Deck 8: Eating and Sleep-Wake Disorders

Question 1

Which of the following represents the typical profile of a patient with either anorexia nervosa or bulimia nervosa?

A)Young female, socially competitive environment
B)Young female, history of depression
C)Young female , highly competitive
D)Any age female, few friends

Answer 1

Young female, socially competitive environment

Question 2

Individuals who experience loss of control of their eating and consume great quantities of food but do not engage in any attempts to compensate for their binge would be diagnosed with

A)bulimia nervosa, nonpurging type.
B)binge eating disorder.
C)obsessive-compulsive disorder.
D)buffet disorder.

Answer 2

binge eating disorder.

Question 3

When individuals with anorexia nervosa have been evaluated over long periods of time, it has been found that the percentage of individuals who die as a result of their disorder is ____.

A)20%
B)5%
C)2%
D)40%

Answer 3

20%

Question 4

Which of the following statements is true?

A)Eating disorders are a way of expressing depression.
B)Eating disorders have a high comorbidity with posttraumatic stress disorder.
C)Over 80% of people with bulimia had an anxiety disorder at some point in their lives.
D)Twenty to thirty percent of people with bulimia nervosa meet the criteria for a mood disorder during the course of their eating disorder.

Question 5

The males most likely to develop an eating disorder such as bulimia nervosa are those who are

A)overweight.
B)depressed.
C)Homosexual or bisexual.
D)only children.

Question 6

Most individuals with bulimia nervosa

A)purge by self-induced vomiting.
B)exercise rigorously after binging.
C)fast for long periods of time after binging.
D)none of these are correct

Question 7

As many as ____ of anorexia nervosa deaths are due to suicide.

A)5% to 10%
B)10% to 15%
C)15% to 20%
D)20% to 30%

Question 8

The chief motivating factor in both anorexia nervosa and bulimia nervosa is

A)a desire to purge.
B)an overwhelming drive to eat.
C)an overwhelming urge to be thin.
D)a desire to starve oneself.

Question 9

Eating disorders are most prevalent in

A)Western cultures where food is scarce.
B)Western cultures where food is plentiful.
C)non-Western cultures where food is scarce.
D)non-Western cultures where food is plentiful.

Question 10

Amy is a young woman who is very competitive and comes from a high-achieving, wealthy family. She is very social and likes the fact that she is quite popular. She believes that her popularity is dependent on the weight and shape of her body. Amy has a boyfriend but worries that she may care more about their relationship than he does. The feature that puts Amy most at risk for an eating disorder is her

A)belief that her weight and body shape influence her popularity.
B)belief that her boyfriend cares less about the relationship than she does.
C)successful family.
D)competitive nature.

Question 11

Recent research suggests that the restricting and bingeing/purging subtypes of anorexia nervosa

A)alternate in the same person in a cyclic fashion.
B)have completely different causes.
C)show few differences in severity of symptoms or personality.
D)are useless distinctions of the same disorder.

Question 12

The most common reason that people with anorexia nervosa generally do not seek treatment on their own is that they

A)are ashamed of their disorder.
B)fear that they will be hospitalized.
C)do not believe they are too thin.
D)have little desire for food.

Question 13

Susan, a woman of relatively normal weight, sometimes eats huge quantities of junk food with no ability to stop herself. She follows this with long periods of complete fasting. Based on this information, Susan would

A)be diagnosed with bulimia nervosa.
B)be diagnosed with anorexia nervosa.
C)not be diagnosed with any disorder because she is of normal weight.
D)not be diagnosed with bulimia nervosa because she is not purging.

Question 14

Jody sometimes eats more than just about any other girl that you know. You wonder if her eating sometimes could be considered bingeing. In order to determine this, you would have to know

A)the caloric intake of the foods.
B)whether she is eating junk foods
C)whether eating gets to be out of her control.
D)the situations under which she eats a great deal.

