Deck 16: Aging and Mental Health

Question 1

Older adults are disproportionately underrepresented as users of mental health services for all of the following reasons,except

A)Older adults themselves are responsible for not seeking psychological help when they need it.
B)Mental health professionals may be less willing or able to treat older adults.
C)Psychologists and psychiatrists prefer to work with younger clients.
D)Family physicians are less likely to treat older patients and refer them to mental health professionals.
E)There is an insufficient number of mental health professionals who specialize in older adults.

Answer 1

Older adults themselves are responsible for not seeking psychological help when they need it.

Question 2

Large-scale community surveys suggest that

A)mental disorders are the most common among older adults.
B)men are more likely to have diagnosable health problems across the lifespan.
C)there is a linear increase with age in lifetime prevalence rates of combined major disorders.
D)except for neurocognitive disorders and sleep-wake disorders,mental disorders are less common among older adults.
E)the highest 12-month prevalence of any mental disorder exists among those over 65.

Answer 2

except for neurocognitive disorders and sleep-wake disorders,mental disorders are less common among older adults.

Question 3

Why is it generally believed that older people with mental illnesses do not benefit from treatment?

A)Older people are more distrustful of psychologists than are younger people.
B)Older people are viewed by many as "set in their ways" and unable to change.
C)The types of disorders usually found in older adults are more resistant to treatment.
D)Mental illnesses are seen as a normal part of aging.
E)Older people tend not to respond to treatment as well as younger people.

Answer 3

Older people are viewed by many as "set in their ways" and unable to change.

Question 4

Milford retired from his job several years ago,and lately he has been feeling lethargic,unhappy,and useless.He does not want to work in the garden or go fishing with his friends.His wife and her friends believe that he is just moody and that everyone will just have to put up with his behaviour.It is likely that

A)every older person feels this way after retiring.
B)in time,he will likely get past his negative feelings.
C)his behaviour reflects a long-standing mental illness that was not apparent until now.
D)if he became involved in other activities,his mood would likely improve.
E)he is probably suffering from a depressive disorder and could benefit from treatment.

Question 5

According to the selective optimization with compensation viewpoint,successful aging involves

A)practising old skills more so that they are not lost to aging.
B)making the most of your skills and substituting areas of strength for areas of weakness.
C)focusing on learning new skills,where applicable.
D)recognizing that you will begin to slow down as you age.
E)continuing to keep activity level high.

Question 6

Why is it important that mental disorders in the elderly be viewed as a cause for concern?

A)Mental disorders are more common among the elderly.
B)It is far more difficult to diagnose and treat the elderly.
C)Older people are more likely to sink into despair.
D)Treating mental disorders in the elderly is far more difficult than when they occur in younger people.
E)Mental disorders in older people are not normal.

Question 7

Three personality characteristics associated with positive health appear to increase across the lifespan.These are:

A)extraversion ; openness ; agreeableness
B)conscientiousness ; emotional stability ; agreeableness
C)conscientiousness ; openness ; agreeableness
D)extraversion ; emotional stability ; agreeableness
E)extraversion ; openness ; conscientiousness

Question 8

Oftentimes,losses of physical functioning,retirement,or death of loved ones will increase the likelihood that an individual will develop a mental disorder because

A)the individual finds it difficult to cope with several losses.
B)the individual becomes depressed and disheartened.
C)he or she does not go for counseling when it is needed.
D)these are known risk factors of mental disorders in the aging population.
E)he or she lacks support from family and friends.

Question 9

Why is it particularly difficult to properly diagnose mental disorders in older adults?

A)Side effects of medications may mimic the symptoms of certain disorders.
B)Clinicians are largely unfamiliar with the disorders specific to this age group.
C)Similar symptoms are indicative of more than one disorder.
D)Older adults often are afraid to get help for their problems.
E)Older individuals are less able to explain their problems than younger patients.

Question 10

Veronica has recently learned that her spouse is suffering from cancer.At this time,Veronica would be moreto mental difficulties,and may not be able to cope with more problems.

A)resigned
B)predisposed
C)reactive
D)resistant
E)vulnerable

Question 11

Which of the following findings is consistent with the Socio-emotional Selectivity Theory (SST)?

