9. Eating Disorders and Sleep-Wake Disorders Multiple-Choice Questions 1. Which person is most likely to develop an eating disorder? A. a 28-year-old female corporate attorney B. a 16-year-old high school male cheerleader C. an 18-year-old female who just entered college D. a 21-year-old male member of a heavy metal band Answer: C 2. An eating disorder characterized by abnormally low weight and an intense fear of gaining weight is ______. A. binge-eating disorder B. identity disorder C. anorexia nervosa D. bulimia nervosa Answer: C 3. An eating disorder characterized by recurrent binge eating followed by self-induced purging is ______. A. binge-eating disorder B. identity disorder C. anorexia nervosa D. bulimia nervosa Answer: D 4. A(n) ______ is a psychological disorder characterized by disturbed patterns of eating and maladaptive ways of controlling weight. A. addiction B. eating disorder C. amenorrhea D. hypermenorrhea Answer: B 5. Eating disorders are often accompanied by the following disorders EXCEPT ______. A. schizophrenia B. depression C. anxiety disorders D. substance abuse disorders Answer: A 6. There are ______ major types of eating disorders. A. two B. four C. six D. eight Answer: A 7. Anorexia nervosa and bulimia nervosa usually begin in ______. A. childhood B. adolescence C. young adulthood D. middle adulthood Answer: B 8. Which of the following people is most likely to develop bulimia nervosa? A. an adolescent male B. an adolescent female C. an adult male D. an adult female Answer: B 9. About ______ percent of females in the United States develop anorexia nervosa. A. 1 B. 5 C. 10 D. 20 Answer: A 10. Between ______ percent of females in the United States develop bulimia nervosa. A. 1 and 3 B. 1 and 3 C. 5 and 10 D. 10 and 15 Answer: B 11. About ______ in 1,000 males in the United States develop anorexia nervosa. A. 1 B. 3 C. 5 D. 7 Answer: B 12. Anorexia nervosa is ______ common among men than women. Bulimia nervosa is ______ common among men than women. A. less, less B. less, more C. more, less D. more, more Answer: A 13. Felicia has an intense fear of being overweight. She also has a distorted body image in which she sees herself as “fat” despite the fact that her physician says she underweight for her height, age, and bone structure. She exercises excessively and still diets despite being 15 pounds lighter than her original dieting goal. She is suffering from ______. A. amenorrhea B. bulimia nervosa C. anorexia nervosa D. cytomegalovirus Answer: C 14. Fear of gaining weight and a distorted self-image are characteristic of ______. A. anorexia nervosa B. bulimia nervosa C. binge-eating disorder D. binge-purge disorder Answer: A 15. In the case of anorexia nervosa in the text, Karen spent hours a day ______. A. speaking on the cell phone to her therapist in another city B. preparing gourmet meals for her family C. thinking about cutting her arm D. trying to figure out ways to attract a certain guy Answer: B 16. In the case of anorexia nervosa in the text, Karen wore ______. A. gaudy earrings and hats to distract people from looking at her figure B. skimpy outfits to show off her slimness C. padded bras to compensate for her small breasts D. baggy clothes to hide her body Answer: D 17. Anorexia nervosa develops most commonly between the ages of ______. A. 6 and 12 B. 12 and 18 C. 18 and 24 D. 24 and 30 Answer: B 18. A frequent observation is that girls with anorexia nervosa use ______ in addition to dieting to control their weights. A. excessive exercise B. amphetamines C. meals rich with fruit and vegetables D. positive imagery of their ideal figures Answer: A 19. Which activity has been associated with higher rates of anorexia among its participants for developing anorexia nervosa? A. attending college B. modeling C. instrumental music D. singing Answer: B 20. The decreased food consumption noted with anorexia can lead to _________. A. overproductive oil glands and acne B. increased thirst C. obstruction or paralysis of the bowels or intestines D. testosterone increases in females resulting in facial hair growth. Answer: C 21. Which of the following is true regarding anorexia nervosa? A. Young girls with anorexia nervosa starve themselves in an attempt to look more masculine. B. Women with anorexia nervosa have little difficulty adjusting to college life and living independently. C. People with anorexia nervosa see themselves as “too fat” despite having dangerously low body weight. D. People with anorexia nervosa eat very little because they have lost their appetite for food. Answer: C 22. The rate of suicide attempts in young women with anorexia nervosa is _____ that of young women in the general population. A. about the same as B. much lower than C. much higher than D. difficult to determine when compared to Answer: C 23. Binge-eating/purging type and restrictive type are two classifications of ______. A. bulimia