Chapter 10: Feeding and Eating Disorders Multiple Choice 1. What is the primary characteristic of anorexia nervosa? a. self-induced vomiting b. eating non-nutrient substances c. repeated episodes of binge eating d. starving oneself Answer: d. 2. During a lecture on eating disorders, the lecturer tells the audience, "Let's be candid, anorexia is a misnomer." Most of the people around you are puzzled until the expert explains. What does she say? a. "Anorexia nervosa is much less prevalent than is generally believed." b. "Anorexia is actually a form of suicide among clinically depressed adolescents." c. "The emphasis should be on the nervosa because this is a neurological disorder." d. "The term anorexia means 'loss of appetite,' but people with this disorder are actually hungry." Answer: d. 3. Individuals who are attempting to become extremely thin by refusing to eat suffer from a. obesity phobia. b. bulimia nervosa. c. anorexia nervosa. d. anti-obesity obsession. Answer: c. 4. Some experts suggest that a better term than “eating” disorder would be “___________” disorder. a. nutrition b. food avoidant c. starvation d. dieting Answer: d. 5. The chief characteristic of bulimia nervosa is a. self-induced vomiting. b. binge eating. c. self-starvation. d. a preoccupation with food. Answer: b. 6. For both anorexia and bulimia, the rate of occurrence in females compared to in males is about a. 2 to 1. b. 5 to 1. c. 10 to 1. d. equal. Answer: c. 7. According to the National Centers for Disease Control and Prevention, at any point in time ___ percent of high school females are attempting to lose weight, as compared with ___ percent of males. a. 44 / 15 b. 15 / 44 c. 10 / 2 d. 2 / 10 Answer: a. 8. A national survey found that almost _____ percent of American women have a negative body image, particularly concerning their waists, hips, and/or thighs. a. 1 b. 25 c. 50 d. 75 Answer: c. 9. According to the textbook, European American and Latina women report higher rates of body dissatisfaction than a. Asian women. b. African American women. c. Middle Eastern women. d. Australian women. Answer: b. 10. DSM-5 does not contain a formal cutoff as to how thin is too thin. What does it suggest as a useful indicator in adults? a. a BMI below 15.5 b. a weight below 16 c. a BMI below 18.5 d. a BMI below 22 Answer: c. 11. In the case of Serrita, whose struggle with anorexia is described in your textbook, what was her attitude about her condition that is common to many diagnosed with anorexia? a. She admitted to being too thin and acknowledged her need to gain weight. b. She admitted to being too thin but denied that she needed to gain weight. c. She denied that she was too thin. d. She admitted to being too thin but blamed it on a biochemical deficiency. Answer: c. 12. The average victim of anorexia nervosa is ____ percent below normal body weight. a. 10 b. 15 c. 25 d. 35 Answer: c. 13. Which of the following is a defining symptom of anorexia nervosa? a. amenorrhea b. fear of gaining weight c. binge eating d. depression Answer: b. 14. An inaccurate perception of body size and shape is known as a. anorexia. b. distorted self image. c. distorted body image. d. bulimia. Answer: c. 15. About _____ percent of people with anorexia nervosa are estimated to die of starvation, suicide, or medical complications stemming from their extreme weight loss. a. 1 b. 5 c. 15 d. 45 Answer: b. 16. One early study found that young women with anorexia nervosa ____________ the size of various body parts in comparison to a normal control group. a. overestimate b. underestimate c. accurately estimate d. avoid considering Answer: a. 17. One reason why individuals with anorexia steadfastly deny problems with their weight seems to be because they a. don't trust others enough to admit the truth. b. have a distorted body image and do not perceive their appearances accurately. c. never feel hungry. d. are often at or near normal weight. Answer: b. 18. Agnes, who suffers from anorexia, is dangerously thin but has been steadfastly refusing to eat enough to gain weight. If Agnes could honestly explain to you why she doesn't eat, what would she probably say? a. "I'm not hungry." b. "I don't enjoy the taste of food and it makes me sick." c. "I am intensely afraid of becoming fat." d. "I want to die." Answer: c. 19. What is amenorrhea? a. disturbed body image b. absence of menstruation c. less than 85 percent expected body weight d. undue influence of body shape on self-evaluation Answer: b. 20. A patient's medical chart includes the word lanugo. You can tell from the chart that the patient has anorexia nervosa. What will you expect to observe when the patient is examined? a. brittle bones b. a wide eyed stare