CH-13 Disorders of Basic Physical Functions – Abnormal Child and Adolescent Psychology : Exam Guide

Chapter 13 Disorders of Basic Physical Functions TRUE OR FALSE 1. It is common for children to exhibit some difficulty in acquiring appropriate habits of elimination, sleep, and eating. Answer: True 2. The view that enuresis is the result of emotional or psychiatric disturbance is well supported. Answer: False 3. Family histories of youngsters with enuresis rarely reveal a number of relatives with the same problem. Answer: False 4. Encopresis refers to the passage of feces into the clothing or other unacceptable area when this is not due to physical disorder. Answer: True 5. A majority of children with encopresis are constipated. Answer: True 6. Research indicates that after age 11, the hours a young person spends asleep decreases significantly, particularly during the week. Answer: True 7. Parasomnias involve difficulty with initiating and maintaining sleep. Answer: False 8. Research indicates that good sleepers do not wake up during the night. Answer: False 9. Obstructive sleep apnea can be diagnosed through a clinical interview. Answer: False 10. Research and clinical observations suggest that sleepwalking is due to nervous system immaturity and is therefore unaffected by psychological factors. Answer: False 11. A majority of children who sleepwalk exhibit an EEG pattern common to children during the first year of life and uncommon to children older than age 3. Answer: True 12. Sleep terrors occur during the rapid eye movement (REM) phase of sleep and at fairly random times during the child’s sleeping pattern. Answer: False 13. Research by Muris et al. (2001) indicates that parents tend to overestimate their children’s nighttime fears. Answer: False 14. Medications are the best treatment for sleep disorders. Answer: False 15. Children’s feeding behaviors are a common concern for at least 50 percent of parents. Answer: True 16. Rumination refers to a disorder of eating in which a child's concerns about eating certain foods result in anxiety and vomiting. Answer: False 17. Pica is frequently observed among developmentally delayed youngsters. Answer: True 18. One feeding disorder associated with infancy or early childhood is sometimes referred to as “failure to thrive.” Answer: True 19. About 1 to 5 percent of pediatric hospital admissions are due to failure to thrive. Answer: True 20. Poor attachment, parental psychopathology, low birth weight, and developmental disability have all been correlated with failure to thrive. Answer: True 21. According to the Centers for Disease Control (2010), the rate of obesity in children and adolescents has steadily declined since the mid-1980s. Answer: False 22. Aside from health issues, children who are obese have few problems. Answer: False 23. Parents often model poor eating and exercise habits. Answer: True 24. Research indicates that in order to be successful, behavioral treatment for weight loss with youth must include a family or parental component. Answer: True 25. Subclinical concerns with weight and unusual eating behaviors are increasingly common in younger adolescents. Answer: True 26. Research suggests that African American and Hispanic females report less body satisfaction than European American females. Answer: False 27. Over 50 percent of cases of anorexia nervosa end in death. Answer: False 28. There is some evidence that eating conflicts, struggles with food, and unpleasant meals in childhood are associated with symptoms of anorexia in adolescence. Answer: True 29. Early sexual abuse puts a child at risk for psychopathology, including eating disorders. Answer: True 30. Our society's valuing of slim and young bodies likely contributes to the development and prevalence of eating disorders. Answer: True 31. Research indicates that body image in young men is seemingly uninfluenced by culture. Answer: False 32. Families of people with eating disorders are reported to have a higher incidence of weight problems, but are less likely to have physical illnesses, affective disorders, or alcoholism. Answer: False 33. Interpersonal psychotherapy (IPT) does not directly target eating symptoms, but addresses interpersonal deficits, interpersonal role disputes, role transitions and grief. Answer: True 34. Antidepressants have recently been found to be helpful in maintaining weight in anorexic patients. Answer: False 35. Prevention programs designed to help young girls to recognize and challenge cultural messages have been proven to increase body esteem. Answer: True MULTIPLE CHOICE 36. The usual sequence of control over elimination is A. nighttime bowel control, nighttime bladder control, daytime bowel control, nighttime bladder control. B. nighttime bowel control, daytime bowel control, nighttime bladder control, daytime bladder control. C. nighttime bowel control, daytime bowel control, daytime bladder control, nighttime bladder control. D. daytime bowel control, daytime bladder control, nighttime bowel control, nighttime bladder control. Answer: C 37. The lack of urinary controls is usually not diagnosed as enuresis prior to the age of A. 18 months. B. 3 years. C. 5 years. D. 10 years. Answer: C 38. A 5-year-old boy is referred to a clinic for the treatment of enuresis. He wets his bed at night, but remains dry during the daytime. He does not exhibit any other behavior problems. His mother reports that her son slept through the night without wetting for about a year, or until his baby sister was born. The boy would probably be described as exhibiting A. nocturnal and secondary enuresis. B. diurnal and secondary enuresis. C. nocturnal and primary enuresis. D. aggressive enuresis. Answer: A 39. Which of the following statements regarding enuresis is accurate? A. Prevalence of enuresis increases with age. B. Boys and girls are equally likely to have enuresis. C. Elevated levels of antidiuretic hormones are associated with enuresis. D. Reduced bladder capacity may be associated with enuresis. Answer: D 40. The hypothesis that enuresis is a disorder of sleep arousal refers to the idea that A. the child's wetting causes arousal, thus interrupting sleep. B. the child with enuresis is an unusually deep sleeper. C. the child is sexually aroused by dreams and this results in wetting. D. repeated bed wetting leads to disruption of the sleep-wake cycle. Answer: B 41. The medication most frequently employed in the treatment of enuresis is A. librium. B. diuretics. C. desmopressin acetate. D. imipramine. Answer: C 42. Which of the following statements regarding the urine-alarm system is accurate? A. There is little research support for this approach. B. The system works by sounding an alarm at given periods during the night, thus waking the child before he or she urinates. C. The system is effective in a majority of cases. D. The system has been found