Question 15

A binge-eating episode is characterized by food intake of at least how many calories?

A)1,000
B)2,000
C)The calorie number does not matter, as long as it's too much junk food
D)The calorie number varies from person to person; a binge-eating episode is not defined by the number of calories

Question 16

The approximate percentage of patients with eating disorders who will experience depression at some point in their lives is approximately ____.

A)15%
B)35%
C)71%
D)85%

Question 17

The hallmark of anorexia nervosa is

A)food refusal.
B)a binge-purge cycle.
C)15% or lower weight than is expected for that height and body size.
D)a morbid fear of gaining weight and relentlessly pursue thinness.

Question 18

Since about 1960, most Westernized countries have experienced a dramatic

A)decrease in the incidence of anorexia nervosa and bulimia nervosa.
B)increase in the incidence of anorexia nervosa and bulimia nervosa.
C)increase in the incidence of anorexia nervosa but a decrease in the incidence of bulimia nervosa.
D)increase in the incidence of bulimia nervosa but no change in the rate of anorexia nervosa.

Question 19

Which of the following statements is true regarding the effectiveness of purging for reducing caloric intake?

A)Vomiting reduces almost 100% of calories consumed if done immediately after eating.
B)Laxatives reduce more calories than vomiting because it works immediately.
C)Vomiting reduces approximately 50% of calories consumed, up to 24 hours after eating.
D)Vomiting reduces approximately 50% of calories consumed, less if delayed after eating.

Question 20

Patients with bulimia nervosa often present with additional psychological disorders, particularly ________ and ________.

A)body dysmorphic disorder; substance disorders
B)mood disorders; sexual disorders
C)anxiety disorders; mood disorders
D)obsessive compulsive disorder; sexual disorders

Question 21

Of the following, the group in which we would expect to see the highest incidence of anorexia nervosa is

A)homosexual men.
B)female body builders.
C)ballet dancers.
D)female track stars.

Question 22

Which of the following might help to explain the vast differences in the incidence of eating disorders among men and women?

A)The influence of behavioral genetics
B)The fact that boys are encouraged to play sports and girls to be active in social functions
C)The fact that puberty brings boys' bodies closer to the societal ideal and girls' bodies further from the societal ideal
D)The differences in the way boys and girls tend to gain weight from overeating

Question 23

Men generally desire to be

A)equal to their present weight.
B)heavier and more muscular.
C)lighter than the male median weight considered attractive by women.
D)15 pounds lighter than their present weight.

Question 24

An eating disorder characterized by recurrent food refusal, leading to dangerously low body weight is called _______.

A)binging.
B)bulimia nervosa.
C)binge-eating disorder.
D)anorexia nervosa.

Question 25

The median range for onset for bulimia nervosa and anorexia nervosa is

A)18 to 21.
B)8 to 15.
C)20 to 26.
D)25 to 30.

Question 26

Some of the most convincing evidence that helps to explain the observed increase in the incidence of anorexia nervosa and bulimia nervosa over the past half century is

A)improved diagnostic and reporting practices.
B)concurrent increases in the rate of depression.
C)the generally improved health of the society and an increased emphasis on diet and exercise.
D)a strong relationship between exposure to media images depicting the thin-ideal body and body image concerns in women.

Question 27

With regard to the biological influences of anorexia nervosa and bulimia nervosa, the most accurate statement is that

A)anorexia nervosa and bulimia nervosa are culturally determined and not biologically influenced.
B)the biological influences of anorexia nervosa and bulimia nervosa have not been studied.
C)eating disorders run in families and seem to have a genetic component.
D)although studies are limited, there does appear to be a large biological influence for anorexia nervosa and bulimia nervosa.

Question 28

The families of patients with anorexia nervosa are typically characterized as

A)dysfunctional and disorganized.
B)tend to attribute their problems to other people and often deny or ignore conflicts or negative feelings.
C)reserved and quiet.
D)no different than the average family.

