Stress & Anxiety Quiz

1. The 'fight-or-flight' response is triggered by the body's stress system. Which part of the brain initiates this response?

1. The amygdala
2. The cerebellum
3. The hippocampus
4. The prefrontal cortex

2. Cortisol is often called the 'stress hormone.' Which glands produce it?

1. The adrenal glands
2. The pancreas
3. The pituitary glands
4. The thyroid gland

3. What distinguishes acute stress from chronic stress?

1. Acute stress is caused by physical threats; chronic stress is caused by psychological threats only
2. Acute stress is short-term and often beneficial (e.g. before a performance); chronic stress is persistent and harmful to health over time
3. Acute stress only affects the mind; chronic stress only affects the body
4. Acute stress triggers the relaxation response; chronic stress triggers the fight-or-flight response

4. Mindfulness-based stress reduction (MBSR) was developed by which researcher?

1. Aaron Beck
2. Albert Ellis
3. Jon Kabat-Zinn
4. Martin Seligman

5. Deep breathing exercises reduce stress partly by activating which nervous system?

1. The central nervous system
2. The parasympathetic nervous system
3. The somatic nervous system
4. The sympathetic nervous system

6. Generalised Anxiety Disorder (GAD) is characterised by:

1. Intense fear of specific objects or situations
2. Persistent, excessive worry about multiple areas of life that is difficult to control, lasting at least 6 months
3. Recurrent intrusive thoughts and compulsive behaviours
4. Sudden, intense episodes of fear with physical symptoms (panic attacks)

7. The 4-7-8 breathing technique involves inhaling for 4 counts, holding for 7 counts, and exhaling for 8 counts. Why is a longer exhale particularly important?

1. Longer exhales activate the parasympathetic nervous system more strongly than inhalation, promoting relaxation
2. Longer exhales ensure more oxygen reaches the brain during stress
3. Longer exhales increase carbon dioxide levels, which improves focus
4. The specific ratio of 4-7-8 triggers the release of serotonin directly

8. Which evidence-based therapy is widely considered the gold-standard treatment for anxiety disorders?

1. Cognitive Behavioural Therapy (CBT)
2. Eye Movement Desensitisation and Reprocessing (EMDR)
3. Humanistic therapy
4. Psychoanalysis

9. Exercise is well-documented as a stress and anxiety reducer. What neurochemical change does regular aerobic exercise produce that contributes to improved mood?

1. It dramatically increases dopamine only
2. It increases adrenaline, which improves alertness and reduces anxiety over time
3. It increases endorphins, BDNF, serotonin, dopamine, and reduces cortisol
4. It only reduces cortisol without increasing feel-good chemicals

10. Chronic stress can suppress the immune system. Which of the following is a well-documented effect of prolonged stress on immunity?

1. It only affects immunity in people over 60
2. It permanently destroys T-cells and B-cells
3. It slows wound healing, reduces vaccine effectiveness, and increases susceptibility to infections
4. It strengthens the immune response by keeping it in a constant state of readiness

11. Social connection is a powerful buffer against stress and anxiety. What is the term for the physiological stress-reducing mechanism triggered by social support?

1. The placebo effect
2. The safety signal response
3. The social bonding hypothesis
4. The tend-and-befriend response

12. Which physical symptom is commonly caused by stress and anxiety through muscle tension?

1. Improved coordination and balance
2. Improved digestion and reduced acid reflux
3. Lower sensitivity to pain
4. Tension headaches and muscle pain (particularly in the neck, shoulders, and jaw)

13. The 'negativity bias' in human cognition refers to what tendency, and how does it relate to stress and anxiety?

1. The tendency to interpret ambiguous situations as threatening even when evidence is neutral
2. The tendency to pay more attention to and be more affected by negative experiences than equally intense positive ones, amplifying perceived threats
3. The tendency to remember only negative events from childhood
4. The tendency to view other people's behaviour more negatively than our own

14. What does the term 'allostatic load' refer to in the context of stress and health?

1. The amount of stress a person can handle before developing an anxiety disorder
2. The cumulative 'wear and tear' on the body and brain from chronic stress and repeated stress responses
3. The hormonal load of cortisol released in a single acute stress event
4. The maximum weight a person can safely carry without physical injury

15. Which class of medication is commonly prescribed for anxiety disorders in the short-term (but carries a risk of dependence)?

1. Benzodiazepines (e.g. diazepam, lorazepam)
2. Beta-blockers
3. SSRIs (selective serotonin reuptake inhibitors)
4. Tricyclic antidepressants

16. Cold water exposure (such as cold showers) is increasingly promoted for stress resilience. What physiological mechanism is proposed to underlie its benefits?

1. It activates the sympathetic nervous system initially (cold shock), followed by a stronger parasympathetic rebound, and over time trains the stress response
2. It directly increases serotonin production through skin receptors
3. It flushes cortisol from the bloodstream through increased blood flow to the skin
4. It raises body temperature, which relaxes muscles and reduces cortisol

17. Journaling is a commonly recommended stress management tool. What specific type of journaling has the strongest research evidence for psychological benefit?

1. Daily habit tracking and to-do lists
2. Expressive writing — writing about the emotional content of difficult experiences for 15-20 minutes
3. Gratitude journaling only, listing three positive things per day
4. Stream-of-consciousness journaling (writing whatever comes to mind)

18. Work-related stress and burnout are major public health issues. The Maslach Burnout Inventory identifies three dimensions of burnout. What are they?

1. Emotional exhaustion, depersonalisation, and reduced sense of personal accomplishment
2. Overwork, underappreciation, and lack of autonomy
3. Physical exhaustion, cognitive impairment, and social withdrawal
4. Stress, anxiety, and depression

19. Nature exposure ('green time') has measurable effects on stress. What does research show about spending time in nature?

1. It is effective for relaxation but has no measurable physiological effects
2. It mainly benefits children and elderly people; effects in working adults are minimal
3. It only benefits people who already enjoy outdoor activities
4. It reduces cortisol, lowers blood pressure and heart rate, improves mood, and reduces rumination

20. Which of the following is the most evidence-based self-help strategy for managing anxiety in the long term?

1. Avoiding all anxiety-provoking situations to prevent overwhelming stress
2. Gradually and systematically facing feared situations (exposure) combined with developing coping skills
3. Keeping extremely busy to avoid time to feel anxious
4. Using alcohol or cannabis regularly to reduce physical symptoms of anxiety