A)Older adults process negative information less deeply than positive information.
B)Older adults process positive information less deeply than negative information.
C)Older adults tend to focus more on negative information than younger adults.
D)Older adults are less likely to respond positively do emotional advertisements.
E)Older adults are more future-oriented than are younger adults.

Question 12

Cross-sectional surveys are limited in that they cannot tell us if the results are due to

A)the paradox of aging.
B)normal aging.
C)an aging effect.
D)a cohort effect.
E)client barriers.

Question 13

A normal aging process involves

A)reminiscing and memory loss.
B)decreased functioning of bodily organs.
C)some type of pathology.
D)an increase in disorders such as Alzheimer's disease.
E)development of diseases and poor health.

Question 14

Historically,the majority of older people with mental disorders were labeled as "eccentric," and treatment consisted of

A)isolation or institutionalization.
B)improved diet and fresh air.
C)psychoanalysis.
D)medications.
E)psychosurgery.

Question 15

extended psychoanalytic theory by suggesting that there are critical issues for successful functioning across the lifespan.

A)Anna Freud
B)Sigmund Freud
C)Erik Erikson
D)Melanie Klein
E)Carl Jung

Question 16

Which of the following provides one reasonable explanation as to why the percentage of older individuals has increased and will likely continue to increase over time?

A)higher levels of education
B)effective medications that slow the aging process
C)more support from younger generations
D)substantial drop in new births
E)an increase in natural,anti-aging products

Question 17

The reason that theoretical frameworks of mental disorder have not typically been extended to older adults could be due to the early thinking of.

A)Freud
B)Erikson
C)Baltes
D)Carstensen
E)Hayflick

Question 18

In many nursing homes,older individuals play games such as bingo,or get involved in sing-alongs.According to the selective optimization/compensation view,low stress activities such as these are believed to

A)keep older people from becoming upset and withdrawn.
B)keep older people active.
C)ensure that older people with disorders such as Alzheimer's remain active.
D)help sharpen memory skills.
E)allow older people to socialize.

Question 19

The finding that there is a decreasing prevalence of most mental disorders with age should be interpreted cautiously for which of the following reasons?

A)Older adults are more likely to remember having symptoms of a disorder.
B)Older adults who participate in surveys may reflect a survivor effect.
C)Older adults are less likely to express symptoms in somatic ways.
D)Older adults are more likely to participate in surveys because they have more time.
E)Older adults are more likely to report their symptoms.

Question 20

In Canada,the age group that will grow the most will be the

A)over-65 population.
B)over-80 population.
C)over-55 population.
D)over-35 population.
E)over-45 population.

Question 21

Which of the following statements about suicide and older Canadians is TRUE?

A)Older Canadian women were around 6 times more likely to commit suicide than older Canadian men.
B)Suicide attempts are more common among young Canadians,but attempts by older Canadians are more successful.
C)Older Canadian women were more likely to attempt drug overdose than any other group.
D)Older Canadian men were around 3 times more likely to commit suicide than older Canadian women.
E)Older Canadians are less likely than younger Canadians to commit suicide.

Question 22

What is an important first step when treating insomnia disorder?

A)Determine what stage of sleep is most frequently lost due to the insomnia.
B)Determine whether the sleep problems are due to stressful life events before treating them with drugs.
C)Ensure that patients are not taking another drug that will contra-indicate the effects of the sedative.
D)Determine whether the symptoms are being caused by another drug or disorder.
E)Ensure that the sedatives/hypnotics are the proper dosage,especially for older adults.

Question 23

The diagnostic criteria for insomnia disorder include all of the following EXCEPT

A)The disturbance is not due to the direct physiological effects of a substance or a general medical condition.
B)Main complaint is difficulty falling or staying asleep,for at least one month.
C)There is significant distress or impairment in some area of functioning.
D)Sleep disturbance is frequently accompanied by nightmares which cause nighttime awakening.
E)The disturbance does not occur exclusively during the course of another mental disorder.

Question 24

Depression iscommon in older people and when it occurs,tends to be.