c. irregular heart beat d. fine, downy hair on her face and trunk Answer: d. 21. Priya's physician is distressed by her anorexia nervosa. Her weight loss is bad enough, but her medical tests show clear signs of an electrolyte imbalance. What is the physician's major concern? a. possible cardiac problems b. a low level of serotonin that often precedes suicide c. a low level of dopamine that often leads to motor difficulties d. brain abnormalities suggesting epileptic-like seizures Answer: a. 22. A film producer wants to make a movie describing several cases of young women who have been diagnosed as suffering from anorexia nervosa. He is especially interested in exploring some of the psychological dynamics related to the disorder. Which of the following titles might be the best choice for the film? a. A Struggle for Control: Anorexia Nervosa b. Anorexia Nervosa: I Don't Want to Grow Up c. How Depression Masquerades as Eating Disorders d. Sexual Disorders and Anorexia Nervosa: A Two-Way Street Answer: a. 23. Janice suffers from anorexia and is extremely careful about how much she eats. How does she probably feel about this? a. She takes great pride in her control and self-denial. b. She feels like she has no control over her behavior. c. She is greatly ashamed and desperately wants help. d. Since she doesn't believe she has a problem, she has no strong feelings about this one way or the other. Answer: a. 24. People diagnosed with anorexia who do not also binge eat or purge are generally less __________, when compared to those who exhibit these symptoms. a. comorbid b. depressed c. anxious d. self-obsessed Answer: b. 25. Which of these are likely to be comorbid with anorexia nervosa? a. bipolar disorder and somatization disorder b. depression and obsessive-compulsive disorder c. agoraphobia and borderline personality disorder d. hypochondriasis and dependent personality disorder Answer: b. 26. Terrell will do almost anything for extra credit. He sees a sign recruiting participants for research on eating. When he inquires, he is told the study involves semi-starvation. He is a bit leery now, so he heads over to the library to read up on the topic. What he finds persuades him to look for other ways to earn extra credit. What did he find? a. Semi-starvation experiments are associated with a high mortality rate. b. The experience will lead to symptoms similar to posttraumatic stress disorder. c. Semi-starvation permanently alters the biological mechanisms that control eating. d. Participants are likely to develop obsessions and compulsions concerning food that continue after they return to their normal weight. Answer: d. 27. In the two cases of eating disorders presented in your textbook—Serrita with anorexia and Michelle with bulimia—there was a very clear difference in their emotional reactions to their behavior. Serrita felt _________ while Michelle felt _________. a. shame / pride b. pride / shame c. out of control / in control d. depressed / euphoric Answer: b. 28. What types of food are individuals with bulimia nervosa most likely to consume during an episode of binge eating? a. high protein foods b. foods they do not ordinarily eat c. foods that are high in cholesterol d. non-nutritive, high bulk substances Answer: b. 29. Assume that each of the following individuals has a diagnosis of bulimia nervosa. Which one of them is most likely to engage in an episode of binge eating at this point? a. Penelope, who is upset over failing two exams and just had an argument with her parents b. Farrah, who is wondering what will happen to her town now that a major employer has cut back on jobs c. Diane, who is watching television and feels sleepy as she listens to the reports of political polls d. Suchira, who just won a scholarship to the college she wanted to attend and is going out to celebrate Answer: a. 30. In the middle of an episode of binge eating, how is a woman likely to describe how she feels? a. delusional b. lacking control c. in a hypnotic trance d. invigorated and energetic Answer: b. 31. What are the primary characteristics of bulimia nervosa? a. pica and amenorrhea b. low body weight and pica c. binge eating and purging d. eating non-nutrient substances and sexual dysfunctions Answer: c. 32. The DSM-5 criteria for bulimia nervosa refer to compensatory behavior. Which of the following represents this type of behavior? a. going to the gym to watch others exercise b. use of laxatives after an episode of bingeing c. feeling out of control during an episode of bingeing d. fantasizing about food rather than giving in to the temptation to eat Answer: b. 33. Bulimia nervosa almost always involves purging. This means that individuals with bulimia nervosa a. engage