Quiz — Chapter 12: Stress and Resilience

25 questions. Multiple choice unless otherwise indicated. Answers with explanations at the end.

1. Selye's General Adaptation Syndrome describes stress as a three-stage process. The correct sequence is:

a) Resistance → Alarm → Exhaustion b) Alarm → Resistance → Exhaustion c) Alarm → Exhaustion → Resistance d) Resistance → Exhaustion → Alarm

2. The primary hormone associated with the HPA axis stress response is:

a) Adrenaline (epinephrine) b) Serotonin c) Cortisol d) Dopamine

3. Chronic elevation of cortisol has been associated with:

a) Improved memory consolidation and immune function b) Impaired hippocampal function, suppressed immune response, and increased cardiovascular risk c) Decreased anxiety and improved emotional regulation d) Enhanced performance on complex cognitive tasks

4. Lazarus and Folkman's transactional model of stress proposes that:

a) Stress is determined primarily by the objective severity of the stressor b) Stress is a personality trait that some people have and others do not c) Stress arises from the transaction between person and environment, mediated by appraisal processes d) Stress is identical across individuals who face the same stressor

5. In Lazarus and Folkman's model, "secondary appraisal" refers to:

a) The second time a stressor is evaluated, after initial exposure b) The evaluation of whether the stressor is relevant to wellbeing c) The evaluation of available coping options — "what can I do about this?" d) The interpretation of the stressor's emotional significance

6. Eustress is defined as:

a) Stress that is externally imposed rather than self-generated b) Positive stress — manageable challenge that produces engagement, growth, and performance enhancement c) Stress caused by external life events rather than internal thoughts d) Any stress that is resolved within 24 hours

7. Problem-focused coping is most effective when:

a) The stressor is uncontrollable and the emotional experience is overwhelming b) The stressor is controllable and can be directly addressed c) The person lacks the emotional regulation skills for emotion-focused coping d) The stressor involves other people rather than tasks or situations

8. Emotion-focused coping is most effective when:

a) The stressor is controllable and problem-solving would be effective b) The person is too tired to engage in problem-solving c) The stressor is uncontrollable and the focus of coping should be on managing the emotional experience d) The stressor is external rather than internal

9. Meaning-based coping, as developed by Park and Folkman, refers to:

a) Using religious or spiritual beliefs to explain suffering b) Finding or creating meaning in stressful experience — which restores motivation and supports continued coping c) Writing about the meaning of stressful events in a journal d) The use of cognitive reframing to make stressors seem less significant

10. Research on social support consistently finds that:

a) Social support is helpful primarily for women; men recover from stress better independently b) The quantity of social relationships matters more than their quality c) People with strong social support networks have lower mortality rates and better stress outcomes d) Social support helps with psychological distress but has no effect on physical health

11. The "stress buffering" effect of social support refers to:

a) The way social support prevents stressful events from occurring b) The way the presence of trusted others reduces physiological stress responses and changes the appraisal of stressors c) The ability of supportive others to solve problems on behalf of the stressed person d) The way social support improves sleep quality during stressful periods

12. Which of the following statements about resilience is most accurate?

a) Resilient people do not experience significant distress during adversity b) Resilience is a fixed trait that some people have and others lack c) Resilience is a dynamic process supported by both internal resources and external factors; it varies across domains and over time d) High resilience requires prior experience of major adversity

13. Which of the following is an internal resource that supports resilience?

a) Access to economic stability b) Strong community support c) Self-efficacy — belief that one's actions can influence outcomes d) Role models and mentors

14. Post-traumatic growth (PTG) refers to:

a) The natural reduction in distress symptoms over time following trauma b) Positive psychological changes that emerge in the struggle with highly challenging life circumstances c) The process of returning to pre-trauma functioning d) A therapeutic technique for processing traumatic memories