nervosa B. anorexia nervosa C. binge-eating disorder D. binge-purge disorder Answer: B 24. There are ______ general subtypes of anorexia nervosa. A. two B. four C. six D. eight Answer: A 25. Annette suffers from recurrent episodes of gorging on large quantities of food followed by purging through self-induced vomiting in order to prevent gaining weight. Although her weight is well below normal to the point that others see her as “skin and bones,” she worries excessively about being fat. She also has impulse control problems in other areas of her life. She is suffering from ______. A. binge-eating/purging anorexia B. restrictive anorexia C. bulimia nervosa D. binge-eating disorder Answer: A 26. Lois has an intense fear of being overweight. Although she talks a lot about food, she hardly eats at all. She also has a distorted body image in which she sees herself as "fat" despite the fact that her physician says she is 20% underweight for her height, age, and bone structure. She exercises excessively and still rigidly and obsessively diets despite being 15 pounds lighter than her original dieting goal. She is suffering from ______. A. binge-eating/purging anorexia nervosa B. restrictive anorexia nervosa C. bulimia nervosa D. binge-eating disorder Answer: B 27. Which of the following characteristics are noted in people with the eating/purging type of anorexia nervosa? A. a consistently cautious, conservative lifestyle B. careful control of eating C. obsessively controlled appearance D. substance abuse and/or stealing Answer: D 28. People with anorexia nervosa may lose as much as ______ percent of their original weight. A. 25 B. 35 C. 45 D. 55 Answer: B 29. The absence or suppression of menstruation is called ______. A. dysmenorrhea B. hypomenorrhea C. hypermenorrhea D. amenorrhea Answer: D 30. All of the following are medical complications that can result from anorexia nervosa EXCEPT ______. A. osteoporosis B. high blood pressure C. amenorrhea D. heart irregularities Answer: B 31. Amenorrhea refers to the ______, which is a symptom of anorexia. A. absence or suppression of menstruation B. yellow coloring C. fine, downy hair D. brittle bones Answer: A 32. You meet a slender girl with a yellow hue to her rather dry, cracking skin; she has fine, downy hair. With this appearance, you suspect that she may have ______. A. anorexia nervosa B. bulimia nervosa C. binge eating disorder D. ulcers Answer: A 33. Bous, the Greek word which is the root for bulimia, means ______. A. hunger B. ox C. gigantic D. nerves Answer: B 34. Diane suffers from recurrent episodes of gorging on large quantities of food followed by purging through self-induced vomiting in order to prevent gaining weight. Although her weight is normal, and her ideal weight is relatively normal, she worries excessively about looking or becoming fat. She is suffering from ______. A. amenorrhea B. anorexia nervosa C. bulimia nervosa D. cytomegalovirus Answer: C 35. Hayley suffers from recurrent episodes of gorging on large quantities of food followed by purging through self-induced vomiting in order to prevent gaining weight. Although her weight is normal, and her ideal weight is relatively normal, she worries excessively about looking or becoming fat. She is suffering from ______. A. binge-eating/purging anorexia B. restrictive anorexia C. bulimia nervosa D. binge-eating disorder Answer: C 36. The average age of onset for bulimia nervosa is the ______. A. childhood to preteens B. early to mid-teens C. late adolescence to early adulthood D. early adulthood to mid-adulthood. Answer: C 37. Which of the following is one of the DSM diagnostic criteria for bulimia nervosa? A. Emphasis on a healthy appearing body. B. Regular purging by means of laxatives, fasting, self-induced vomiting, or strenuous exercise. C. In females, the absence of three or more consecutive menstrual periods. D. Nonchalance about weight and body appearance. Answer: B 38. The available evidence shows ______. A. poor women are most likely to develop eating disorders B. middle-class women are most likely to develop eating disorders C. upper-class women are most likely to develop eating disorders D. no strong linkage between socioeconomic status and eating disorders Answer: D 39. Which of the following is a medical complication related to bulimia nervosa? A. diabetes B. disturbed menstrual function C. damage to vision D. increased sensitivity to vomit Answer: D 40. The available evidence shows ______ between socioeconomic status and eating disorders. A. a strong relationship B. no strong linkage C. inconclusive evidence D. that when ethnicity is also considered, there is a strong relationship Answer: B 41. A person with bulimia nervosa who repeatedly vomits or abuses laxatives and diuretics puts themselves at risk for ______. A. diabetes B. sudden death C. cancer D. ulcers Answer: B 42. Repeated vomiting or abuse of