in self-induced vomiting. b. try to rid themselves of what they feel to be evil demons. c. use various means to eliminate the food that they have consumed during their binges. d. cannot easily be distinguished from individuals with anorexia nervosa. Answer: c. 34. Although bulimia nervosa is often referred to as the "binge-purge" disorder, this is misleading because a. it is not really a disorder; most people binge at least occasionally. b. there are other ways to compensate for binges that don't involve purging. c. some individuals with bulimia nervosa overeat frequently but not always in the form of a binge. d. bulimia nervosa involves bingeing or purging, but not both. Answer: b. 35. Which of the following symptoms is a diagnostic criteria for both anorexia nervosa and bulimia nervosa? a. fasting b. bingeing c. excessive emphasis on body shape and weight d. intense fear of becoming pregnant Answer: c. 36. Which psychological problem often occurs with bulimia nervosa? a. depression b. gender identity disorder c. antisocial personality disorder d. histrionic personality disorder Answer: a. 37. When thinking about comorbid conditions in regard to a client just diagnosed with bulimia nervosa, you are most concerned about the possibility of a. bipolar disorder. b. psychopathy. c. depression . d. borderline personality disorder. Answer: c. 38. Janet is making her annual visit to the dentist. As he is examining her mouth, she senses some concern. She asks if he has found cavities, and he says no. He finally comes right out and asks if she has bulimia. What clue suggested this possible diagnosis? a. eroded dental enamel b. large gaps between teeth c. teeth that are growing in crooked d. open sores at the base of the teeth Answer: a. 39. Seiko suffers from an eating disorder characterized by frequent binges. We can be reasonably certain that she a. suffers from bulimia nervosa. b. suffers from either bulimia nervosa or anorexia nervosa of the binge-eating/purging type. c. also purges. d. does not purge. Answer: a. 40. Ann has the diagnosis of anorexia nervosa, the restricting type. What does this diagnosis mean to the team of professionals that is going to treat her? a. She rarely engages in bingeing or purging. b. Her personality characteristics have made it difficult to determine if she has a problem at all. c. She has a rare form of anorexia nervosa in which she is able to maintain her weight within five pounds of her expected weight. d. The treatments that can be used are limited to those that can address the underlying biological malfunctions responsible for the disorder. Answer: a. 41. The validity of the distinction between the restricting type and the binge eating/purging type of anorexia nervosa is questioned mainly because a. they both express a gender bias. b. they do not differ in terms of comorbidity, recovery, relapse, or mortality. c. individuals diagnosed with either subtype describe themselves in similar terms. d. these subtypes are clearly distinct and never appear with any overlapping. Answer: b. 42. Which of the following diagnoses is new to the DSM-5? a. binge-eating disorder b. pica c. rumination disorder d. bulimia nervosa Answer: a. 43. Which is most accurate with regard to why the purging and nonpurging subtypes of bulimia nervosa were removed from DSM-5? a. They were not supported by the research. b. The subtypes were separated into distinct diagnoses. c. This distinction was only useful when deciding on treatment strategies. d. The distinction was confusing to clinicians. Answer: a. 44. Which of the following individuals would meet the common criteria for defining obesity? a. a clerk with a BMI greater than 25 b. a veteran with a BMI greater than 30 c. a teacher with a BMI greater than 35 d. an officer with a BMI greater than 40 Answer: b. 45. Which of the following is a diagnostic criterion for binge-eating disorder? a. feeling satisfied after eating b. feeling embarrassed while eating c. purging after eating d. feeling happy after eating Answer: b. 46. Which of the following statements about the prevalence of eating disorders is most accurate? a. Anorexia is common throughout the population. b. Anorexia is rare in the general population but common among certain segments. c. The prevalence of bulimia is declining, while the prevalence of anorexia is increasing. d. Bulimia is increasingly most rapidly among young males. Answer: b. 47. A researcher discussing the prevalence of eating disorders makes reference to what she says is a cohort effect for these disorders. What does this mean? a. Eating disorders tend to run in close-knit families. b. Women born after 1960 have a higher rate of bulimia nervosa than women born prior to 