to be more expensive than medication. Answer: C 43. The treatment program for enuresis developed by Houts and his colleagues is known as A. the Desmopressin Program. B. Full Bladder Training. C. Full Spectrum Home Training. D. the Retention Control Program. Answer: C 44. Results of research, such as that by Houts and his colleagues, suggest that the prevention of relapses in treating enuresis is facilitated by A. overlearning. B. covert conditioning. C. treating younger children. D. the addition of verbal psychotherapy. Answer: A 45. Most treatments of encopresis A. combine medical and psychodynamic management. B. combine medical and behavioral management. C. combine behavioral and psychodynamic management. D. avoid the use of enemas. Answer: B 46. Current treatments for encopresis A. are not very successful. B. try to avoid parental involvement. C. are likely to include positive reinforcement for appropriate toileting behavior and being clean. D. are initially successful, but relapse rates are high. Answer: C 47. Which of the following statements regarding normal sleep patterns is correct? A. There is considerable individual variation in what would be considered normal sleep. B. The amount of time spent in REM sleep increases as we age. C. The sequence (pattern) in which various sleep stages occur remains the same from birth through early adolescence. D. EEG waves are faster during the deepest part of sleep. Answer: A 48. The two broad phases of sleep are A. childhood and adult. B. rapid eye movement and nonrapid eye movement. C. EEG and non-EEG. D. nocturnal and diurnal. Answer: B 49. Surveys suggest that approximately _________ percent of infants and younger children experience some form of sleep problem that is disturbing to the family. A. 5 B. 15 C. 25 D. 45 Answer: C 50. Sleep disorders are usually classified into two major categories A. difficulties in initiation and maintenance and difficulties in arousal and transition. B. insomnias and hypersomnias. C. nightmares and dreams. D. nightmares and night terrors. Answer: A 51. A child experiences difficulty regarding arousal from sleep and transitions between sleep stages. These problems fall in the category of A. REM sleep. B. non-REM sleep. C. dyssomnia. D. parasomnia. Answer: D 52. Obstructive sleep apnea is A. rare in children in adolescents. B. treated with stimulant medication. C. easily recognizable by parents and professionals. D. characterized by loud snoring, pauses and difficulty breathing, restlessness and sweating during sleep. Answer: D 53. Sleepwalking A. is always followed by the child achieving full consciousness. B. is clearly not a physical danger since it occurs only among very agile children. C. is probably the acting out of a dream. D. occurs primarily in the first one to three hours of sleep. Answer: D 54. Regarding sleepwalking, A. approximately 1 to 6 percent of children experience isolated episodes of walking in their sleep. B. sleepwalking disorder occurs in approximately 15 percent of children. C. it appears to be influenced by insufficient sleep, changes in sleep routines and settings and stress. D. no genetic component is evident. Answer: C 55. A sleeping child suddenly sits upright in bed and screams. The child still appears to be sleeping, but shows obvious physiological signs of distress and appears disoriented. Eventually, the child returns to sleep without fully awakening and has no memory of this event the next day. The child has experienced A. a nightmare. B. a sleep terror. C. insomnia. D. an anxiety attack. Answer: B 56. Sleep terrors A. occur during REM sleep. B. usually occur about 2 hours into sleep. C. are quite common. D. are remembered for their vivid dreams. Answer: B 57. Nightmares A. occur during REM sleep. B. occur during the first third of the night. C. are quite rare. D. are unrelated to daytime anxieties. Answer: A 58. The differentiation between children's nightmares and sleep terrors includes which of the following? A. Nightmares occur during non-REM sleep, whereas sleep terrors occur during REM sleep. B. During nightmares the child is easy to arouse and responsive to the environment, whereas during sleep terrors the child is difficult to arouse and largely unresponsive to the environment. C. There is limited or no memory for nightmares, whereas the contents of sleep terrors may be remembered fairly clearly. D. There is intense physiological arousal during nightmares, whereas there is only moderate physiological arousal during sleep terrors. Answer: B 59. Which of the following interventions for the problems of bedtime refusal, difficulty falling asleep, and nighttime wakenings are supported by research? A. Punishment B. Bedtime routines. C. Scheduled awakenings D. Pharmacological treatments. Answer: B 60. _________ appears to be successful in the treatment of sleep terrors. A. Scheduled awakenings B. Family education C. Play therapy D. Pharmacological treatment Answer: B 61. Rumination is an eating disorder in which the youngster A. worries about what kinds of foods to eat. B. has concerns with weight and body image. C. experiences anxiety when eating occurs outside of the home. D. voluntarily regurgitates food or liquid. Answer: D 62. The most common explanation of rumination is that A. it is the infant's way of worrying. B. it is caused by an overindulgent mother. C. it is associated with self-stimulation and sensory deprivation in the environment. D. the infant's immature nervous system doesn't experience the events as aversive. Answer: C 63. A child who habitually eats substances such as paint, dirt, and bugs would likely be described as displaying the disorder known as A. pica. B. rumination. C. bulimia. D. obsessive-compulsive disorder. Answer: A 64. The diagnosis of pica is made only after the child is 2 years old because A. observation of behavior must cover at least a several-year period. B. prior to this the symptoms associated with pica are characteristic of normally developing infants. C. children cannot be interviewed prior to this age. D. children do not feed themselves until they are 2. Answer: B 65. A young child exhibits a persistent failure to eat adequately that results in the child’s failure to gain weight. This child would likely receive a diagnosis of A. rumination disorder. B. pica. C. infantile anorexia. D. feeding disorder of infancy or early childhood. Answer: D 66. Which of the following statements regarding childhood obesity is accurate? A. There are no ethnic differences in regard to risk for childhood obesity. B. Obesity is characterized by a body mass index at or above the 85th percentile. C. The prevalence of childhood obesity has decreased. D. The rates of obesity have only increased in girls. Answer: B 67. Which of the following statements regarding childhood obesity is supported by research? A. In a sample of inner city students, overweight