laxatives can lead to ____________. A. excessive iron in the blood B. a potassium deficiency C. acne D. vitamin B deficiency Answer: B 43. Probably the most important factors in the development of eating disorders such as anorexia nervosa and bulimia nervosa are ______. A. genetic factors that predispose many women to these disorders B. social pressures and expectancies placed on young women to base their self-worth on their appearance C. personal efforts to overcome real problems with eating too much and getting fat D. improperly learned eating behaviors during infancy and early childhood Answer: B 44. Among college women, 1 in ______ were found to feel embarrassed when buying a single chocolate bar. A. 3 B. 5 C. 7 D. 9 Answer: C 45. Girls as young as ______ express more dissatisfaction with their bodies than do boys. A. 8 B. 10 C. 11 D. 12 Answer: A 46. A standard measure of overweight and obesity that takes both body weight and height into account is the _____. A. WAIS B. BMI C. WISC D. BMW Answer: B 47. The BMI takes ______ into account. A. only weight B. only weight and age C. weight and height D. weight and lifestyle Answer: C 48. ______ out of five young women in the United States have gone on a diet by the time they reach their 18th birthdays. A. One B. Two C. Three D. Four Answer: D 49. A study of the mass body index of ______ between 1920 and 1990 shows a clear trend towards the idealization of thinness in women. A. winners of the Oscar for best actress B. winners of the Olympic gold medal in diving C. first ladies of the United States D. Miss America pageant winners Answer: D 50. Women with bulimia tend to be ______. A. shy and have few close friends B. shy but have several close friends C. outgoing, but have few close friends D. outgoing and have many close friends Answer: A 51. Women with bulimia nervosa are more likely than other women to have experienced ______. A. date or acquaintance rape B. sexual harassment C. abrupt weaning from the breast or bottle D. childhood sexual or physical abuse Answer: D 52. Which of the following statements is true regarding women with bulimia nervosa? A. They have flexible attitudes. B. They never dieted prior to the onset of bulimia. C. They have “black and white” thinking. D. They were of normal weight prior to developing bulimia. Answer: C 53. Purging is ______ because it produces relief from anxiety over gaining weight. A. classically conditioned B. positively reinforced C. modelled D. negatively reinforced Answer: D 54. Women with bulimia nervosa tend to be both perfectionistic and ______ in their thinking patterns. A. moderate B. dichotomous C. conservative D. liberal Answer: B 55. Psychodynamic theorists view anorexia nervosa as ______. A. a type of weight phobia B. the result of the daughter's faulty identification with her mother C. an unconscious effort to remain a prepubescent child D. a method of punishing overprotective, smothering parents Answer: C 56. Families of young women with eating disorders tend to be ______ supportive and nurturing and _______ overprotective than those of young women without eating disorders. A. less, less B. less, more C. more, less D. more, more Answer: B 57. Systems theorists view anorexia nervosa as ______. A. a type of weight phobia B. an effort to remain a prepubescent child C. a method used by the anorexic for diverting family attention away from marital tensions and family conflict onto themselves D. a method for punishing overdemanding, manipulative parents Answer: C 58. The text refers to an article, “______ and Fat as a Feminist Issue,” in discussing a controversy about societal causes of eating disorders. A. Princess Diana B. Mary Kate Olson C. Barbie D. Britney Spears Answer: C 59. The Barbie doll was designed to fit an idealized ______ fantasy of the female form. A. childhood B. feminine C. 16th century D. male Answer: D 60. Interest in the biological underpinnings of eating disorders, especially bulimia nervosa, has largely focused on the role of the neurotransmitter ______. A. serotonin B. dopamine C. epinephrine D. acetylcholine Answer: A 61. Prozac and Zoloft appear to ______ episodes in patients with bulimia nervosa. A. decrease binge-eating B. increase binge-eating C. decrease purging D. increase purging Answer: A 62. Studies of twins have found ______ for a genetic component to anorexia nervosa and ______ for a genetic component to bulimia nervosa. A. no evidence, no evidence B. support, no evidence C. evidence, no support D. evidence, evidence Answer: D 63. The diathesis stress model views eating disorders as primarily ______. A. a type of weight phobia B. an effort to remain a prepubescent child C. genetically inherited tendencies that interact with family and social pressures D. a method of punishing parents for feelings of loneliness and alienation they experience in the home Answer: C 64. Emily is a college freshmen with