Question 29

Which of the teenage girls described below is at greatest risk for developing an eating disorder?

A)Alice is currently on a diet; her friendship clique also diet aggressively.
B)Sue is of average to slightly above average weight but wants to lose a few pounds.
C)Megan's friends are concerned about the weight she has lost since she began working out with the swim team.
D)Jean has always been fairly thin despite the fact that she eats quite normally.

Question 30

The strongest contributions to etiology of eating disorders seem to be

A)genetic.
B)psychological.
C)somatogenic.
D)sociocultural.

Question 31

Which of the following statements is true about individuals with an eating disorder?

A)They have a diminished sense of personal control.
B)They may manifest as having strikingly low self-esteem.
C)They display more perfectionistic attitudes
D)All of these are correct

Question 32

When women are asked to identify the most attractive female body weight, they typically identify a weight that is

A)lower than the weight identified by men.
B)the same as the weight identified by men.
C)higher than the weight identified by men.
D)20% lower than their own body weight.

Question 33

With regard to drug treatments for patients with bulimia nervosa, which of the following statements is true?

A)Medications have not been found to be effective for the treatment of bulimia nervosa.
B)Antidepressants have some effectiveness in the treatment of bulimia nervosa.
C)Benzodiazepine medications have some effectiveness in the treatment of bulimia nervosa.
D)Antipsychotic medications have been found to be effective for the treatment of bulimia nervosa.

Question 34

A study of foreign-born students who are attending Western universities shows that

A)anorexia nervosa and bulimia nervosa do not occur in students who were raised in countries where these disorders do not exist.
B)anorexia nervosa and bulimia nervosa are observed in some students who were raised in countries where these disorders do not exist.
C)anorexia nervosa, but not bulimia nervosa, has been observed in some students who were raised in countries where these disorders do not exist.
D)bulimia nervosa, but not anorexia nervosa, has been observed in some students who were raised in countries where these disorders do not exist.

Question 35

Which of the following young women appears to be at the highest risk for developing an eating disorder?

A)Linda, whose mom and dad recently divorced
B)Carla, whose family members always seem to be fighting with each other
C)Sandy, whose family emphasizes achievement, support, and communication
D)Bonnie, whose family is hard-driving, concerned about external appearances, and eager to maintain harmony

Question 36

Genetic influences on eating disorders most likely involve

A)a specific gene for each actual eating disorder.
B)an inherited personality tendency that may make development of an eating disorder more likely.
C)multiple genes interacting in ways not yet determined and that directly produce eating disordered behavior.
D)recessive genes.

Question 37

Which of the following statements is true?

A)Once bulimia nervosa develops, it is virtually untreatable.
B)Once bulimia nervosa develops, it tends to be chronic if untreated.
C)People with bulimia nervosa eventually shift to symptoms of other eating disorders.
D)Bulimia nervosa is more resistant to treatment than anorexia nervosa

Question 38

Which of the following statements is true with regard to drug treatments for patients with anorexia nervosa?

A)Medications have not generally been found to be effective for the treatment of anorexia nervosa.
B)Antidepressants have some effectiveness in the treatment of anorexia nervosa.
C)Anti-anxiety medications have some effectiveness in the treatment of anorexia nervosa.
D)Antipsychotic medications have been found to be effective for the treatment of anorexia nervosa.

Question 39

When considering all the factors that influence the development of psychological disorders, it seems that that the _______ is unique in the extent of its role in eating disorders.

A)strong influence of genetics
B)role of family instability
C)power of neurobiological influences
D)influence of society and culture

Question 40

The increase in the incidence of eating disorders such as anorexia nervosa and bulimia nervosa has been referred to as a "collision between our culture and our physiology." The most accurate interpretation of this statement is that

A)people have become too dependent on media determinations of beauty.
B)media standards of beauty are increasingly unattainable for the average woman.
C)dieting has become a fad that has been taken to an extreme.
D)beauty is now being defined by different cultures in society than before.