A)more ; more severe
B)less ; less severe
C)more ; less severe
D)less ; more chronic
E)more ; less chronic

Question 25

Which of the following statements regarding depressive disorders and older adults is true?

A)Both major depressive disorder and persistent depressive disorder are more prevalent among younger than older adults.
B)There is a higher prevalence of depressive disorders among older men.
C)There is a higher prevalence of depressive disorders among older women.
D)Depressive disorders are easier to treat in older adults.
E)Major depressive disorder is one of the less common psychiatric problems among older adults.

Question 26

Strength and Vulnerability Integration Theory posits that aging is associated with
Ability to regulate emotions due to several factors,including:.

A)decreased ; increasing stressors and increased activation of the HPA axis
B)increased ; possession of a time-limited perspective with greater emphasis on emotionality ; meaningful goals,increased present-moment awareness,strength based appraisal of information
C)decreased ; increasing stressors,slower processing speed,proneness to rumination
D)increased ; increased time to make social connections,consider various ways of meeting needs,avoiding stressors,and coping with existing stressors
E)decreased ; increasing stressors,slower processing speed,proneness to rumination and increased activation of the HPA axis

Question 27

This treatment process involves educating the patient about normal age-related changes in sleeping,and involves techniques such as relaxation training and changing sleep habits.

A)brief dynamic therapy
B)cognitive-behavioural therapy
C)hypnotherapy
D)sleep therapy
E)remote relaxation transmission

Question 28

Each of the following factors are believed to cause insomnia disorder EXCEPT

A)a poor sleep environment.
B)physical disorders.
C)substances.
D)comorbidity.
E)shift work.

Question 29

Research has shown which of the following treatments to be most effective for older adults suffering from depressive disorders?

A)cognitive therapy
B)drug therapy
C)a wide array of treatments have been shown to be effective
D)behavioural therapy
E)brief dynamic psychotherapy

Question 30

Depressive disorders areamong older adults than younger adults.

A)less common
B)more or less common,depending on the type of disorder
C)equally prevalent
D)more common
E)ten times more common

Question 31

Who is most likely to commit suicide?

A)an unmarried man from Canada
B)a widowed elderly man from the U.S.
C)a married elderly woman from the U.S.
D)a married senior from Canada
E)a widowed elderly man from Canada

Question 32

All of the following statements are true regarding the use of ECT among older adults with depressive disorders EXCEPT

A)serious complications such as cardiorespiratory problems may result.
B)ECT appears more effective with older than younger adults.
C)physicians are generally recommended to consider other treatments.
D)it can result in short-term transient memory problems.
E)due to the problems,ECT is less likely to be used to treat older adults.

Question 33

John's wife Marge has lately been waking up frequently,because her husband continually kicks her throughout the night.John went to his physician,who suspected that John was suffering from

A)"The kicks".
B)secondary insomnia disorder.
C)poor sleep hygiene.
D)primary insomnia disorder.
E)nocturnal myoclonus.

Question 34

Why is drug therapy not necessarily the best choice for older adults who suffer from depressive disorders?

A)Drugs have a shorter half-time in older people and are less effective.
B)Drug therapy is more effective with younger adults.
C)Side effects are tolerated less well in older adults.
D)Older adults are less likely to remember to take their medication.
E)Older adults do better with psychotherapy.

Question 35

What is the main difference in the symptoms of major depressive disorder between younger and older adults?

A)Younger adults are more likely to report sleep difficulties.
B)Older adults are more likely to report feelings of guilt and sadness.
C)Older adults are more likely to report feelings of worthlessness.
D)Older adults are more likely to report somatic symptoms.
E)Younger adults are more likely to report physical complaints.

Question 36

One of the major difficulties in determining whether an older adult is suffering from a depressive disorder is

A)many people feel that it is normal for older people to be depressed.
B)older people don't want to admit that they feel depressed.
C)many older people experience higher levels of sadness,but not true depression.
D)other medical problems have similar symptoms to depressive disorders.
E)depressive disorders are not common among older adults.

