Deck 16: Mental Disorders and Aging

Question 1

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A) keep older people from becoming upset and withdrawn.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.

Answer 1

ensure that older people with disorders such as Alzheimer's remain active.

Question 2

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

Answer 2

conscientiousness ; emotional stability ; agreeableness

Question 3

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.

Answer 3

Side effects of medications may mimic the symptoms of certain disorders.

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 mood 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

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 7

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 8

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.

Question 9

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 10

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 11

________ 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 12

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.

Question 13

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 14

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 15

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 16

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

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

Question 17

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 18

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 dementia and sleep disorders, mental disorders are less common among older adults.
E) the highest 12-month prevalence of any mental disorder exists among those over 65.

Question 19

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 20

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 21

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 22

The diagnostic criteria for primary insomnia 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 23

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

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

Question 24

Mood disorders are __________ among 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 25

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 26

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 27

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 28

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

A) Both major depressive disorder and dysthymic 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 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

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 31

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 32

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 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.
C) poor sleep hygiene.
D) primary insomnia.
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 an important first step when treating sleep problems such as primary insomnia?

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 36

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 37

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 38

Sleeping 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

Depression is _____ common 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 40

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) primary insomnia
B) hypersomnia
C) somnambulism
D) sleep apnea
E) nocturnal myoclonus

Question 41

Whereas delirium refers to __________, dementia 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 42

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 43

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

Question 44

Delerium in older patients is often misdiagnosed as

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

Question 45

The most common mental disorder among older adults is

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

Question 46

In contrast to early-onset schizophrenia, late-onset schizophrenia is __________ and mostly affects __________.

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

Question 47

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 dementia.
E) Alzheimer's disease.

Question 48

Blockage of the upper airways results in __________ apnea, 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 49

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 50

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 51

Significant symptoms of ________ are among the most common psychiatric symptoms experienced by older adults.

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

Question 52

The three most common anxiety disorders among older adults are

A) panic disorder, GAD, and social phobia.
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 phobia, specific phobia, and GAD.

Question 53

DSM-5 proposes to create a new category - _________ which will contain the following diagnoses: _______________.

A) neurocognitive disorders; delirium, major neurocognitive disorder, and mild neurocognitive disorder
B) neurocognitive disorders; major neurocognitive disorder, and mild neurocognitive disorder
C) neurocognitive disorders; delirium and major neurocognitive disorder
D) neuro-degenerative disorders; delirium, major neuro-degenerative disorder, and mild neuro-degenerative disorder
E) neuro-degenerative disorders; delirium, major neuro-degenerative disorder

Question 54

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 55

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) paranoid schizophrenia.
C) late-onset schizophrenia.
D) delusional disorder.
E) early-onset schizophrenia.

Question 56

Research cited in the text finds that older people are __________ seeking 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 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

DSM-5 proposes to include diagnosis of Restless Leg Syndrome, which is the second most common_______ disorder in older adults and which involves_______.

A) movement ; unpleasant sensations and the urge to move one's legs
B) sleep ; 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 59

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-IV-TR does not recognize anxiety in older populations.

Question 60

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

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

Question 61

What is the main difference between pseudo-dementia and dementia?

A) Pseudo-dementia has an earlier onset, while dementia develops later.
B) Pseudo-dementia involves loss of cognitive functioning, whereas idementia 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 dementia usually does not.
D) The loss of cognitive functioning in dementia is reversible.
E) The loss of cognitive functioning in pseudo-dementia is generally not degenerative.

Question 62

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 63

Cortical dementias primarily attack __________, whereas subcortical dementias 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 64

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

Question 65

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 66

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

A) secondary dementias.
B) pseudodementias.
C) comorbidity.
D) primary dementias.
E) senility.

Question 67

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 68

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

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

Question 69

The prognosis of vascular dementia is __________ than for AD, with a __________ progression.

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

Question 70

The second most common cause of dementia is

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

Question 71

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 72

It is estimated that at least __________ percent of dementias 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 73

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 74

Lewy body dementia differs from AD and vascular dementia in that __________ is/are present.

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

Question 75

The diagnostic criteria for MCI include all of the following EXCEPT

A) dementia.
B) memory complaints.
C) impaired short-term memory.
D) otherwise normal cognitive functioning.
E) unimpaired social or occupational functioning.

Question 76

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

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

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

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

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

Why is dementia no longer referred to as senility or senile dementia?

A) Senile dementia affects older people mainly from Asian and European countries.
B) The age of political correctness led to a change.
C) The deterioration that occurs is no longer believed to be a normal part of the aging process.
D) There are many different disorders under the category of dementia.
E) Different symptoms were found to be characteristic of both disorders.