children were more likely to be absent than normal weight children. B. Children who are overweight are generally perceived as likeable and friendly. C. Negative attitudes about obesity begin around puberty. D. Any negative effects of obesity disappear after high school. Answer: A 68. In a study by Israel and Shapiro, parents of overweight children enrolled in a weight-loss program completed behavior problem checklists. In general, the results suggest that these overweight children have psychological difficulties to an _________ extent than do members of the general child population, but that the extent of their problems are _________ as those of children referred to clinics for psychological services. A. greater; as great B. greater; not as great C. lesser; as great D. lesser; not as great Answer: B 69. Current knowledge regarding the etiology of obesity suggests that A. psychological factors are primary. B. biological factors are primary. C. social factors are primary. D. the causes are probably multiple and complex. Answer: D 70. The results of the Israel et al. study of parent training and the treatment of obese children suggest that A. parent training results in parents being overinvolved with their children and therefore the child is less successful. B. the knowledge of child management skills is not enhanced by the addition of this specific training to a standard behavioral weight-loss program. C. parent training results in superior maintenance of weight loss over a one-year follow-up period. D. parent training produces improvements over the weight maintenance achieved by the standard treatment group at the end of treatment, but not at one year following treatment. Answer: C 71. The Israel et al. study examining the inclusion of enhanced self-management skills in the treatment of obese youngsters found that self-management training A. resulted in poorer weight loss during treatment. B. resulted in superior weight loss during treatment. C. increased the likelihood of a youngster returning to pretreatment weight patterns following treatment. D. reduced the likelihood of a youngster returning to pretreatment weight patterns following treatment. Answer: D 72. A young person eats more during an hour period than most people would be expected to eat during that period. She also reports that she was unable to control her eating during this period. This behavior is known as A. a binge. B. a purge. C. bulimia. D. anorexia. Answer: A 73. In conceptualizing eating disorders such as anorexia and bulimia, an important distinction that has received some support is A. between restricting intake or purging. B. between individuals diagnosed as anorexia nervosa whose weight is near normal and those with the diagnosis whose weight is 15 percent or more below ideal weight. C. between individuals diagnosed with bulimia who binge and those who do not. D. between pre- and post-menarchal females with anorexia. Answer: A 74. "Eating Disorder Not Otherwise Specified" A. may be applied for binge eating disorder. B. is not a DSM-IV diagnosis. C. is not a DSM-IV diagnosis that can be applied to children or adolescents. D. is a DSM-IV diagnosis only for males. Answer: A 75. An adolescent female whose ideal weight is 120 lbs. weighs 95 lbs. She repeatedly engages in self-induced vomiting and exhibits an intense fear of gaining weight. She claims she feels fat and is highly concerned with her body's shape. In addition, her menstruation has been disrupted and she has a number of other physical problems. According to DSM-IV she would most likely receive the diagnosis of A. anorexia nervosa. B. bulimia nervosa. C. phobia. D. obsessive-compulsive disorder. Answer: A 76. DSM-IV distinguishes between two types of anorexia known as A. normal weight vs. underweight. B. binging vs. purging. C. binge-eating/purging vs. restricting. D. primary vs. secondary. Answer: C 77. A young woman whose ideal weight is 105 pounds, weighs 110 pounds. She engages in recurrent episodes of binge eating and repeatedly fasts and engages in excessive exercise to prevent weight gain. The young woman's self-esteem is based primarily on how her body looks. She would most likely receive a DSM-IV diagnosis of A. anorexia nervosa. B. bulimia nervosa. C. restructuring anorexia. D. borderline obesity. Answer: B 78. DSM-IV distinguishes between two types of bulimia labeled as A. anorexic and obese. B. normal weight and overweight. C. purging and no purging. D. binging and nonbinding. Answer: C 79. Which of the following statements regarding the prevalence of eating disorders is accurate? A. Youth with “partial syndrome” or subclinical symptoms do not experience much impairment. B. EDNOS is less common than anorexia and bulimia. C. Females represent about 90 percent of all cases. D. Anorexia nervosa is more commonly diagnosed than bulimia nervosa. Answer: C 80. Which of the following is true? A. By the 4th or 5th grade many girls are worried about becoming overweight or desire to be thinner. B. Young women in westernized culture are at no greater risk for eating disorders. C. Co-occurring problems are rare. D. The typical age of onset for eating disorders is 9-12 years of age. Answer: A 81. In regard to the impact of biological influences on eating disordered behavior A. exposure to higher testosterone is often implicated. B. increased hormonal changes at puberty are hypothesized to increase risk. C. increased serotonin activity has been observed in individuals with anorexia and bulimia. D. genetic influences are significant in preadolescents but fade through adolescence and adulthood. Answer: B 82. The notion that anorexia begins as an attempt to control genuine obesity A. is strongly supported. B. may apply to anorexia nervosa in females, but does not apply to males. C. is clearly not a factor in the development of anorexia. D. needs to explain why only some girls persist in the common social ritual of dieting beyond the point of socially desired slimness. Answer: D 83. The classic image of a young anorexic girl as trapped by her family "like a sparrow in a golden cage" is attributable to A. Anna Freud. B. Hilda Bruch. C. Christopher Fairburn. D. Karen Carpenter. Answer: B 84. In the Maudsley family approach: A. the family is seen as pathological. B. the treatment avoids focusing on the eating disorder, but rather address dynamics. C. families are encouraged to work out for themselves how to get the patient to gain weight. D. only works when the family is seen together. Answer: C 85. The treatment approach for bulimia nervosa for which there is the best controlled research support is A. antidepressant medication. B. the family-systems approach of Minuchin. C. cognitive-behavioral treatment. D. hospitalization. Answer: C 86. Treatment for bulimia nervosa from a cognitive-behavioral view A. assumes that hormonal imbalance is at the core of the disorder. B. assumes that cognitive distortions regarding shape and weight are the primary features of the disorder. C. has been found to be equal to pharmacotherapy in its effectiveness. D. hospitalizes the young person in the early stages of treatment. Answer: B BRIEF ESSAY QUESTIONS 87. Compare and contrast the various types of treatment used for enuresis. Answer: Enuresis, or bedwetting, can be a challenging condition to manage. Treatment options vary depending on the underlying causes and the individual's age and circumstances. Here are the main types of treatment used for enuresis: 1. Behavioral Therapies: • Bedwetting Alarms: These devices sense moisture and wake the individual when they begin to wet the bed, conditioning them to wake up before fully emptying their bladder. • Bladder Training: This involves learning to hold urine for progressively longer periods, gradually increasing bladder capacity and control. • Scheduled Voiding: Establishing a routine for urination, which can help prevent accidents. 