Question 37

Esther has been having problems falling asleep at night,and when she finally manages to fall asleep,she awakens frequently,for apparently no reason.During the day,she feels extremely tired,depressed,and anxious.If you were Esther's psychologist,what would you suspect to be her problem?

A)insomnia disorder
B)hypersomnolence
C)somnambulism
D)sleep apnea
E)nocturnal myoclonus

Question 38

Sleep-wake patterns often change in older adults.All of the following are considered changes EXCEPT

A)circadian rhythms change.
B)changes in the organization of sleep stages.
C)less synchronous Stage 2 EEG activity.
D)decreases in total sleep time.
E)increases in the length of REM periods.

Question 39

Which of the following reasons for choosing non-pharmacological treatments is NOT supported by clinical observations or research?

A)Increased renal clearance in older persons can increase drug tolerance
B)Polypharmacy is an issue for many older persons
C)Older people actually prefer psychotherapy for treatment of depression
D)Drug interactions can have unknown and dangerous consequences for older persons
E)ECT often has undesirable side effects

Question 40

Which pair of factors places an older individual at greatest risk for developing depression?

A)low income and poor physical health
B)lack of support and poor emotional health
C)poor physical and emotional health
D)low income and lack of support
E)poor physical health and lack of support

Question 41

Delerium in older patients is often misdiagnosed as

A)neurocognitive disorder.
B)delusional disorder.
C)generalized anxiety disorder.
D)late-onset schizophrenia.
E)dissociative identity disorder.

Question 42

Research cited in the text finds that older people areseeking professional help for psychological problems.In particular,are.

A)often ; anxiety disorders ; often treated.
B)often ; bipolar disorders ; often treated.
C)rarely ; anxiety disorders ; not often treated.
D)rarely ; personality disorders ; not often treated.
E)often ; personality disorders ; often treated.

Question 43

What is the main difference between pseudo-dementia and dementia genuine cognitive disorder?

A)Pseudo-dementia has an earlier onset,while dementia develops later.
B)Pseudo-dementia involves loss of cognitive functioning,whereas neurocognitive impairment refers to the loss of one's normal personality.
C)Pseudo-dementia involves a decrease in the individual's capacity to care for him or herself,while neurocognitive impairment usually does not.
D)The loss of cognitive functioning in a neurocognitive disorder is reversible.
E)The loss of cognitive functioning in pseudo-dementia is generally not degenerative.

Question 44

The most common mental disorder among older adults is

A)neurocognitive disorder.
B)delerium.
C)anxiety disorder.
D)memory loss.
E)depression.

Question 45

Blockage of the upper airways results inapnea,while apnea is due to impairment of activation in the medullary respiratory centre.

A)upper; medullary
B)obstructive; central
C)upper; central
D)obstructive; medullary
E)mixed; peripheral

Question 46

Significant symptoms ofare among the most common psychiatric symptoms experienced by older adults.

A)self-harm
B)mania
C)anxiety
D)substance abuse
E)dissociation

Question 47

An excessive fear of eating out in public or speaking in public is indicative of
,while fear of a specific object or situation indicates that the individual is suffering.

A)social anxiety disorder; GAD
B)specific phobia; social anxiety disorder
C)specific phobia; GAD
D)public anxiety; private anxiety
E)social anxiety disorder; specific phobia

Question 48

What is the major difference between the symptoms of late and early onset schizophrenia?

A)Hallucinations and delusions are more often of a persecutory nature in early-onset cases.
B)Hallucinations and delusions are more bizarre in early-onset cases.
C)Lack of logical thought is found more often in late-onset schizophrenia.
D)Late-onset schizophrenia is more likely to involve disorganized speech and flattened affect.
E)Hallucinations and delusions are more bizarre in late-onset cases.

Question 49

Whereas delirium refers to,neurocognitive disorder refers to

A)short-term disturbance of consciousness ; permanent losses in memory,judgment and/or reasoning ability
B)short-term disturbance of consciousness ; short-term loss of memory,judgment and/or reasoning ability
C)short-term and temporary loss of memory ; permanent disturbance of consciousness
D)long-term and permanent disturbance of consciousness ; permanent losses in memory,judgment and reasoning ability
E)short term and temporary or permanent loss of reasoning ability ; short-term and temporary or permanent losses in memory

Question 50

Recent research cited in the text found that chronic anxiety in older adults leads to increased risk of

A)heart disease and accidental death.
B)cancer and accidental death.
C)obsessive-compulsive disorder.
D)heart disease and vascular disease.
E)Alzheimer's disease.