15. The five domains most commonly reported in post-traumatic growth are:

a) Reduced anxiety, improved sleep, better relationships, career success, and health improvement b) Personal strength, new possibilities, relating to others, appreciation for life, and spiritual/existential change c) Cognitive flexibility, emotional regulation, social connection, purpose, and recovery speed d) Academic achievement, professional advancement, financial improvement, reduced health risk, and longevity

16. Which of the following is a critical caveat about post-traumatic growth?

a) PTG is observed only in people who experienced trauma before age 40 b) PTG requires professional psychological intervention to occur c) PTG does not mean the adversity was good or the suffering was worth it; it coexists with genuine loss d) PTG is incompatible with continued distress symptoms

17. Which of the following is the most robustly supported physiological stress intervention?

a) Dietary supplements for cortisol regulation b) Regular aerobic exercise c) Biofeedback technology d) Cold exposure therapy

18. The physiological mechanism by which extended exhalation reduces stress is:

a) It increases blood CO2 levels, which activates the calm response b) It activates the vagus nerve and the parasympathetic nervous system, countering sympathetic activation c) It reduces oxygen consumption, decreasing energy expenditure d) It distracts the mind from stressful thoughts

19. Cognitive reappraisal as a stress management technique involves:

a) Suppressing distressing thoughts until the stressor has passed b) Challenging the accuracy of stressful thoughts through logical analysis c) Revising the interpretation of a stressor — finding the most accurate available framing rather than the most threatening one d) Writing about stressful events in detail to process their emotional content

20. The distinction between rumination and productive problem-solving thought is primarily:

a) Rumination is emotional; problem-solving is cognitive b) Rumination is about the past; problem-solving is about the future c) Problem-solving is directed toward action, generates options, and has a natural stopping point; rumination is circular, non-productive, and consuming d) Rumination is pathological; problem-solving is always adaptive

21. Bonanno's research on trajectories after major adversity identified the most common trajectory as:

a) Chronic dysfunction b) Recovery (significant impairment followed by gradual return to functioning) c) Delayed response d) Resilience (stable functioning throughout)

22. Bonanno's finding that many people follow the "resilient trajectory" after major loss has which practical implication?

a) People who recover quickly from loss are not grieving deeply enough b) The absence of dramatic symptoms after loss is not evidence of pathology — genuine resilience after adversity is more common than previously assumed c) Loss and trauma rarely cause significant distress in psychologically healthy people d) Grief therapy is unnecessary because most people recover on their own

23. The chapter's discussion of acceptance (in stress management) clarifies that acceptance is:

a) Approving of the stressor or claiming it is not painful b) Resignation — giving up on changing what could be changed c) Genuine acknowledgment of an uncontrollable reality without secondary suffering about the fact of the suffering d) A technique from Eastern meditation traditions with limited empirical support

24. The chapter notes that "social support" is not uniformly protective. What is the important caveat?

a) Social support is only protective when the supporter has mental health training b) Social support from family is more protective than support from friends c) Not all social interactions are supportive; social relationships are also significant sources of stress, and quality matters more than quantity d) Social support becomes less effective with age

25. (Short answer) Describe the difference between problem-focused, emotion-focused, and meaning-based coping, and explain the principle that should govern which type of coping is used in a given situation. (4–6 sentences)

Answer Key

1. b — The correct GAS sequence is Alarm → Resistance → Exhaustion. In alarm, the body mobilizes; in resistance, it maintains heightened activation; in exhaustion, resources are depleted.

2. c — Cortisol is the primary hormone associated with the HPA axis stress response. Adrenaline (epinephrine) is associated with the faster SAM system response.

3. b — Chronic cortisol elevation impairs hippocampal function (memory and emotional regulation), suppresses immune response, and increases cardiovascular risk. These are well-documented effects of sustained stress.

4. c — Lazarus and Folkman's transactional model: stress arises from the transaction between person and environment, mediated by appraisal. Not determined by objective severity (a) or individual trait (b); not identical across individuals facing the same stressor (d).

5. c — Secondary appraisal evaluates available coping options ("What can I do about this?"). Primary appraisal (d) assesses whether the stressor is relevant and how threatening. Secondary appraisal is the first (not second) evaluation in time for existing stressors (a is incorrect).

