Deck 8: Eating and Sleep-Wake Disorders

Question 1

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.
B)binge-eating disorder.
C)obsessive-compulsive disorder.
D)anorexia nervosa.

Answer 1

binge-eating disorder.

Question 2

When individuals with anorexia nervosa are 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 2

20%.

Question 3

After engaging in an extended session of binge eating, Thomas goes to the bathroom and makes himself vomit.He thinks that he has removed all of the food he consumed from his stomach, but in fact he will only have removed around _____ of the calories he consumed.

A)one-third
B)one-quarter
C)one-half
D)two-thirds

Answer 3

one-half

Question 4

The most serious medical consequence of bulimia nervosa is potential

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

Question 5

Which of the following diagnoses would require the noticeable loss of weight?

A)anorexia nervosa
B)bulimia nervosa
C)binge-eating disorder
D)body dysmorphic disorder

Question 6

Individuals with bulimia nervosa are typically

A)within 10% of their 'normal' weight.
B)very overweight.
C)very underweight.
D)overweight during the development of the disorder but become underweight as the disorder progresses.

Question 7

Approximately ___ of anorexia nervosa deaths are due to suicide.

A)5-10%
B)10-15%
C)20-30%
D)40-45%

Question 8

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 becomes out of her control.
D)the situations under which she eats a great deal.

Question 9

Bontle 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.Bontle has a boyfriend but worries that she may care more about their relationship than he does.The feature that puts Bontle most at risk for an eating disorder such as bulimia nervosa 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 10

The most significant feature of bulimia nervosa is

A)purging.
B)overeating.
C)overeating followed by an urge to vomit.
D)binge eating followed by compensatory behaviour.

Question 11

The most common reason that anorexic individuals generally do not seek treatment on their own is that they

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

Question 12

Between 1960 and 1995, most developed countries 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 and no change in the rate of anorexia nervosa.

Question 13

The best evidence that binge-eating disorder (BED) might not just be a special case of bulimia nervosa is that

A)more males than females suffer from BED.
B)no genetic component has been identified for BED.
C)there is a greater likelihood of remission and a better response to treatment for BED.
D)the average age of onset is much younger for BED than it is for bulimia nervosa or anorexia nervosa.

Question 14

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 15

Lebo, 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, Lebo

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

Question 16

Research (Eddy et al., 2002) suggests that the restricting and bingeing/purging subtypes of anorexia nervosa

A)are really different disorders.
B)have completely different causes.
C)show few differences in severity of symptoms.
D)are useless distinctions of the same disorder.

Question 17

Binge-eating disorder is characterised by

A)laxative use.
B)purging.
C)a lack of compensatory behaviours.
D)emaciation.

Question 18

People 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 19

A common medical complication found in both bulimia nervosa and anorexia nervosa is

A)brittle hair.
B)downy hair on limbs.
C)electrolyte imbalance.
D)cessation of menstrual cycle.

Question 20

The death rate (including suicide) due to anorexia nervosa is

A)higher than for any other psychological disorder except depression.
B)lower than that of most psychological disorders.
C)higher than for any other psychological disorder reviewed in your text.
D)the highest of all of the psychological disorders.

Question 21

Many clinicians suggest that the most difficult part of treatment for anorexia nervosa, and the part of treatment where many anorexic individuals 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 shape and addressing interpersonal disruptions in their lives.
D)when they become bulimic.

Question 22

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

A)attitudes towards 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 the above

Question 23

An important aspect of the cognitive-behavioural approach to the management of bulimia nervosa involves

A)changing patients' dysfunctional thoughts regarding their weight 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 where she can be alone.

Question 24

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

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

Question 25

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

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

Question 26

The most important and immediate goal in the treatment of a patient with anorexia nervosa is

A)family acceptance of the problem.
B)weight gain.
C)balanced diet.
D)the resolution of family issues.

Question 27

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 behavioural 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 28

One major problem with the use of medication in the management 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 29

Which of the following statements is TRUE?