Question 51

The treatment of choice for elderly patients suffering from psychotic disorders is

A)neuroleptics.
B)psychoanalysis.
C)psychological treatment.
D)institutionalization.
E)psychosurgery.

Question 52

In contrast to early-onset schizophrenia,late-onset schizophrenia isand mostly affects.

A)not common; men and women equally
B)common; men
C)not common; women
D)common; women
E)not common; men

Question 53

All of the following statements are true about sleep apnea EXCEPT

A)the disorder results in hypoxemia.
B)sufferers often have difficulty remembering things.
C)sleep apnea is more common in men,especially with age.
D)sufferers often fall asleep during meetings,concerts,movies,etc.
E)episodes of cessation of breathing occur that last 10 seconds and occur approximately twice per night.

Question 54

At the moment,the most empirically-supported treatments for insomnia in older persons are

A)massage therapy and pharmacotherapy.
B)sleep restriction therapy and pharmacotherapy.
C)pharmacotherapy and multi-component CBT.
D)sleep restriction therapy and multi-component CBT.
E)massage therapy and sleep hygiene approaches.

Question 55

Treatment of sleep apnea often involves all of the following EXCEPT

A)learning to avoid sleeping on one's back.
B)losing weight.
C)avoiding alcohol and hypnotic medication.
D)wearing a mask attached to an air compressor while sleeping.
E)cognitive-behavioural therapy.

Question 56

Restless Leg Syndrome,which is the second most commondisorder in older adults involves.

A)movement ; unpleasant sensations and the urge to move one's legs
B)sleep-wake ; unpleasant sensations and the urge to move one's legs
C)movement ; muscle spasms in the legs with unknown medical origin
D)sleep ; muscle spasms with unknown medical origin
E)movement ; unpleasant muscle spasms that are relieved by intentional action

Question 57

Which of the following statements is TRUE regarding the treatment of anxiety disorders in older adults?

A)Psychological methods are usually less effective with older adults.
B)Doctors prefer medication despite the side effects.
C)A combination of drug and behavioural therapy has been shown to be the most effective.
D)Cognitive-behavioural therapy is generally not effective compared to no treatment.
E)Pharmacological treatments are effective and have few side effects.

Question 58

Fred believes that his children are attempting to have him put in an "old-age" home,and he is quite upset.Every time his son and daughter come to visit,Fred tells them that he refuses to go to a home and he knows they are trying to trick him into agreeing.Fred's children are concerned,however,because they have not mentioned a residential home in years.Fred appears to be suffering from

A)brief psychotic disorder.
B)schizophrenia.
C)late-onset schizophrenia.
D)delusional disorder.
E)early-onset schizophrenia.

Question 59

The three most common anxiety disorders among older adults are

A)panic disorder,GAD,and social anxiety disorder.
B)social phobia,obsessive-compulsive disorder,and PTSD.
C)specific phobia,panic disorder,and obsessive-compulsive disorder.
D)panic disorder,GAD,and PTSD.
E)social anxiety disorder,specific phobia,and GAD.

Question 60

Which of the following problems is common when attempting to diagnose anxiety disorders in older adults?

A)Anxiety disorders in older people are often comorbid with substance abuse.
B)Older adults often over-report anxiety symptoms.
C)Anxiety disorders in older people are often comorbid with personality disorders.
D)Most of the scales used to measure symptoms of anxiety have been validated only with younger adults.
E)The DSM-5 does not recognize anxiety in older populations.

Question 61

During the middle stage of Alzheimer's disease,sufferers may show

A)difficulty recognizing or naming people or things.
B)problems with concentration.
C)total incontinence.
D)stooped posture.
E)delusions.

Question 62

It is estimated that at leastpercent of neurocognitive disorders are due exclusively to.