anorexia nervosa whose weight has been dropping to dangerous, even life-threatening levels. The treatment that Emily needs is ______. A. cognitive behavioral B. behavioral C. interpersonal therapy D. hospitalization Answer: D 65. The specific behavioral techniques widely used for successfully reducing episodes of self-induced vomiting in cases of bulimia nervosa are ______. A. exposure with response prevention B. chain-breaking and response cost C. negative reinforcement and cue-controlled relaxation D. systematic desensitization and response cost Answer: A 66. ______ therapy is an alternative for treating bulimia when cognitive-behavioral treatment fails. A. Psychoanalytic B. Interpersonal C. Behavioral D. Person-centred Answer: B 67. Antidepressant drugs such as Prozac have shown _______ results in treating bulimia nervosa and _______ results in treating anorexia nervosa A. effective; effective B. effective; mixed C. mixed; effective D. mixed; mixed Answer: B 68. Obesity is classified as a ______. A. medical condition B. psychological disorder C. sociocultural disorder D. developmental disorder Answer: A 69. Obesity puts individuals at risk for which of the following? A. some forms of cancer B. Alzheimer’s Disease C. liver disease D. Grave’s Disease Answer: A 70. About ______ percent of American adults are clinically obese. A. 10 B. 13 C. 23 D. 33 Answer: D 71. About ______ of Americans are overweight. A. one-third B. one-half C. two-thirds D. three-fourths Answer: C 72. One in ______ American children and teens are either overweight or obese. A. two B. three C. five D. seven Answer: B 73. Obesity accounts for an estimated ______ excess deaths in the United States each year. A. 160,000 B. 260,000 C. 360,000 D. 560,000 Answer: A 74. Experts estimate that obesity decreases a person life span by ______ years. A. 2-3 B. 6-7 C. 10-12 D. 16-18 Answer: B 75. Americans today average ______ more calories per day than 30 years ago. A. 175 B. 350 C. 530 D. 680 Answer: C 76. According to the text, the key to preventing obesity is ______. A. avoiding carbohydrates B. matching energy expenditure with caloric intake C. keeping a daily weight chart D. avoiding fast food restaurants Answer: B 77. As dieters lose large amounts of weight and attempt to keep it off, their bodies ______. A. stop burning calories B. burn fewer calories than their pre-diet rate C. continue to burn calories at their pre-diet rate D. burn more calories than their pre-diet rate Answer: B 78. When you lose weight beyond a genetically determined set point, your body responds by ______. A. slowing down your metabolism B. stabilizing your metabolism C. increasing your metabolism D. causing your metabolism to fluctuate Answer: A 79. The slowing of metabolism associated with dieting could be offset by ________. A. using diet pills as a supplement B. periodic indulgences of desserts C. a vigorous exercise program D. multivitamins Answer: C 80. Fat cells are ______. A. corpulent cells B. excess epidermal cells C. adipose tissue D. striated tissue Answer: C 81. Adipose tissue is comprised of cells that ______. A. burn fructose B. attack infectious agents C. support the skeletal structure D. store fat Answer: D 82. The brain structure that signals when we are hungry is the ______. A. pituitary gland B. thalamus C. hippocampus D. hypothalamus Answer: D 83. Which of the following is true about obesity? A. Obese people have about the same amount of adipose tissue than normal weight people. B. People with higher levels of adipose tissue feel hungry sooner than other people, even with similar levels of food intake. C. Adipose tissue metabolizes food more rapidly than muscle tissue. D. Dieting eliminates large numbers of fat cells. Answer: B 84. A “big gulp” 64-ounce non-diet soft drink contains ______ calories. A. 400 B. 550 C. 700 D. 800 Answer: D 85. After Santa Claus, the character recognized by most children is ______. A. Barbie B. Ronald McDonald C. The Rock D. Big Bird Answer: B 86. According to psychodynamic theory, obese people are fixated in the ______ stage. A. oral B. anal C. phallic D. genital Answer: A 87. Psychodynamic theorists would expect orally fixated people to have specific conflicts concerning ______. A. endurance B. dreams C. achievement D. independence Answer: D 88. Overeating in orally fixated people would likely be triggered by ______. A. reminders of the Oedipus complex B. sexual intercourse C. stress D. nightmares Answer: C 89. Obesity is highest among people of ______ socioeconomic status. A. low B. middle C. upper middle D. upper Answer: A 90. Albert weighs about forty percent more than his ideal body weight. He is most likely to be in which socioeconomic group? A. upper class B. upper-middle class C. lower-middle class D. lower class Answer: D 91. Which of the following people is at highest risk of being obese? A. a wealthy African American male B. a poor