A)Anorexia nervosa typically occurs at a much earlier age than bulimia nervosa.
B)Once bulimia nervosa develops, it tends to be chronic if untreated.
C)Bulimic individuals eventually shift to symptoms of other eating disorders.
D)Bulimia nervosa is more resistant to treatment than anorexia nervosa.

Question 30

Research reported in your text conducted by Grilo, Masheb, and Wilson (2006) found that patients with binge-eating disorder who responded rapidly to cognitive-behavioural therapy (by the fourth week) tended to

A)have good responses to therapy in both the short and long term.
B)have good short-term responses but show higher rates of long-term relapse.
C)have a difficult time in the short term but show good long-term responses.
D)relapse almost immediately after treatment is discontinued.

Question 31

With regard to treatment for eating disorders, Prozac is considered to be an effective treatment in the long term for

A)anorexia nervosa but not bulimia nervosa.
B)bulimia nervosa but not anorexia nervosa.
C)both anorexia nervosa and bulimia nervosa .
D)neither anorexia nervosa or bulimia nervosa.

Question 32

Nomvula has been in treatment for anorexia nervosa for the past two months.Over this time, she has gained weight to the point where her weight 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 33

Which of the following statements is TRUE with regard to the management of binge-eating disorder?

A)Cognitive-behavioural therapy and self-help appear to be effective.
B)Cognitive-behavioural therapy appears to be effective but self-help does not.
C)Neither cognitive-behavioural nor self-help appear to be effective.
D)Antidepressant medication is the only proven treatment.

Question 34

One intriguing result from the studies comparing cognitive-behavioural therapy (CBT) and interpersonal therapy (IPT) for bulimia nervosa is the finding that

A)IPT is more effective in the short term but CBT is more effective when we look at how well patients are doing one year following treatment.
B)IPT and CBT appear to be indistinguishable in terms of their effectiveness in the short and long term, despite their very different approaches.
C)IPT is always more effective than CBT.
D)CBT is more effective in the short term, but IPT patients 'catch up' and will do as well as CBT patients one year after treatment.

Question 35

Studies of the effectiveness of cognitive-behavioural treatment for bulimia nervosa have demonstrated

A)significant short-term gains in the reduction of purging, but little change in binge-eating behaviour.
B)significant short-term gains in the reduction of binge eating, but no long-term gains.
C)a few short-term gains in the reduction of binge eating and purging, but no long-term gains.
D)significant short- and long-term gains in the reduction of binge eating and purging.

Question 36

An early stage of Amy's cognitive-behavioural treatment for bulimia nervosa is likely to involve

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

Question 37

A comparison of cognitive-behavioural therapy (CBT) and interpersonal therapy (IPT) for the management of bulimia nervosa indicates that at the end of treatment,

A)CBT was superior to IPT.
B)IPT was superior to CBT.
C)CBT and IPT had equivalent rates of helping clients improve.
D)neither therapy was successful at helping clients improve.

Question 38

With respect to eating disorders, drug treatments

A)have not been found to be solely effective in the treating of anorexia nervosa.
B)had no benefit in preventing relapse in patients with anorexia nervosa.
C)do not have long-lasting effects on bulimia nervosa.
D)all of the above

Question 39

The median age of onset for all eating disorders is ____________ years of age.

A)13-19
B)18-21
C)20-26
D)10-14

Question 40

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 with strikingly low self-esteem.
C)They display more perfectionistic attitudes.
D)all of the above

Question 41

Hendrik 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, Hendrik 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 42

Individuals suffering from primary insomnia

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 43

Outcome research regarding the long-term success of treatment for eating disorders indicates that

A)anorexia nervosa patients tend to have a better prognosis than bulimia nervosa patients.
B)bulimia nervosa patients tend to have a better prognosis than anorexia nervosa patients.
C)both anorexia nervosa and bulimia nervosa patients almost always make a full and long-term recovery after treatment.
D)neither anorexia nervosa nor bulimia nervosa patients tend to make long-term recoveries, with most patients going through repeated bouts of these disorders throughout their lives.