Question 41

The percentage of the adult population of the United States with a body mass index in the obese range was approximately ____ in 2000, rising to approximately ____ in 2014.

A)10%; 15%
B)20%; 28%
C)30.5%; 37.7%
D)40%; 42%

Question 42

The most serious medical consequence of bulimia nervosa excluding death is potential

A)electrolyte imbalance.
B)salivary gland damage.
C)starvation.
D)tooth erosion.

Question 43

The most accurate statement regarding the use of self-help diet books in the treatment of obesity is that

A)there is a moderate level of long-term effectiveness.
B)they are effective only when used in combination with physician counseling.
C)they are more effective than commercial self-help programs such as Jenny Craig.
D)some individuals may lose some weight in the short term but almost always regain that weight.

Question 44

Programs that have the best chance of success for preventing eating disorders should target specific behaviors and

A)should be administered to all girls under 15 years of age to prevent the disorder from developing.
B)should be administered to girls under 15 years of age who are concerned about being overweight.
C)should be administered to all girls 15 years of age or older to prevent the disorder from developing
D)should be administered to girls 15 years of age or older who are concerned about being overweight.

Question 45

Jill has been in treatment for anorexia nervosa for the past two months. Over this time, she has gained weight to the point where she is in the average range for a woman of her height. The fact that she gained weight fairly quickly in treatment means

A)her prognosis for a full recovery is very good.
B)she is probably in need of little, if any, more treatment.
C)she has completed the most difficult part of her treatment.
D)little in terms of how likely she is to be successful in the long term.

Question 46

What is self-induced vomiting or laxative abuse used to compensate for excessive food ingestion?

A)Purging techniques
B)Obesity
C)Anorexia nervosa
D)Binge-eating disorder

Question 47

Matilda has had anorexia nervosa for several years. She started losing weight because her family said she needed to lose a few pounds. A crucial part of treatment for Matilda is family therapy that focuses on the issues regarding

A)attitudes toward body shape and image distortions.
B)negative communications in the family regarding food and eating.
C)dysfunctional communication in the family regarding food and eating.
D)all of these are correct

Question 48

Which of the following statements is true regarding body fat in those with bulimia nervosa?

A)Women with bulimia tend to have less body fat than those without the disorder.
B)Women with bulimia tend to have the same amount of body fat than those without the disorder.
C)Women with bulimia tend to have more body fat than those without the disorder.
D)Body fat fluctuates very quickly between higher and lower than average in women with bulimia.

Question 49

What body mass index (BMI) level is considered starvation?

A)20
B)16
C)13
D)4

Question 50

Two forms of maladaptive eating patterns associated with obesity are ________ and ________.

A)binge eating disorder; night eating syndrome
B)binge eating disorder; pica
C)pica; night eating syndrome
D)night eating syndrome; caloric deregulative disorder

Question 51

An early stage of the cognitive-behavioral treatment (along with education about the physical consequences of binge eating and purging) for Mary, who has bulimia nervosa, will likely involve

A)antidepressant medication.
B)family therapy.
C)small, frequent meals.
D)in-patient treatment.

Question 52

An important aspect of the cognitive-behavioral approach to the treatment of bulimia nervosa is that it involves

A)changing patients' dysfunctional thoughts regarding their weight, body shape, and previous weight control strategies.
B)helping the patient's family learn new ways of interacting with each other and with the patient.
C)changing the type and frequency of reinforcement associated with being an identified patient.
D)making sure that the patient has a lot of quiet time when he or she can be alone.

Question 53

One major problem with the use of medication in the treatment of bulimia nervosa is that

A)well-controlled studies have not found medication more effective than a placebo.
B)the beneficial effects of the medication may be short term.
C)side effects make most patients discontinue the medication.
D)patients refuse to take their medication.