1960. c. Families that place a special emphasis on eating meals together have high rates of eating disorders. d. The frequency of eating disorders is strongly related to the rate among friends, especially in high school. Answer: b. 48. What have epidemiologists found concerning the frequency of eating disorders? a. Bulimia nervosa is more common than anorexia nervosa. b. Anorexia nervosa is more common than bulimia nervosa. c. Bulimia nervosa and anorexia nervosa occur at the same rates. d. The rates of these eating disorders have reached a peak and are now declining. Answer: a. 49. Which of the following is a reason frequently given by scientists to explain the much higher rate of eating disorders among females? a. Women are much more likely than men to base self-image on body image. b. Men are not concerned about appearance. c. Men do not have to be concerned about the cultural image of good looks. d. Women do not tend to judge men based on appearance. Answer: a. 50. Although it is certainly an unusual source of data for researchers, some have looked at Playboy centerfolds and Miss America Beauty pageant contestants. How is this research relevant to eating disorders? a. The emphasis on thinness is a relatively recent phenomenon in the last 20 years. b. These women’s facial features indicated they had dieted beyond the point of medical safety. c. Between 1959 and 1988, their ratio of weight to height for these groups declined dramatically. d. In their interviews, almost all of these women gave subtle clues suggesting they were in deep conflict concerning weight control. Answer: c. 51. A cross-cultural researcher is investigating the relationship between body weight and wealth in Third World countries. Which of the following is most likely to summarize the relationship? a. There is no relationship between body weight and wealth. b. There is a strong positive relationship between body weight and wealth. c. There is a strong negative relationship between body weight and wealth. d. It is the same as the relationship found in industrialized nations. Answer: b. 52. Your friend is a whiz when it comes to maps. He decides to create a computerized map showing the countries where eating disorders are likely to occur. He asks you for assistance in creating this visual image. What will you tell him? a. These disorders occur in nearly all societies. b. These disorders occur only in the United States and Canada. c. These disorders occur in cultures with small population growth. d. These disorders occur almost exclusively in North America, Europe, and industrialized Asian countries. Answer: d. 53. Which of the following falls within the typical range for the onset of eating disorders? a. early childhood b. adolescence c. middle adulthood d. late adulthood Answer: c. 54. Which of the following occupations is associated with an elevated risk for developing eating disorders? a. nurse b. singer c. secretary d. gymnast Answer: d. 55. You have been asked to design a targeted prevention program of eating disorders. Which group would receive the most focus in your program design? a. lower-class 20- to 24-year-old black females b. upper-class 16- to 20- year-old black females c. lower-class 24- to 30- year-old white females d. upper-class 16- to 20-year-old white females Answer: d. 56. The tendency to develop eating disorders seems related to which of the following variables? a. high school grades b. degree of extraversion c. exposure to popular media d. ratio of female to male friends Answer: c. 57. Compared to families of individuals with anorexia nervosa, which of the following are you more likely to find in families of individuals with bulimia nervosa? a. cohesion and the absence of conflict b. conflict and rejection c. multiple instances of eating disorders d. medical illnesses affecting many family members Answer: b. 58. Which of the following characterizes the concept proposed by Minuchin of the enmeshed family? a. mood disorders run in the family b. family members are overly involved in one another's lives c. the children in the family were born within short periods of time d. family members have overlapping responsibilities within the home Answer: b. 59. What have researchers found concerning the relationship between eating disorders and an individual's report of sexual abuse? a. Sexual abuse is reported much more frequently by those with eating disorders than other pathologies. b. The rate of reports of sexual abuse among those with eating disorders is lower than in the general population. c. Sexual abuse is reported by those with anorexia at higher rates than those with other pathologies, but not those with bulimia. d. The rate of reports of sexual abuse among