A)20; Alzheimer's disease
B)50; vascular insults
C)25; vascular insults
D)50; Alzheimer's disease
E)75; Alzheimer's disease

Question 63

The "survivor effect" interpretation of the declining prevalence data dictates that individuals with mental disorders have higher mortality rates.

Question 64

Increased pathology is part of the normal aging process and must be accepted as inevitable.

Question 65

interests researchers and clinicians because it is thought to represent a transitional state between normal aging and neurocognitive disorder.

A)Impairment of intellect
B)Mild cognitive impairment
C)Frontotemporal cognitive impairment
D)Vascular disease
E)Secondary cognitive impairment

Question 66

Two myths concerning mental disorders and aging are that mental illness is common among older people and that treatment is not beneficial.

Question 67

Treatment of Alzheimer's disease with drugs results in

A)slowing,but not stopping the disease.
B)reducing the wandering behaviour but not the forgetfulness.
C)a reversal of the symptoms.
D)halting the progression of the disease.
E)reducing mild cognitive impairment but not the physical complications.

Question 68

Lewy body disease differs from AD and vascular disease in thatis/are present.

A)a dissociative disorder
B)recurrent well-formed hallucinations
C)delusions of persecution
D)aggressive behaviour
E)personality disorders

Question 69

You are an accomplished painter in your 70's and find that arthritis prevents you from enjoying the lengthy painting sessions that you love.Selective Optimization with Compensation theory suggests that you

A)obtain occupational therapy in order to treat and minimize the impact of your arthritis.
B)shorten the length of your painting sessions,paint subjects that have less fine detail,and explore opportunities to work or volunteer as an instructor.
C)seek counseling in order to minimize the impact of diminished function.
D)seek counseling in order to mourn the loss of your painting activity and identify new and similar activities that you can do,such as attending art shows.
E)meet regularly with peers who are in a similar position,engage in reminiscing of your painting career,and encourage younger people to paint.

Question 70

Frontotemporal lobar degeneration is a term used to describe a heterogeneous group of disorders including

A)Alzheimer's disease.
B)Lewy body disease.
C)Pick's disease.
D)primary cognitive impairment.
E)vascular disease.

Question 71

Depression,nutritional deficiency,and other disorders can cause symptoms similar to neurocognitive disorders,such as forgetfulness and difficulty concentrating.These occurrences are also known as

A)mild cognitive impairment.
B)pseudodementias.
C)comorbidity.
D)major cognitive impairment.
E)senility.

Question 72

The "cohort effect" interpretation of the data showing declining prevalence suggests that people become more resilient over time.

Question 73

The diathesis-stress model can be applied when there are two psycho-social factors: the loss of the death of a loved one (as diathesis)and being laid off from work (as stressor),triggering the emergence of mental disorder.

Question 74

Cortical cognitive impairment primarily attack,whereas subcortical cognitive primarily attack.

A)the occipital lobes; the frontal lobes
B)the cerebellum; the cerebral cortex
C)white matter; grey matter
D)brainstem areas; the cerebral cortex
E)grey matter; white matter

Question 75

The second most common cause of neurocognitive disorder is

A)Alzheimer's disease.
B)cerebrovascular damage.
C)Parkinson's.
D)senility.
E)alcoholism.

Question 76

Common symptoms that occur during the first stage of Alzheimer's include

A)aggression.
B)sleep difficulties.
C)speech and language difficulties.
D)repetitive actions.
E)problems with concentration.

Question 77

The brains of those suffering from Alzheimer's disease are characterized by

A)less electrical stimulation.
B)plaques and tangles.
C)decreased dopamine activity levels.
D)smaller frontal lobes.
E)lesions.

Question 78

The increased health and longevity of Canadians solely accounts for the increase in the proportion of older people in our population.

Question 79

Possible protective factors against AD include all of the following EXCEPT

A)high-fat protein diets.
B)vegetarian diet.
C)regular and moderate consumption of red wine.
D)dietary antioxidants.
E)lipid-lowering drugs.

Question 80

The prognosis of vascular disease isthan for AD,with a progression.

A)better; slower
B)worse; similar
C)worse; faster
D)worse; slower
E)better; similar