to draw up an

individual contract with each student, describing exactly what the student must do to earn a

particular privilege.
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Time Out

The technique involves temporary change or separation of the child from the environment

where inappropriate behavior has occurred. It is an educational and parenting technique

recommended by some developmental psychologists as an effective measure to ensure child

discipline. Recommended for younger children. Separating from 5-15 minutes allowing the

child to calm down as well as discourage inappropriate behavior.

Prompting

Prompting is a technique used when one has to teach children new skills, the therapists and

teachers provide instructions and prompts until the target skill is achieved completely.

A prompt is a cue or hint meant to help a child to perform a desired behavior, skill or part of a

skill. Prompts are beneficial for the child to become fully independent in the skills, the

prompts need to be decrease over time until they are no longer needed.

Hierarchy of Prompting

• Natural cues

• Gesture

• Verbal

• Visual/ pictorial

• Modeling

• Partial physical

• Full Physical

Example from daily life

A student used to disturb other students, by creating noise, snatching things from others and

disturbing them throughout the tution timing. So, he was punished by taking away the money

he used to bring to the place for the lunch, and after he used to get done with all his work, the

money was returned to him. This helped modifying his behavior.

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Question no 4. Discuss the immune system and describe the strategies that can help us to

improve our immune system?

Answer:

Immune System

The microbes that cause infection are transmitted to people in several ways:

• Direct transmission involves bodily contact, such as handshaking, kissing, and sexual

intercourse. For example, genital herpes is typically contracted by direct transmission.

• Indirect transmission (or environmental transmission) occurs when microbes are

passed to an individual via airborne particles, dust, water, soil, or food. Influenza is an

example of an environmentally transmitted disease.

• Biological transmission occurs when a transmitting agent, such as a mosquito, picks

up microbes, changes them into a form conducive to growth in the human body, and

passes them on to the human. Yellow fever, for example, is transmitted by this

method.

• Mechanical transmission is the passage of a microbe to an individual by means of a

carrier that is not directly involved in the disease process. Dirty hands, bad water, rats,

mice, and flies can be implicated in mechanical transmission.

Immunity

Immunity is the body’s resistance to invading organisms. It may develop

either naturally or artificially. Some natural immunity is passed from the mother to

the child at birth and through breast feeding, although this type of immunity is only

temporary. Natural immunity is also acquired through disease.

Artificial immunity. Artificial immunity is acquired through vaccinations and

inoculations. For example, most children and adolescents receive shots for a variety of

disease so that they will not contract these diseases, should they be exposed.
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• Natural immunity is involved in defense against pathogens. The cells involved in

natural immunity provide defense not against a particular pathogen, but rather against

many pathogens.

• Natural killer cells are believed to be important in signaling potential harm and in

limiting early phases of viral infections.

• Natural immunity occurs through four main ways: anatomical barriers, phagocytosis,

antimicrobial substances, and inflammatory responses.

Strategies to improve immune system

• Maintaining healthy diet

• Keeping active

• Exercising Regularly

• Regular check-ups

• Adapting healthy life style

• Keeping in view the nutritional components of food

• Avoiding unhealthy habits as smoking or drinking

• Eat a diet high in fruits and vegetables

• Maintain a healthy weight

• Get adequate sleep

• Taking steps to avoid infection, such as washing your hands frequently and cooking

meats thoroughly

• Minimizing stress
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Question no 5. Write an importance of doctor patient communication and how the

environment of hospital effect the patients and relate it with our culture?

Answer:

Doctor patient communication plays a very important and primary role because following

the recommendations of health professionals is considered essential to patient recovery.

Whether the doctor patient communication is effective or not, it can be predicted by a

combination of patient satisfaction with the process of the consultation, understanding of the

information given and recall of this information.

Patient satisfaction

The extent of patient satisfaction with the consultation determines how effective has been

the communication. Certain aspects have to be kept in view while communicating, some of

them are as follows;

• Affective Aspect- emotional support and understanding

• Behavioural Aspects- prescribing and explaining

• Competence- Appropriateness of referral and diagnosis

Satisfaction is determined by the content of the consultation and that patients want to know

as much information as possible, even if this is bad news.

Humour in Communication

The relationship between humour in consultation and patient satisfaction is considered vital

source of rapport building and flexible communication between the doctor and patient. The

use of humour helps removing tension in patients. Patient satisfaction is increasingly used in

health care assessment as an indirect measure of health outcome based on the assumption that

a satisfied patient will be a healthier patient.

The doctor’s understanding of the problem matters a lot as communication will be effective

when the doctor has complete understanding of the reasons why the patient is seeking help.
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The adequacy of the explanation of the problem is directly related to the feeling of being

helped that develops in the patients.

Oral information

Another way of improving communication is to look out for the content of an oral

communication. Following factors are important:

• Primacy effect – patients have a tendency to remember the first thing they are told

• To help them reduce stress

• To simplify the information

• To use repetition and being specific

Environment of hospital effecting the patients

The environment of the hospitals should be kept as relaxing as possible, patients usually get

upset if the environment is too rushy, and inconvenient for the patient. Environment also

influences how one sees his problems; the communication can get affected if the environment

is not favourable. The calm and peaceful hospital environment has to be ensured and the

patient should be satisfied that everything that happens between the doctor and patient

remains confidential, so the patient can easily communicate and express his problems and

feeling about it.

In our culture hospital setups are not very sophisticated, there are several issues that need to

be addressed starting from the areas where the hospitals are located to the spaciousness of the

rooms where patients are dealt. Hospital environment is not very patient friendly in some of

the hospitals, and services are not provided as they should be. The consultation of the doctors

is not very effective as they are more focused of the target of seeing as much patients as they

can rather than looking out for the quality of consultation they provide. The hospital

authorities usually are not very co-operative when it comes to patient concerns, so the

patients might not be as satisfied as they could be if only the quality of services get improved.