those with eating disorders is similar to that found in other pathologies. Answer: d. 60. The A&E cable channel is presenting the biography of Dr. Hilde Bruch. The presentation includes interviews with Dr. Bruch, who is asked to explain her theory of the development of eating disorders. What does she say? a. Impulsive, out of control young women use eating disorders as a means of rebelling. b. Overly compliant young women use dieting as a means to wrest some control from their parents. c. A fear of sexual dysfunction motivates some young adolescents to try to stop the maturation process cold in its tracks. d. The scapegoating of a young adolescent female leaves her with no other means to deal with the stress of living in a dysfunctional family. Answer: b. 61. Which of the following findings seems to support Hilde Bruch's view of the etiology of eating disorders? a. The rate of anorexia nervosa has been increasing in recent decades. b. Anorexia nervosa is found almost exclusively in the United States, Europe, and Japan. c. The parents of children with eating disorders are very likely to have used strict, punitive discipline. d. Young women with eating disorders tend to set unrealistic, perfectionistic goals. Answer: d. 62. An expert on eating disorders describes those with such disorders as "lacking interoceptive awareness." Which of the following characterizes this lack? a. People with eating disorders do not recognize internal cues, including emotional states and hunger. b. Those with eating disorders do not understand how other people are trying to influence their behavior in subtle ways. c. People with eating disorders do not pay attention to the nonverbal behavior of individuals during conversations. d. Those with eating disorders often confuse hunger pangs with signs of deeper psychological significance. Answer: a. 63. Researchers are finding an increased rate of which mental disorder in both victims of eating disorders and their family members? a. schizotypal personality disorder b. panic attack c. depression d. PTSD Answer: c. 64. An expert on eating disorders is giving a talk about the relationship between eating disorders and depression. Which of the following would be an appropriate title for this talk? a. "Depression: The Primary Cause of Eating Disorders" b. "Depression: Both Cause and Effect" c. "Successful Treatment of Eating Disorders Has No Effect on Depression" d. "Eating Disorders Are Symptoms of Depression" Answer: b. 65. Efforts to understand the relationship between depression and eating disorders have focused on which of the following depressive symptoms? a. psychomotor retardation b. sleep disturbances c. low self-esteem d. generalized anxiety Answer: c. 66. Research participants have been asked to identify with a figure within a series of schematic figures of women ranging from very thin to very obese. What is the subject of this research? a. body-size delusional systems b. deficits in sensory perception c. dissatisfaction with body image d. the effects of punishment on eating behavior Answer: c. 67. ___________ ,or a negative mood state, commonly triggers episodes of binge eating according to Vogele and Gibson. a. Anapraxsis b. Hysteria c. Anhedonia d. Dysphoria Answer: d. 68. Ann suffers from bulimia and has been gaining weight. Her parents are concerned and have been encouraging her to go on a diet. What would you tell her and her parents? a. "She lacks the will power to diet successfully." b. "She has an unconscious reason to maintain weight." c. "An inherited endocrine dysfunction is most likely responsible for the difficulty she has losing weight." d. "Dieting is likely to contribute directly to subsequent binge eating." Answer: d. 69. A medical technician looks up from the microscope and says to his supervisor, "I think we have a case of hyperlipogenesis here. " What would this information tell the physician about the patient whose tests the technician just analyzed? a. The patient suffered cardiac arrest secondary to an eating disorder. b. The patient's body is storing an abnormally large amount of fat in fat cells. c. The patient's endocrine system is working at a high rate that will soon lead to exhaustion. d. The patient's heart rate has increased as a result of having to push more blood through clogged arteries. Answer: b. 70. A weight level the body seems to defend by adjusting its rate of energy use is called the a. weight set point. b. ideal weight. c. metabolic weight. d. energy/weight balance. Answer: a. 71. With respect to the role of genetics in eating disorders, it is most likely that a. anorexia is inherited, but not bulimia. b. bulimia is inherited, but not anorexia. c. genetics might influence some personality