6. b — Eustress is positive stress — the manageable challenge stress associated with engagement, growth, and performance enhancement. It is not defined by its source (a, c) or duration (d).

7. b — Problem-focused coping is most effective when the stressor is controllable and can be directly addressed. Applying it to uncontrollable stressors is ineffective and depleting.

8. c — Emotion-focused coping is most effective when the stressor is uncontrollable and the relevant work is managing the emotional experience rather than changing the situation.

9. b — Meaning-based coping: finding or creating meaning in stressful experience. This is distinct from religious belief specifically (a), journaling (c), or minimizing (d).

10. c — Multiple large studies show that strong social support networks predict lower mortality and better stress outcomes. The effect is not gender-limited (a); quality matters enormously (b); physical health effects are well-documented (d).

11. b — Buffering: the presence of trusted others reduces physiological stress responses and changes the appraisal of stressors (problems that can be shared feel less threatening). It is not about preventing events (a) or solving problems for the person (c).

12. c — Resilience is a dynamic process, not a fixed trait, supported by both internal and external resources. Resilient people do experience distress (a is false); resilience is not fixed (b); prior adversity is not required (d).

13. c — Self-efficacy is an internal resource that supports resilience. Economic stability (a), community support (b), and mentors (d) are external resources.

14. b — PTG: positive psychological changes emerging from the struggle with highly challenging circumstances. Not mere symptom reduction (a), return to baseline (c), or a therapeutic technique (d).

15. b — The five PTG domains: personal strength, new possibilities, relating to others, appreciation for life, and spiritual/existential change. These are Tedeschi and Calhoun's original domains.

16. c — The key caveat: PTG does not mean the adversity was good or the suffering was worthwhile. The growth coexists with genuine loss and pain. PTG is not age-limited (a); professional intervention is not required (b); it is compatible with continued distress (d).

17. b — Regular aerobic exercise is the most robustly supported physiological stress intervention, with effects on HPA axis reactivity, mood, cognition, sleep, and immune function.

18. b — Extended exhalation activates the vagus nerve and the parasympathetic nervous system, directly countering the sympathetic activation of the stress response. This is a well-documented physiological mechanism.

19. c — Reappraisal: revising the interpretation of the stressor toward the most accurate available framing. Not suppression (a), logical challenge (b is closer to standard CBT), or expressive writing (d).

20. c — The key distinction: problem-solving is directed, generates options, and terminates naturally when the problem is addressed. Rumination is circular, non-productive, and consumes without progressing. Not simply temporal (b) or inherently pathological (d).

21. d — Bonanno found that the most common trajectory was resilience — stable functioning throughout, grief experienced but not clinically impairing. This contradicted prior assumptions that significant short-term impairment after loss was universal.

22. b — The practical implication: absence of dramatic symptoms after loss is not evidence of pathology. Many people are genuinely resilient, and assuming they should be more distressed is itself a burden. This does not imply loss causes no distress (c) or that therapy is unnecessary (d).

23. c — Acceptance: genuine acknowledgment of uncontrollable reality without secondary suffering. Not approval (a), not resignation (b) — those are mischaracterizations. The empirical support from ACT research is substantial (d is incorrect).

24. c — The key caveat: social relationships are also significant sources of stress; quality matters more than quantity; not all social interactions are supportive or buffering.

25. (Model answer) Problem-focused coping addresses the source of the stress — changing the situation, developing skills, seeking practical solutions. Emotion-focused coping addresses the emotional experience of stress — managing how one feels about the situation through reappraisal, acceptance, or support-seeking. Meaning-based coping involves finding or creating significance in the stressful experience itself. The principle governing which type to use is the controllability of the stressor: problem-focused coping is most effective when the stressor can be addressed through action; emotion-focused coping is most effective when the stressor cannot be changed and the work is to manage the emotional response; meaning-based coping is most relevant for major stressors where neither action nor pure emotion regulation is sufficient.