Question 44

In studies of Internet-based eating disorder prevention programmes (Winzelberg et al., 2000) such as the 'Student Bodies' programme,

A)the participants showed no beneficial effects.
B)participants reported improvement in body image and decreased drive for thinness.
C)not a single participant developed symptoms of an eating disorder.
D)the drop-out rate was extremely high.

Question 45

As we grow older, it seems that the amount of sleep we require

A)decreases.
B)increases.
C)stays the same.
D)decreases until early adulthood and then begins to increase again.

Question 46

Sleep research suggests that

A)REM sleep is related to depression.
B)sleep abnormalities follow clinical depression.
C)sleep problems do not predict who is at risk for later mood disorders.
D)sleep deprivation has permanent antidepressant effects on some people.

Question 47

Sam sleeps for eight or more hours every night but never feels rested.He can't understand why he is always tired despite the fact that he reports no difficulties with the quality or quantity of his sleep.Of the following, Sam's most likely diagnosis is

A)hypersomnolence disorder.
B)sleep apnoea.
C)narcolepsy.
D)non-specific parasomnia.

Question 48

As of 2014, the percentage of adult women in South Africa with a body mass index in the obese range was

A)12%.
B)17%.
C)26%.
D)40%.

Question 49

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

A)respiration.
B)muscle movements.
C)pulse rate.
D)metabolic rate.

Question 50

Of the following, the correct pairing is

A)dyssomnia - sleepwalking
B)dyssomnia - inability to fall asleep
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 51

Individuals who feel tired and cranky all day despite falling asleep at a normal hour and awakening at their usual time are most likely suffering from a(n)

A)parasomnia.
B)dyssomnia.
C)type of REM sleep deprivation.
D)anxiety problem.

Question 52

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 53

Sleep studies suggest that around 40% of South Africans

A)get more than six hours of sleep a night.
B)report feeling excessively sleepy during the day.
C)have insomnia.
D)need less than five hours of sleep a night.

Question 54

Lack of adequate sleep is associated with

A)depression.
B)irritability.
C)emotionality.
D)all of the above

Question 55

Programmes that have the best chance of success for preventing eating disorders

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 56

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

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

Question 57

Takalani started having difficulty falling asleep during final exam week.Although exams are over, he now starts to worry about sleep right after dinner.Even the sight of his bed makes him very anxious.The fact that Takalani'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 58

Individuals with night eating syndrome

A)consume a third of their daily intake after their evening meal.
B)binge during the night.
C)do not wake up while eating during the night.
D)often purge after eating.

Question 59

Adolescents tend to shift towards a

A)biologically determined later sleep schedule.
B)culturally determined earlier sleep schedule.
C)biologically determined earlier sleep schedule.
D)culturally determined later sleep schedule.

Question 60

The percentage of the South African population that reports some symptoms of insomnia during any given year is approximately

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

Question 61

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

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

Question 62

When attempting to 'reset the biological clock' of an individual with a circadian rhythm sleep disorder, it is generally easier and more effective to

A)make the patient's bedtime earlier.
B)leave the patient's bedtime alone and change the duration of sleep.
C)make the patient's bedtime later.
D)keep the person awake for several days in a row.

Question 63

Benzodiazepine medication is not recommended as a long-term solution for the treatment of insomnia because of

A)the addictive properties of these medications.
B)rebound insomnia that occurs after the medication is discontinued.
C)excessive sleepiness that may persist during the day.
D)all of the above

Question 64

Obstructive sleep apnoea is characterised by

A)complete cessation of respiratory activity for brief periods.
B)interruption of air flow and brief cessation of respiratory activity.
C)interruption of air flow without cessation of respiratory activity.
D)central nervous system disorders and trauma.