characteristics that increase the risk for eating disorders. d. eating disorders are responses to cultural pressures and are totally unrelated to genetics. Answer: c. 72. The etiology of eating disorders underscores the importance of equifinality, which is the idea that a. eating disorders always cause death. b. there are many pathways to developing an eating disorder. c. all eating disorders develop in the same way. d. eating disorders are entirely caused by genetic factors. Answer: b. 73. Although extremely rare, eating disorders have been linked to lesions in the a. striatum. b. cerebellum. c. hippocampus. d. hypothalamus. Answer: d. 74. What is the first goal of the treatment of anorexia nervosa? a. gaining at least a minimal amount of weight b. developing insight into negative feelings about weight c. removing the social stigma associated with the illness d. exploring possible reasons for the illness, such as social pressure Answer: a. 75. In establishing an eating disorder clinic, your group of professionals is keen to include all of the therapies that are currently being used to treat these disorders. You will likely include several different therapies, including a. token economies. b. Bruch's psychodynamic therapy. c. hypnosis. d. role playing. Answer: b. 76. The most widely studied form of family therapy for eating disorders involves parents initially taking complete control over the child’s eating. Age-appropriate autonomy is returned to the child as eating improves. This system is called the a. parental control method. b. pyschodynamic method. c. Montreux method. d. Maudsley method. Answer: d. 77. In one study, ___________ lead to a 70 to 80 percent reduction in binge eating and purging. a. psychodynamic therapy b. aversive conditioning c. client centered therapy d. cognitive behavior therapy Answer: d. 78. Frances suffers from bulimia nervosa and is seeing a therapist who is focusing on normalizing her eating patterns and addressing her dysfunctional attitudes. Which form of therapy is her therapist providing? a. psychodynamic therapy b. aversive conditioning c. interpersonal therapy d. cognitive behavior therapy Answer: d. 79. Paula suffers from bulimia nervosa and is considering treatment with an antidepressant medication. Knowing that you have been studying this issue, she asks your opinion. What should you tell her? a. "Antidepressants have been shown to be very effective." b. "Antidepressants will help you with your purging but not with your bingeing." c. "Relapse is common when medication is stopped." d. "Because antidepressants make you feel better, you will be less motivated to deal with your eating disorder." Answer: c. 80. Which form of therapy is emerging as an effective treatment for bulimia nervosa because patients continue to improve after the end of therapy? a. psychodynamic therapy b. behavior therapy c. interpersonal therapy d. selective serotonin reuptake inhibitors Answer: c. 81. A cognitive psychologist is proposing a study of the effectiveness of several forms of therapy for treating anorexia nervosa. She sends her proposal to the ethics committee for review. Although the committee approves the proposal from an ethics standpoint, one of the committee members writes her a note saying, "Be aware of the allegiance effect." What will this note mean to the psychologist in regard to her proposal? a. Clients will show greater recovery when they are treated by the same therapists across time. b. Clients will work hard to recover to demonstrate that their choice of therapist is indeed the best. c. Because she is a cognitive therapist she is more likely to find that form of therapy to be the most successful. d. Funding agencies will be more likely to give grants to researchers who are responsive to the needs of the granting agency. Answer: c. 82. __________ is a form of treatment that does not address eating disorders directly and was actually used as the placebo treatment in several early studies. Still, this form of treatment has been found to be more effective after 12 months than therapies that are directed at eating disorders. a. Interpersonal therapy b. Antianxiety medications c. Antidepressant medications d. Education about nutrition and health Answer: a. 83. How do long-term outcomes for the treatment of anorexia nervosa compare to long-term outcomes for the treatment of bulimia nervosa? a. The long-term success is greater for bulimia nervosa. b. The long-term success is greater for anorexia nervosa. c. There is no difference in long-term outcomes for treating these disorders. d. Although there is a higher mortality rate for anorexia, the success of treatment is otherwise better for anorexia. Answer: a. 84. A third