Question 54

Many clinicians suggest that the most difficult part of treatment for anorexia nervosa, and the part of treatment where many people with anorexia nervosa are not successful, is

A)initial weight gain.
B)admitting that there is a problem and agreeing to begin treatment.
C)changing their attitudes regarding body and self-image
D)when they become bulimic.

Question 55

A comparison of cognitive-behavioral therapy-enhanced (CBT-E) and interpersonal therapy (IPT) for the treatment of bulimia nervosa indicates that one year after treatment,

A)IPT was superior to CBT-E.
B)CBT-E was superior to IPT.
C)CBT-E was equivalent to IPT.
D)CBT-E was more effective in short term and IPT was more effective in long term.

Question 56

Based on the research reported in your text regarding available treatments for bulimia nervosa, we can conclude that treatment that focuses on ________ and ________ is most effective in gaining rapid control of bulimia nervosa and maintaining these gains over the long term.

A)dysfunctional thoughts; actual disordered behaviors
B)family functioning; social relationships
C)classical conditioning; operant learning
D)biological processes; genetics

Question 57

In studies of Internet-based eating disorder prevention programs such as the "Student Bodies" program,

A)the participants showed no beneficial effects.
B)participants reported improvement in body image and decreased drive for thinness.
C)Virtually no participant has developed symptoms of an eating disorder.
D)the drop-out rate has been extremely high.

Question 58

The hallmark of bulimia nervosa is

A)repeated vomiting.
B)out of control eating followed by compensatory behavior.
C)over-exercise in conjunction with fasting.
D)being extremely underweight.

Question 59

Henderson and Brownell (2004) believe that the largest contributor to the obesity epidemic is

A)the increase in amount of food available due to modern agricultural technology.
B)the changing standards of beauty that people are resisting.
C)an inactive, sedentary lifestyle combined with high-fat, high-energy diet.
D)the lack of nutritional science and understanding of human metabolism.

Question 60

Studies of the effectiveness of cognitive-behavioral therapy-enhanced (CBT-E) treatment for bulimia nervosa have demonstrated that

A)CBT-E is effective for short-term improvements but not long-term.
B)CBT-E is not effective.
C)CBT-E is less effective than interpersonal psychotherapy.
D)at the present time, CBT-E would seem to be the treatment of choice for adults.

Question 61

Before a clinician can diagnose hypersomnia, it is necessary to rule out all of the following EXCEPT

A)sleep apnea.
B)insomnia
C)early life exposure to a viral infection such as mononucleosis.
D)current medical conditions that would account for the symptoms.

Question 62

Fred has been having a great deal of trouble initiating and maintaining sleep. He guesses that he is sleeping for an average of about three hours each night and complains that he feels terrible during the day. In addition, Fred has always experienced some anxiety but has recently felt a tremendous increase in his overall anxiety level. The existence of both a sleep disorder and anxiety

A)makes the diagnosis of primary insomnia incorrect.
B)increases our confidence that primary insomnia is the correct diagnosis.
C)indicates that the insomnia is a result of the anxiety rather than a cause of the anxiety.
D)is extremely common, since sleep problems can be both a cause and a result of anxiety.

Question 63

People who do not get enough sleep are also more susceptible to

A)obesity.
B)illnesses.
C)hypersomnolence.
D)rapid eye movement.

Question 64

Of the following, the only symptom that both patients with narcolepsy and patients with hypersomnia experience is

A)falling asleep during normal waking hours.
B)sudden loss of muscle tone.
C)sleep paralysis.
D)hypnagogic hallucinations.

Question 65

In the diagnosis of insomnia, the clinician takes into account several factors, one of which is the patient's

A)behavior while awake.
B)sleeping muscle movement as measured by an electromyogram.
C)amount of sleep time that the patient believes is appropriate.
D)objective measure of the polysomnographic (PSG) evaluation.