2. Lifestyle and Dietary Changes: • Fluid Restriction: Limiting fluids before bedtime can reduce the amount of urine produced during the night. • Voiding Schedule: Encouraging regular trips to the bathroom during the day can help ensure the bladder empties fully, reducing the likelihood of nighttime accidents. 3. Medications: • Desmopressin (DDAVP): This medication reduces the amount of urine produced by the kidneys and can be effective for some individuals, particularly those with nighttime polyuria (excessive urine production at night). • Tricyclic Antidepressants (TCAs): These medications can relax the bladder and increase bladder capacity, reducing the frequency of bedwetting episodes. 4. Counseling and Support: • Psychotherapy: In cases where enuresis is related to psychological factors such as stress or trauma, therapy may be beneficial. • Support Groups: Joining a support group for individuals with enuresis can provide emotional support and practical tips for managing the condition. 5. Alternative Therapies: • Acupuncture: Some studies suggest acupuncture may be beneficial for treating enuresis, although more research is needed. • Hypnosis: Hypnotherapy has been used as a treatment for enuresis, with some individuals experiencing improvement in symptoms. In summary, treatment for enuresis often involves a combination of behavioral therapies, lifestyle modifications, and, in some cases, medications. The most appropriate treatment will depend on the individual's age, the underlying causes of their bedwetting, and their personal preferences. It's essential to work closely with healthcare providers to develop a comprehensive treatment plan tailored to the individual's needs. 88. What is encopresis and what are some of the commonly held causes and treatments? Answer: Encopresis is a condition characterized by the repeated passing of stool into inappropriate places, such as clothing or the floor, by a child who is past the age of toilet training. It is often related to chronic constipation and stool withholding behaviors. Here are some commonly held causes and treatments for encopresis: Causes: 1. Constipation: Chronic constipation can lead to a buildup of hard, dry stool in the rectum, which can cause leakage of liquid stool around the impacted stool. 2. Stool Withholding: Children may withhold stool due to fear of pain during bowel movements, leading to a cycle of constipation and stool leakage. 3. Psychological Factors: Stressful life events, changes in routine, or emotional issues can contribute to encopresis. 4. Dietary Factors: Poor diet, low fiber intake, and inadequate fluid intake can contribute to constipation and encopresis. Treatments: 1. Behavioral Therapies: • Toilet Training: Reinforcing proper toilet habits and schedules can help. • Positive Reinforcement: Praising the child for using the toilet correctly can be effective. • Toilet Schedules: Encouraging regular toilet sitting times, especially after meals, can help establish a routine. 2. Dietary Changes: • High-Fiber Diet: Increasing fiber intake through fruits, vegetables, and whole grains can improve bowel movements. • Adequate Fluid Intake: Drinking plenty of water helps keep stools soft and easier to pass. 3. Medications: • Stool Softeners/Laxatives: These can help soften stools and make them easier to pass, reducing the likelihood of constipation. • Enemas: In severe cases, enemas may be used to clear the bowel of impacted stool. 4. Counseling and Support: • Psychotherapy: Counseling can help address any underlying psychological issues contributing to encopresis. • Parental Education: Parents may benefit from education on effective toilet training techniques and how to manage encopresis. 5. Education and Support Groups: • Joining a support group for parents of children with encopresis can provide valuable support and advice. Encopresis treatment typically involves a combination of approaches tailored to the individual child's needs. It's essential for parents to work closely with healthcare providers to develop an effective treatment plan. 89. Describe the symptoms and problems associated with sleep apnea. What treatments are commonly used? Answer: Sleep apnea is a sleep disorder characterized by pauses in breathing or shallow breaths during sleep. These pauses can last from a few seconds to minutes and can occur multiple times per hour. There are two main types of sleep apnea: obstructive sleep apnea (OSA) and central sleep apnea (CSA). Symptoms: 1. Loud snoring 2. Gasping or choking during sleep 3. Daytime sleepiness or fatigue 4. Morning headaches 5. Irritability or mood changes 6. Difficulty concentrating 7. Dry mouth or sore throat upon waking Problems Associated with Sleep Apnea: 1. Poor sleep quality: Frequent awakenings during the night can lead to fragmented sleep and daytime sleepiness. 2. Daytime dysfunction: Sleep apnea can cause daytime fatigue, difficulty concentrating, and irritability, affecting work and daily activities. 3. Cardiovascular problems: Untreated sleep apnea is associated with an increased risk of high blood pressure, heart attack, stroke, and irregular heartbeats. 4. Metabolic issues: Sleep apnea is linked to insulin resistance, glucose intolerance, and metabolic syndrome. 5. Complications with medications and surgery: Sleep apnea can increase the risk of complications during and after surgery, as well as with certain medications that suppress breathing. Treatments: 1. Continuous Positive Airway Pressure (CPAP): CPAP is the most common and effective treatment for sleep apnea. It involves wearing a mask over the nose or nose and mouth during sleep, which delivers a continuous flow of air to keep the airway open. 2. Oral Appliances: These devices are worn in the mouth during sleep to help keep the airway open by positioning the jaw forward. 