Question 65

While suddenly and unexpectedly falling asleep during normal waking hours, Shareen experiences vivid hallucinations of being in a horrible car crash.The experience is so realistic that she actually feels physical sensations as if the hallucination were real.Shareen's most likely diagnosis is

A)sleep apnoea.
B)hypersomnia.
C)schizophrenia.
D)narcolepsy.

Question 66

The reason that antidepressant medications are sometimes used to treat narcolepsy is that

A)narcolepsy is often caused by depression.
B)the anti-anxiety properties of these medications reduce narcolepsy.
C)these medications suppress REM sleep that can trigger cataplexy.
D)antidepressants are found to reduce hypnagogic hallucinations.

Question 67

Kurt sits up every night screaming.He does not remember these terrors nor is he easily awakened or comforted.What should Kurt's mother do?

A)Wake Kurt up during the attack.
B)Make sure that Kurt is very tired before going to bed.
C)Use scheduled awakenings to briefly wake Kurt before an attack occurs.
D)All of these have been demonstrated to reduce the frequency and duration of sleep terrors.

Question 68

In which of the following situations is Mohamed, 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 favourite team

Question 69

Sleepwalking is characterised by all of the following EXCEPT

A)acting out a dream.
B)occurrence during NREM stages of sleep.
C)no memory of the sleepwalking event.
D)occurrence primarily in children.

Question 70

Rose sleeps about eight hours each night.She awakens feeling fine and well rested, but she tends to fall asleep about two or three times during the day.We can conclude that

A)Rose should be diagnosed with primary insomnia.
B)Rose would be diagnosed with hypersomnolence disorder if her symptoms cause disruptions or distress in her life.
C)Rose should be diagnosed with a parasomnia.
D)a medical condition is a more appropriate diagnosis than a sleep disorder.

Question 71

Eating disorders such as anorexia nervosa and bulimia nervosa are generally attributed to cultural and societal influences.At the same time, there appears to be a genetic influence.Explain how culture and genetics may interact in the development of anorexia nervosa and bulimia nervosa.

Question 72

Which of the following conditions is thought to be a potential explanation for UFO experiences?

A)sleep paralysis
B)cataplexy
C)hypnagogic hallucinations
D)sleep apnoea

Question 73

All of the following are examples of causes of circadian rhythm sleep disorder EXCEPT

A)jet lag.
B)shift work.
C)delayed sleep phase.
D)sleep rebound.

Question 74

Abnormal events such as nightmares, sleep terrors and sleepwalking that occur during sleep or during the twilight time between sleep and waking are classified as

A)parasomnias
B)dyssomnias
C)narcolepsy
D)REM disorders

Question 75

A severe difficulty in regulating sleep that is induced by jet lag or by working rotating shifts is an example of

A)circadian rhythm sleep disorder
B)sleep apnoea.
C)hypersomnolence disorder.
D)narcolepsy.

Question 76

The different types of sleep apnoea are

A)obstructive, central and sleep-related hypoventilation.
B)obstructive, chronic and sleep-related hypoventilation.
C)central, chronic and mixed.
D)hypersomnolent, chronic and parasomnic

Question 77

An individual who wakes up feeling that there are other people in the room but is unable to move or say anything may be experiencing

A)cataplexy associated with sleep apnoea.
B)hypnagogic hallucinations associated with hypersomnia.
C)sleep paralysis and hypnagogic hallucinations associated with narcolepsy.
D)sleep paralysis and hypnogogic hallucinations associated with hypersomnia.

Question 78

Cataplexy as experienced by patients with narcolepsy can be characterised by

A)sudden, minor loss of muscle tone.
B)physical collapse.
C)slight muscle weakness.
D)any of these

Question 79

Two factors that help regulate our natural sleep/wake cycles are

A)melanin and auditory stimulation.
B)melatonin and auditory stimulation.
C)melatonin and light.
D)light and blood sugar levels.

Question 80

Medical treatments for severe sleep apnoea include medication, mechanical devices and

A)surgery.
B)exercise of the neck muscles.
C)a high protein diet.
D)changing the patient's sleep schedule.