Question 66

Individuals suffering from insomnia disorder

A)do not sleep at all.
B)have difficulty initiating or maintaining sleep.
C)wake up during their sleep cycle with severe nightmares.
D)frequently sleepwalk.

Question 67

Of the following, the correct pairing is

A)dyssomnia-sleepwalking.
B)dyssomnia-a sleep disturbance.
C)parasomnia-waking up after three or four hours of sleep and then being unable to fall back to sleep.
D)parasomnia-lack of REM sleep.

Question 68

While a patient sleeps, a polysomnographic evaluation collects data on all of the following characteristics EXCEPT

A)respiration.
B)leg movement.
C)brain waves.
D)metabolic rate.

Question 69

The term "primary" in the diagnosis of primary insomnia refers to the fact that

A)the person has never been diagnosed with insomnia before.
B)the sleep disturbance is not due to another medical or psychiatric condition.
C)the sleep disorder is a primary cause of other medical or psychiatric conditions that the individual is experiencing.
D)other sleep disorders generally follow a diagnosis of primary insomnia.

Question 70

Samantha started having difficulty falling asleep during final exam week. Although exams are over, she now starts to worry about sleep right after dinner. Even the sight of her bed makes her very anxious. The fact that Samantha's insomnia continues long after the stress of exams is over points to the role of ________ in the maintenance of sleep disorders.

A)biology
B)other medical conditions
C)learning
D)unknown factors

Question 71

The most comprehensive evaluation of sleep is performed by a(n)

A)polysomnographic evaluation.
B)actigraphic evaluation.
C)electromyographic evaluation.
D)electroencephalographic evaluation

Question 72

Joe has recently started having a great deal of difficulty falling asleep. In addition, he frequently wakes up during the night and has trouble falling back to sleep once awakened. At this point we can conclude that Joe's sleep problems are influenced by

A)medical conditions.
B)psychological concerns.
C)a genetic variant.
D)either medical or psychiatric conditions.

Question 73

Individuals with a sleep efficiency of 90%

A)spend more of their "bed time" awake than asleep.
B)have a diagnosable sleep disorder.
C)need to increase the number of hours in bed.
D)spend 10% of their "bed time" awake.

Question 74

Individuals who complain about the quality of sleep despite sleeping a reasonable number of hours might be suffering from

A)a dyssomnia.
B)a parasomnia
C)a dream anxiety disorder.
D)a sleepwalking disorder.

Question 75

In which of the following situations is Bill, who has narcolepsy, most likely to experience cataplexy?

A)Immediately upon waking up after a long, restful sleep
B)At any random moment
C)Under hypnosis
D)While jumping up and cheering for his favorite team

Question 76

The integrative model of the causes of sleep disorders suggests that most individuals develop sleep disorders as a result of the interaction between

A)biological and lifestyle factors.
B)learning and family stress.
C)genetics and bedtime habits.
D)learning and cognition.

Question 77

Which of the following statements best describes the relationship between alcohol and sleep?

A)Alcohol may help initiate sleep, but it interrupts ongoing sleep and can be the cause of a sleep disorder.
B)Alcohol may help initiate sleep and enhance ongoing sleep, but it leads to addiction if used as a sleep aid.
C)Alcohol increases REM sleep.
D)Alcohol increases total sleep time in an effective manner, but continued use produces tolerance that negates this beneficial effect.

Question 78

One biological factor that has been related to individuals who experience insomnia is

A)lower body temperature.
B)higher body temperature.
C)low body weight.
D)percentage of body fat.

Question 79

The percentage of the general population that reports some symptoms of insomnia during any given year is approximately ____.

A)10%
B)20%
C)33%
D)50%

Question 80

The fact that people who have unrealistic expectations, such as "I must sleep a full eight hours every night" or "I will be unable to function," are more likely to experience insomnia suggests that insomnia is at least partially influenced by

A)cognition.
B)early learning.
C)biological predisposition.
D)our current hectic lifestyle.