3. Lifestyle Changes: Losing weight, avoiding alcohol and sedatives before bed, and sleeping on your side can help reduce symptoms. 4. Surgery: In some cases, surgery may be recommended to remove excess tissue in the throat or reposition the jaw. 5. Positional Therapy: Devices or techniques that encourage sleeping in a specific position to prevent the airway from becoming blocked. 6. Medications: Medications are generally not used as a primary treatment for sleep apnea but may be prescribed in some cases to help manage symptoms. Treatment for sleep apnea is tailored to the individual and may involve a combination of approaches. It's important to work closely with healthcare providers to find the most effective treatment plan for managing sleep apnea and improving overall health. 90. What are the hypothesized causes of sleepwalking disorder? Answer: Sleepwalking, also known as somnambulism, is a sleep disorder that involves walking or performing other complex behaviors while asleep. The exact cause of sleepwalking is not fully understood, but several factors are believed to contribute to the development of this disorder: 1. Genetics: There appears to be a genetic component to sleepwalking, as it tends to run in families. Certain genetic factors may predispose individuals to sleepwalking episodes. 2. Sleep Deprivation: Not getting enough sleep or experiencing poor sleep quality can increase the likelihood of sleepwalking. Sleepwalking episodes are more common during periods of sleep deprivation. 3. Stress and Anxiety: Stressful life events or anxiety can trigger sleepwalking episodes in susceptible individuals. Emotional disturbances can disrupt normal sleep patterns and lead to sleepwalking. 4. Sleep Environment: Disruptions in the sleep environment, such as noise or unfamiliar surroundings, can contribute to sleepwalking. Changes in routine or sleeping in a new environment can increase the risk of sleepwalking episodes. 5. Medical Conditions: Certain medical conditions, such as gastroesophageal reflux (GERD), restless legs syndrome (RLS), and obstructive sleep apnea (OSA), have been associated with an increased risk of sleepwalking. 6. Medications: Some medications, such as sedatives, hypnotics, and certain antidepressants, can increase the likelihood of sleepwalking in susceptible individuals. 7. Fever: Fever, especially in children, can trigger sleepwalking episodes. The body's response to fever, including changes in sleep patterns, can contribute to sleepwalking. 8. Other Sleep Disorders: Sleepwalking can be associated with other sleep disorders, such as sleep apnea or restless legs syndrome, which disrupt normal sleep patterns and increase the risk of sleepwalking. It's important to note that the exact cause of sleepwalking can vary from person to person, and multiple factors may contribute to the development of this disorder. Treatment for sleepwalking may involve addressing underlying sleep disturbances, reducing stress and anxiety, and creating a safe sleep environment to prevent injury during sleepwalking episodes. Consulting with a healthcare professional is recommended for proper diagnosis and management of sleepwalking disorder. 91. Briefly describe four characteristics that differentiate nightmares and sleep terrors. Answer: Nightmares and sleep terrors are both types of parasomnias that occur during sleep, but they have distinct characteristics that differentiate them: 1. Content and Recall: • Nightmares: Nightmares are vivid, frightening dreams that occur during REM (rapid eye movement) sleep and are often easily remembered upon waking. They usually involve a threat to survival, self-esteem, or security. • Sleep Terrors: Sleep terrors, also known as night terrors, typically occur during non-REM (NREM) sleep, specifically during the transition from stage 3 to stage 4 sleep. Individuals experiencing sleep terrors may have no recall of the episode or only partial recall. The content of sleep terrors is often not remembered and may not involve a specific dream or scenario. 2. Timing and Behavior: • Nightmares: Nightmares usually occur later in the sleep cycle, during REM sleep, which is associated with vivid dreaming. Individuals experiencing nightmares may awaken from the dream and can often describe the content of the nightmare. • Sleep Terrors: Sleep terrors typically occur during the first few hours of sleep, during the deeper stages of NREM sleep. During a sleep terror episode, the individual may sit up in bed, scream, thrash around, or display other agitated behaviors. They may appear confused or disoriented and may not respond to attempts to comfort them. 3. Physiological Responses: • Nightmares: Physiological responses during nightmares are typical of REM sleep, including increased heart rate, sweating, and rapid breathing. These responses are consistent with the emotional content of the dream. • Sleep Terrors: During sleep terrors, physiological responses such as increased heart rate and sweating may also occur, but they are often more intense than those seen in nightmares. These responses are not necessarily related to the content of the dream, as sleep terrors are not typically associated with a specific dream scenario. 4. Frequency and Development: • Nightmares: Nightmares are more common in children, but they can occur at any age. They may be triggered by stress, anxiety, or trauma and may occur sporadically or frequently. • Sleep Terrors: Sleep terrors are more common in children and tend to peak between ages 4 and 12, after which they often decrease in frequency and severity. They may be more common in children with a family history of sleep terrors and may be triggered by factors such as sleep deprivation, fever, or stress. In summary, nightmares are vivid, frightening dreams that occur during REM sleep and are often easily remembered, while sleep terrors are episodes of intense fear or agitation that occur during NREM sleep and are often not remembered. Nightmares are more common in older individuals and may be triggered by stress or anxiety, while sleep terrors are more common in children and may be triggered by factors such as sleep deprivation or fever. 92. Sleep problems are a common complaint among parents. What advice can be offered to diminish or eliminate sleep problems with children? Answer: Parents can take several steps to help diminish or eliminate sleep problems in children: 1. Establish a Consistent Bedtime Routine: A regular bedtime routine helps signal to the child that it's time to wind down and prepare for sleep. This can include activities like reading a book, taking a bath, or listening to calming music. 2. Create a Comfortable Sleep Environment: Ensure that the child's bedroom is conducive to sleep. This includes a comfortable mattress and pillows, appropriate room temperature, and minimal noise and light. 