generation of more successful prevention efforts for eating disorders does not directly focus on body image or disordered eating. These efforts attack the thinness ideal indirectly, or focus on a. eliminating unhealthy eating habits rather than promoting healthy habits. b. promoting healthy eating rather than eliminating unhealthy habits. c. encouraging healthy communications styles in families. d. eliminating unhealthy communication styles in families. Answer: b. 85. A __________ study is a research study in which neither the patient nor the therapist knows if the patient is receiving the treatment in question or the placebo. a. double blind b. double control c. dependent control d. post hoc Answer: a. Short Answer 86. An eating disorder is a severe disturbance in eating behavior that results from an obsessive fear of gaining weight. Some experts have suggested that __________ disorder would be a more accurate term to describe this disturbance. Answer: dieting Answer: dieting 87. ____________ eating is defined as eating an amount of food that is clearly larger than most people would eat under similar circumstances in a fixed period of time, for example, less than 2 hours. Answer: Binge 88. ____________ involves behaviors designed to eliminate consumed food from the body. Answer: Purging 89. ____________ is often comorbid with bulimia, especially in bulimic patients who self induce vomiting. Answer: Depression 90. ____________ includes two subtypes; the restricting type and the binge eating/purging type. Answer: Anorexia nervosa 91. A __________ is a group that shares some feature in common, for example, year of birth. Answer: cohort 92. Psychological studies repeatedly show that exposure to images of super-thin women increases body image __________ among girls and young women. Answer: dissatisfaction 93. Some experts argue that pressures to be strong and muscular have created a new eating disorder among males sometimes called “reverse anorexia,” which is characterized by excessive emphasis on extreme muscularity and often accompanied by the abuse of anabolic steroids. This disorder is referred to by some as the __________ complex. Answer: Adonis 94. Recognition of internal cues, including hunger and various emotional states, is called __________ awareness. Answer: interoceptive 95. A __________ body image is a highly critical evaluation of one’s weight and shape that is thought, by clinicians, to contribute to the development of eating disorders. Answer: negative 96. Predictors of a better prognosis for eating disorders include an early age of onset, conflict-free parent–child relationships, early treatment, less weight loss, and the absence of binge eating and __________ . Answer: purging 97. In the long run, viewed in a timeframe longer than 12 months, the most effective form of psychotherapy for the treatment of bulimia nervosa seems to be __________ . Answer: interpersonal 98. Third generation eating disorder prevention programs that have had the most success in reducing binge eating are ones that focus on __________ weight or eating programs. Answer: healthy Essay 99. Discuss the defining characteristics of anorexia. Answer: The most obvious and most dangerous symptom is significantly low weight. While DSM-5 has no formal cutoff, the average victim is 25 to 30 percent below normal body weight. The second defining characteristic is an intense fear of gaining weight. This fear is not assuaged by weight loss. In fact, the fear may grow more intense as the individual loses more weight. The final defining symptom is a disturbance in how weight or shape is experienced. Many individuals with eating disorders tend to deny that they have any problem at all with weight. Other symptoms, including amenorrhea, medical complications, and comorbid psychological disorders may be present in an individual suffering from anorexia as well. 100. Explain why bulimia nervosa and anorexia nervosa are both considered to be characterized by a struggle for control. Answer: People with bulimia feel out of control and ashamed of their lack of control, and their disorder is an attempt to regain a sense of control. People with anorexia pride themselves in self-control, and their disorder is typified by excessive self-control. 101. How does DSM-5 handle obesity and binge-eating disorder? Answer: Binge-eating disorder, a new diagnosis that has been added to DSM-5, is defined by episodes of binge eating without compensatory behavior. Binge eating is associated with a number of psychological and physical difficulties, including obesity. Obesity, which is typically defined as having a BMI greater than 30, was also considered for inclusion into DSM-5. Ultimately, obesity was not included. Calling obesity a "mental disorder" is controversial, especially given the high prevalence of overweight individuals in the United States. 