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January 2008--Psychoneuroimmunology: mind-body medicine.

NB: Please note that manual completion of CPD questionnaires will only be possible for the January and February editions of CME. These questionnaires must be submitted by the end of March and April respectively. After this the answers will be available online and, if you have not submitted your questionnaires, you will not be credited with any points for these two months. Go to for future CME CPD questions.


1. Which one of the following statements is untrue? In general terms, symptoms:

A. Portray symbolism with appropriate organ specificity

B. Maintain a consciously unacceptable emotion

C. Are easily eliminated by conscious will alone

D. Achieve the subconscious purpose

E. Punish the patient (suffering).

2. Which one of the following statements is untrue?

A. Introns act as switches to activate or silence DNA gene sequences

B. Early life events have no bearing on future well-being

C. Physiological function can be profoundly altered in hypnosis

D. A patient's semantics and body language provide strong clues to the real problems

E. Spiritual survival is the highest survival priority.

3. True (A) or false (B)--fill in only block A or B: Logic is more powerful than emotion.


4. Mindfulness is (choose one):

A. An acquired state of consciousness

B. Specifically meditation

C. A broadly applicable attentional skill

D. A relaxation technique

E. Identification with thoughts and feelings.

5. Mindfulness-based interventions (MBIs) (choose one):

A. Shift prefrontal activation from left to right

B. Are ineffective in treatment of borderline personality disorder

C. Are generally used for inpatient medical populations

D. Reduce the relapse rate of 1 or more major depressive episodes

E. Are experiential trainings which reduce reactivity and enhance coping.

6. True (A) or false (B)--fill in only block A or B:

Mindfulness is a non-dogmatic, broadly applicable inner resource.


7. Peptides secreted from the brain in relation to stress or a particular mental and emotional state effect immunity by (choose one):

A. Cytotoxicity of lymphocytes

B. Activity of NK cells

C. Macrophage phagocytosis

D. All of the above

E. None of the above.

8. Long-term, chronic increases in adrenalin secretion result in (choose one):

A. An enhancement of cell-mediated defences

B. An increase in NK cell activity

C. Decreased cell-mediated immune responses

D. Increased macrophage phagocytosis

E. Fever.

9. True (A) or false (B)--fill in only block A or B: An individual's attitude and personality can cause cancer or autoimmune conditions.


10. Which one of the following statements is correct?

A. The placebo effect is a state of mind and does not have any real clinical effects

B. Oral placebos are superior to subcutaneous injections in the treatment of migraine

C. Placebo-induced analgesia is blocked by proglumide

D. Placebos release dopamine in patients with Parkinson's disease

E. There is good evidence to support a curative mechanism for placebos.

11. Which one of the following statements is correct?

A. Personality factors are implicated in cancer development

B. Early life traumatic events have little effect on the neuroendocrine stress response systems

C. Acute psychosocial stress is a well-documented trigger for myocardial infarctions

D. Therapeutic touch increases blood cortisol and norepinephrine

E. There is no link between depression and cardiac morbidity.

12. True (A) or false (B)--fill in only block A or B: Emotional stimuli are relayed faster to the amygdala than the cortex.


13. Complementary and alternative medicine use in cancer patients has been estimated at (choose one):

A. 42%

B. 83%

C. 67%

D. 92%.

14. True (A) or false (B)--fill in only block A or B: Hypnosis and guided imagery are effective for post-chemotherapy nausea and vomiting.

15. True (A) or false (B)--fill in only block A or B: Mind-body interventions may have a role in the management of cancer-related symptoms.


16. True (A) or false (B)--fill in only block A or B: The adult brain shows neuroplasticity.

17. True (A) or false (B)--fill in only block A or B: Directed mental activity brings about improved self-reported functioning in patients with obsessive compulsive disorder (OCD) as well as the moderation of the hyperactive neural structures involved in the pathology.


18. Guided imagery may improve clinical depression by (choose one):

A. Reducing cytokine production

B. Improving plasma serotonin levels

C. Directly inhibiting pain pathways

D. Augmenting therapeutic efficacy of antidepressants

E. Enhancing slow-wave sleep.

19. True (A) or false (B)--fill in only block A or B: In a recent study at the Fred Hutchison Cancer Research Center in the USA, the group using guided imagery reported even less pain that those assigned to a therapist who was at their side to offer support during treatment.


20. True (A) or false (B)--fill in only block A or B: Mindfulness-based cognitive therapy has demonstrated efficacy in reducing relapse rates of depression in those with 3 or more episodes.
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Publication:CME: Your SA Journal of CPD
Date:Jan 1, 2008
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