3. Limit Screen Time Before Bed: Avoiding screens (such as TV, tablets, and smartphones) for at least an hour before bedtime can help promote better sleep. The blue light emitted by screens can interfere with the production of melatonin, a hormone that regulates sleep. 4. Encourage Regular Sleep Schedule: Try to maintain a consistent sleep schedule, even on weekends. This helps regulate the child's internal body clock and can make it easier for them to fall asleep and wake up at the same time each day. 5. Address Anxiety and Stress: Help your child manage any anxiety or stress they may be experiencing, as these can interfere with sleep. Encourage open communication and provide reassurance and support. 6. Limit Caffeine Intake: Avoid giving children caffeine, especially in the afternoon and evening, as it can interfere with their ability to fall asleep. 7. Promote Physical Activity: Regular physical activity during the day can help children expend energy and promote better sleep. However, avoid vigorous exercise close to bedtime, as it can be stimulating. 8. Limit Fluid Intake Before Bed: To reduce the likelihood of nighttime awakenings due to the need to use the bathroom, limit fluids in the evening, especially closer to bedtime. 9. Address Underlying Sleep Disorders: If sleep problems persist despite trying these strategies, consult a healthcare professional. There may be underlying sleep disorders, such as sleep apnea or restless legs syndrome, that need to be addressed. It's important to be patient and consistent when implementing these strategies, as it may take time for your child's sleep habits to improve. By creating a calming bedtime routine and promoting a healthy sleep environment, you can help your child develop good sleep habits that can last a lifetime. 93. Using the case study in the textbook on Matthew, the 11 year old with recurrent nightmares, how would you treat a child with recurrent nightmares? Answer: Treating a child with recurrent nightmares, such as Matthew, involves a multifaceted approach that addresses the underlying causes of the nightmares and helps the child develop coping strategies. Based on the case study, here are some treatment strategies that could be effective: 1. Create a Safe Sleep Environment: Ensure that Matthew's bedroom is a comfortable and safe environment for sleep. This includes making sure the room is dark, quiet, and at a comfortable temperature. 2. Establish a Relaxing Bedtime Routine: Help Matthew wind down before bed with a calming bedtime routine. This could include activities like reading a book, taking a warm bath, or practicing relaxation techniques. 3. Address Stress and Anxiety: Talk to Matthew about any stress or anxiety he may be experiencing. Help him identify and cope with stressors in his life, and consider counseling or therapy to help him manage his emotions. 4. Encourage Positive Dream Imagery: Encourage Matthew to think about positive or happy thoughts before bed. This can help counteract the negative imagery in his nightmares. 5. Teach Lucid Dreaming Techniques: Lucid dreaming involves becoming aware that you are dreaming and may allow Matthew to take control of his dreams, potentially reducing their negative impact. 6. Monitor Sleep Patterns: Keep track of Matthew's sleep patterns to identify any triggers or patterns associated with his nightmares. This can help tailor treatment strategies more effectively. 7. Consider Therapy: Cognitive-behavioral therapy (CBT) can be effective in treating nightmares. This type of therapy helps individuals change their thoughts and behaviors related to sleep, reducing the frequency and intensity of nightmares. 8. Medication: In some cases, medication may be prescribed to help manage nightmares, especially if they are related to underlying conditions such as anxiety or PTSD. However, medication is typically used as a last resort and is not recommended for long-term use in children. It's important to work closely with a healthcare professional to develop a treatment plan tailored to Matthew's specific needs. By addressing the underlying causes of his nightmares and teaching him coping strategies, Matthew can learn to manage his nightmares and improve his overall sleep quality. 94. What are the differences and similarities between pica and rumination? Answer: Pica and rumination are both feeding disorders, but they differ in their specific symptoms and underlying causes: Pica: • Definition: Pica is characterized by the persistent eating of non-nutritive, non-food substances, such as dirt, paper, hair, or paint. • Symptoms: The most common symptom of pica is the ingestion of non-food items. This behavior is inappropriate for the individual's developmental level and not part of culturally sanctioned practice. • Causes: The exact cause of pica is unknown, but it is often associated with nutritional deficiencies (such as iron or zinc), developmental disorders (such as autism), or psychological factors (such as stress or trauma). • Treatment: Treatment for pica involves addressing any underlying nutritional deficiencies and providing behavioral interventions to reduce or eliminate the ingestion of non-food substances. Rumination Disorder: • Definition: Rumination disorder is characterized by the repeated regurgitation of food, which is then re-chewed, re-swallowed, or spit out. • Symptoms: The main symptom of rumination disorder is the regurgitation of food within the first 30 minutes after eating, which is not due to a medical condition (such as gastroesophageal reflux) or another mental disorder. • Causes: The exact cause of rumination disorder is unknown, but it is believed to be related to a learned behavior or a response to stress. • Treatment: Treatment for rumination disorder often involves behavioral therapy to help the individual learn to recognize and change the behavior. In some cases, medications may be prescribed to reduce symptoms. Differences: 1. Behavior: Pica involves the ingestion of non-food substances, while rumination involves the regurgitation of food. 2. Underlying Causes: Pica is often associated with nutritional deficiencies or developmental disorders, while rumination is believed to be related to learned behavior or stress. 3. Symptoms: The symptoms of pica and rumination are distinct, with pica involving the ingestion of non-food items and rumination involving the regurgitation of food. Similarities: 1. Both are Feeding Disorders: Both pica and rumination are considered feeding disorders because they involve abnormal eating behaviors. 2. Both may be related to Psychological Factors: While the exact causes of both disorders are not fully understood, psychological factors, such as stress or trauma, may play a role in both pica and rumination. Overall, while pica and rumination are distinct disorders with different symptoms and underlying causes, they are both feeding disorders that require careful evaluation and treatment by healthcare professionals. 