102. What patterns in the epidemiology of eating disorders suggest sociocultural influences on their development? Answer: The prevalence of eating disorders is higher in industrialized societies such as North America, Europe, and industrialized Asian countries. In the United States, the prevalence is higher in whites than blacks, those in higher socioeconomic groups, and women in jobs where slimness is valued. Eating disorders are also more frequent among groups who move into new areas where eating disorders exist, such as among Arabs and Asians who move to Western countries. Finally, in the United States, there are an increasing number of eating disorder cases among well-to-do African Americans. 103. Summarize the research on the biological factors involved in eating and weight regulation. Answer: Physiologically, weight is maintained around weight set points, which are fixed or small ranges in weight. Weight regulation around set points results from the interplay between behavior, peripheral physiological activity, and central physiological activity. The process works like a thermostat to regulate the heating and cooling of air temperature near a given setting. If weight declines, hunger increases and food consumption goes up. There is a slowing of the metabolic rate and movement toward hyperlipogenesis. These reactions have obvious survival value and are likely products of evolution. The body does not distinguish between intentional attempts to lose weight and potential starvation. 104. Summarize what is currently know about the role of genetics and neurophysiology in eating disorders. Answer: Concordance rates for bulimia are higher for monozygotic twins than for dizygotic twins. However, the difference can be explained by several different heritable mechanisms. Eating disorders are unlikely to be directly inherited. Genetics may influence personality characteristic that lead to bulimia, or a certain body type or weight set point may be inherited. Genes clearly affect weight and body type, but we cannot mindlessly conclude that eating disorders are genetic without carefully considering genetic mechanisms and gene-environment interactions. In rare instances, a hormonal disturbance or a lesion in the hypothalamus has been linked to eating disorders. 105. As a clinical psychologist who specializes in the treatment of bulimia nervosa, you have been asked to design a program based on the successful work of Fairburn, who utilized a variety of cognitive-behavioral techniques. Discuss the program you will design. Answer: Fairburn conceptualizes the cause of Bulimia nervosa as a combination of maladaptive tendencies, including an excessive emphasis on weight and shape, perfectionism, and dichotomous “black or white” thinking. His program, that we will replicate, involves three stages. The first stage involves education and behavioral strategies to normalize eating patterns and end the cycle of eating restraint followed by binging and purging. Second, we will introduce traditional cognitive therapy methods that aim to convince the client of her cognitive errors, such as illogical and dysfunctional beliefs about the importance of weight and its the connection to self-image. This stage will draw heavily on the methods introduced by Beck. Third, as clients develop more logical and reasonable cognitions and beliefs, we will attempt to consolidate these into day to day realistic expectations about weight, diet and strategies for relapse prevention. 106. Describe the research on the effectiveness of different forms of therapy for treating bulimia nervosa. Answer: Although interpersonal therapy does not directly address eating disorders, it has emerged as a very successful form of treatment. This therapy focuses on difficulties in close relationships. Interpersonal therapy was studied in an investigation of the effectiveness of cognitive behavior therapy. The researchers used interpersonal therapy as a placebo control group in their study. They were interested in studying the effectiveness of cognitive behavior therapy and needed a credible placebo. At the end of the study, cognitive therapy was more effective than interpersonal therapy. However, at the 12-month follow-up, the interpersonal therapy group continued to improve. They equaled those of the cognitive behavior therapy group and outdistanced those in the behavior therapy alone group. Test Bank for Abnormal Psychology Thomas F. Oltmanns, Robert E. Emery 9780205997947, 9780205970742, 9780134899053, 9780134531830
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