95. Explain the role of psychosocial and cultural factors in promoting obesity in American children. Answer: Psychosocial and cultural factors play significant roles in promoting obesity in American children. These factors can influence children's eating behaviors, physical activity levels, and overall health habits. Some key factors include: 1. Family Environment: Family plays a crucial role in shaping children's eating habits and physical activity levels. Factors such as parental modeling of healthy behaviors, family meals, and access to healthy foods can all impact a child's risk of obesity. 2. Socioeconomic Status: Children from lower socioeconomic backgrounds may have limited access to healthy foods and safe places to play, increasing their risk of obesity. Additionally, stressors associated with poverty can contribute to unhealthy eating behaviors. 3. Advertising and Media Influence: Children are exposed to a large amount of advertising for unhealthy foods, which can influence their food preferences and consumption patterns. Media portrayal of unhealthy body images can also contribute to body dissatisfaction and unhealthy weight control behaviors. 4. School Environment: The school environment plays a significant role in children's health. Access to healthy foods, opportunities for physical activity, and education about nutrition and health can all impact obesity rates among children. 5. Cultural Norms and Beliefs: Cultural norms and beliefs can influence attitudes toward food, body image, and physical activity. For example, certain cultural practices may promote the consumption of high-calorie foods or discourage physical activity. 6. Psychological Factors: Psychological factors such as stress, depression, and low self-esteem can contribute to obesity by influencing eating behaviors and physical activity levels. Addressing these psychosocial and cultural factors is crucial for preventing and reducing obesity in American children. Strategies to promote healthy behaviors include promoting positive body image, providing education about nutrition and physical activity, improving access to healthy foods and safe places to play, and addressing underlying psychological issues. Collaborative efforts involving families, schools, healthcare providers, and communities are essential for creating environments that support healthy lifestyles for children. 96. Review the multifaceted program for treating childhood obesity reported in the textbook. What would you include to ensure long-term success? Answer: The multifaceted program for treating childhood obesity reported in the textbook likely includes a combination of strategies to address various aspects of the child's health and lifestyle. To ensure long-term success, the program should include the following components: 1. Behavioral Interventions: Incorporate behavior modification techniques to promote healthy eating habits, increase physical activity, and reduce sedentary behavior. This may include goal setting, self-monitoring, and rewards for positive behaviors. 2. Nutritional Counseling: Provide education on healthy eating habits, portion control, and reading food labels. Encourage the consumption of fruits, vegetables, whole grains, and lean proteins while limiting sugary drinks and high-fat foods. 3. Physical Activity: Include structured physical activity sessions tailored to the child's age and abilities. Encourage activities that the child enjoys to increase adherence and long-term participation. 4. Family Involvement: Engage the family in the treatment plan to create a supportive environment at home. Encourage family meals, physical activity together, and role modeling of healthy behaviors by parents and siblings. 5. Psychological Support: Address any psychological factors contributing to obesity, such as stress, low self-esteem, or emotional eating. Provide counseling or therapy as needed to help the child develop healthy coping mechanisms. 6. Medical Monitoring: Regularly monitor the child's weight, blood pressure, and other relevant health markers. Adjust the treatment plan as needed based on progress and any medical considerations. 7. Lifestyle Changes: Encourage long-term lifestyle changes rather than short-term dieting. Focus on building sustainable habits that the child can maintain over time. 8. Community Support: Provide access to community resources, such as recreational programs, support groups, or nutrition education classes, to help reinforce healthy behaviors outside of the program. 9. Education and Skill Building: Teach the child and family practical skills for maintaining a healthy lifestyle, such as meal planning, cooking healthy meals, and incorporating physical activity into daily routines. 10. Follow-Up and Support: Offer ongoing support and follow-up to monitor progress, address any setbacks, and celebrate successes. Encourage regular check-ins with healthcare providers to track the child's health and weight status. By including these components in the multifaceted program and ensuring that they are tailored to the child's individual needs and circumstances, the program can promote long-term success in managing and preventing childhood obesity. 97. Briefly describe three considerations usually employed in making distinctions between eating disorders. Answer: When distinguishing between eating disorders, three key considerations are often employed: 1. Behavioral Patterns: Eating disorders are characterized by distinct patterns of behavior related to food intake and body image. Anorexia nervosa is characterized by restrictive eating and intense fear of gaining weight. Bulimia nervosa involves binge eating followed by purging behaviors. Binge eating disorder is characterized by recurrent episodes of binge eating without compensatory behaviors. 2. Psychological Factors: Eating disorders are often associated with psychological factors such as body dissatisfaction, low self-esteem, and distorted body image. These factors can influence the development and maintenance of disordered eating behaviors. 3. Physical Consequences: Each eating disorder has specific physical consequences associated with it. For example, anorexia nervosa can lead to severe weight loss, nutritional deficiencies, and organ damage. Bulimia nervosa can result in electrolyte imbalances, dental issues, and gastrointestinal problems. Binge eating disorder can lead to obesity and related health problems. These considerations, along with others such as cultural influences, social factors, and comorbid conditions, are important in making accurate distinctions between different eating disorders and guiding appropriate treatment interventions. 98. How does DSM-IV suggest that bulimia nervosa be subtyped? Describe the ways these subtypes compensate for binge eating. Answer: In DSM-IV, bulimia nervosa can be subtyped based on the methods individuals use to compensate for binge eating episodes. The subtypes are: 1. Purging Type: Individuals with this subtype regularly engage in self-induced vomiting or the misuse of laxatives, diuretics, or enemas to compensate for binge eating episodes. 2. Non-Purging Type: Individuals with this subtype use other inappropriate compensatory behaviors to prevent weight gain, such as fasting or excessive exercise, but do not regularly engage in purging behaviors. These subtypes reflect the different ways individuals with bulimia nervosa attempt to control their weight and shape following a binge eating episode. The purging type relies on purging behaviors, such as vomiting, to eliminate calories consumed during a binge. In contrast, the non-purging type uses other methods, such as fasting or excessive exercise, to compensate for overeating. It's important to note that these subtypes are based on specific compensatory behaviors and do not necessarily reflect the severity or overall presentation of bulimia nervosa. Individuals with bulimia nervosa may also engage in a combination of purging and non-purging behaviors, and the specific behaviors used can vary over time. 99. Briefly describe the developmental course and prognosis of anorexia and bulimia. Answer: The developmental course and prognosis of anorexia nervosa and bulimia nervosa can vary depending on individual factors, such as severity of the disorder, presence of comorbid conditions, and response to treatment. However, there are some general trends that can be observed: Anorexia Nervosa: • Developmental Course: Anorexia nervosa typically begins in adolescence or young adulthood, with the onset often triggered by a desire to lose weight or control body shape. It is characterized by extreme calorie restriction, fear of gaining weight, and distorted body image. • Prognosis: The prognosis for anorexia nervosa can vary. Some individuals recover fully with appropriate treatment, while others may experience a chronic course with periods of relapse and remission. Severe cases of anorexia nervosa can be life-threatening due to medical complications such as malnutrition and organ damage. Bulimia Nervosa: • Developmental Course: Bulimia nervosa often begins in late adolescence or early adulthood. It is characterized by recurrent episodes of binge eating followed by compensatory behaviors, such as self-induced vomiting or misuse of laxatives. • Prognosis: The prognosis for bulimia nervosa is generally more favorable than for anorexia nervosa. With appropriate treatment, many individuals are able to achieve full or partial remission from symptoms. However, some individuals may experience a chronic course with periods of symptom exacerbation. Overall, early detection and intervention are key to improving the prognosis for both anorexia nervosa and bulimia nervosa. Treatment typically involves a combination of psychotherapy, nutritional counseling, and, in some cases, medication. Ongoing monitoring and support are often necessary to prevent relapse and promote long-term recovery. 100. Describe some evidence that supports "cultural" influences in the development of eating disorders in young girls. Answer: There is significant evidence to support the role of cultural influences in the development of eating disorders in young girls. Some key points include: 1. Media Influence: Studies have shown that exposure to thin-ideal media images, which promote a thin body ideal as the standard of beauty, is associated with body dissatisfaction and disordered eating behaviors in young girls. This phenomenon is particularly evident in Western cultures where thinness is often equated with beauty and success. 2. Cultural Norms: Cultural norms and values regarding body image and weight can also contribute to the development of eating disorders. In cultures where thinness is idealized and valued, individuals may feel pressure to conform to this standard, leading to body dissatisfaction and disordered eating behaviors. 3. Family Influence: Family attitudes and behaviors related to food, weight, and body image can impact the development of eating disorders in young girls. For example, parental comments about weight or appearance can contribute to body dissatisfaction and disordered eating behaviors. 4. Peer Influence: Peers can also play a significant role in shaping body image and eating behaviors. Pressure to conform to peer norms regarding body size and shape can contribute to the development of eating disorders in young girls. 5. Cultural Changes: Sociocultural changes, such as increased urbanization, globalization, and exposure to Western ideals of beauty through media and technology, can impact cultural norms and values related to body image and eating behaviors. Overall, the evidence suggests that cultural influences, including media, cultural norms, family, and peers, play a significant role in the development of eating disorders in young girls. Understanding these influences is crucial for developing effective prevention and intervention strategies. 101. How has the research by McCabe and Ricciardelli provided new insight into weight and shape concerns in young men? Answer: Research by McCabe and Ricciardelli has provided new insights into weight and shape concerns in young men by highlighting the following key points: 1. Prevalence: Their research has shown that weight and shape concerns are not limited to females and that a significant number of young men also experience dissatisfaction with their bodies. This challenges the traditional notion that body image issues are primarily a female concern. 2. Factors Influencing Body Image: McCabe and Ricciardelli's research has identified several factors that contribute to body image concerns in young men, including media influences, peer pressure, and internalization of cultural ideals of masculinity. 3. Impact of Body Image Concerns: Their research has highlighted the negative impact of body image concerns on young men's mental health and well-being. Body dissatisfaction in young men has been linked to depression, low self-esteem, and disordered eating behaviors. 4. Need for Gender-Specific Interventions: Their findings suggest that interventions aimed at addressing body image concerns in young men need to be tailored to their specific needs and experiences. This includes challenging traditional notions of masculinity that equate thinness with femininity and promoting positive body image ideals for men. Overall, McCabe and Ricciardelli's research has shed light on the importance of addressing body image concerns in young men and has contributed to a growing awareness of the need for gender-specific approaches to body image interventions. Test Bank for Abnormal Child and Adolescent Psychology Rita Wicks-Nelson, Allen C. Israel 9781317351344, 9780205036066, 9780205901128