Native American female C. a poor non-Hispanic White male D. a wealthy Hispanic female Answer: B 92. Which of the following people is at lowest risk of being obese? A. a poor African American male B. a poor Native American female C. a wealthy non-Hispanic White male D. a wealthy Hispanic female Answer: C 93. Which of the following statements is true? A. Poorer people turn to religion to cope with the stress of living in the inner city. B. Poorer people exercise more regularly than more affluent people because they must walk everywhere they go. C. Poorer people have more access to information regarding health care but choose not to read it. D. Poorer people have less access to health care. Answer: B 94. What is the prevalence of obesity in Japanese American men compared to men living in Japan? A. equal B. two to three times higher in Japanese Americans C. two to three times higher in men living in Japan D. only 1.5 times higher in men living in Japan if sumo wrestlers are excluded Answer: B 95. Which of the following groups of women show the lowest rates of obesity? A. non-Hispanic White women B. African American women C. Hispanic American women D. There are no differences in rates of obesity among non-Hispanic White women, African American women, and Hispanic-American women. Answer: A 96. Which of the following groups of women show the highest rates of obesity? A. non-Hispanic White women B. African American women C. Hispanic American women D. There are no differences in rates of obesity among non-Hispanic White women, African American women, and Hispanic-American women. Answer: B 97. What is the percentage of people who regain weight they lose after dieting? A. 40 B. 50 C. 70 D. 90 Answer: D 98. The therapeutic approach MOST supported by research in treating bulimia nervosa is ______ therapy. A. traditional psychoanalysis B. family-ecological C. cognitive-behavioral D. sociocultural Answer: C 99. People who have recurrent eating binges but do not purge most likely have ______. A. anorexia nervosa B. bulimia nervosa C. binge-eating disorder D. binge-purge eating disorder Answer: C 100. A person who has a binge-eating disorder may demonstrate which of the following? A. a history of unsuccessful attempts at losing weight B. a history of childhood sexual abuse C. evidence of binge-eating once a month D. a history of laxative abuse Answer: A Diff: 2 Page: 349 101. Binge-eating disorder is closely related to ______. A. being severely underweight B. a history of binging and purging C. obesity and severe obesity D. hypochondriasis Answer: C 102. Phyllis is 28 years old. She is obese and describes herself as a “compulsive overeater.” She has a history of depression and unsuccessful attempts at weight loss. While she has repeated episodes of binge eating, she does not purge herself of the excess food afterwards. Her symptoms sound most typical of someone with ______. A. binge-eating/purging anorexia B. restrictive anorexia C. bulimia nervosa D. binge-eating disorder Answer: D 103. People with ______ are described as compulsive overeaters. A. anorexia nervosa B. bulimia nervosa C. binge-eating disorder D. binge-purging disorder Answer: C 104. Cognitive-behavioral techniques and ______ have been successful in treating binge-eating disorder. A. antidepressants B. psychodynamic therapy C. humanistic therapy D. family therapy Answer: A 105. The DSM-5 uses use the term sleep-wake disorders instead of the earlier DSM diagnostic erm, sleep disorders, in order to underscore ____________. A. that sleep problems affect daytime alertness and functioning B. the problems identified in this classification occur during sleep or at the threshold between sleep and wakefulness C. the need to understand the balance of circadian rhythms D. how important good sleep is to psychological adjustment Answer: B 106. Andy went to a sleep centre where he spent the night wired to devices that tracked his physiological (brain waves, heart and respiration rates) responses while he slept. The assessment Andy underwent is called a _______________. A. polysomnographic (PSG) recording B. an electro encephalo cardiogram sleep study C. a sleep stress assessment D. a delta wave assessment Answer: A 107. Polysomnographic recording is used to help diagnose ______. A. eating disorders B. asthma C. sleep disorders D. cardiovascular disorders Answer: C 108. Which of the following is a physiological response measure buy a polysomnographic recording? A. blood sugar levels B. stomach acid production C. galvanic skin response D. eye movements Answer: D 109. Sleep problems have a major economic impact, accounting for more than ________ sick days among the nation’s workers. A. 100 million B. 100, 000 C. 250 million D. 500 million Answer: C 110. People with ______ have difficulty falling asleep or remaining asleep, or achieving restorative sleep. A. insomnia disorder B. narcolepsy C. cataplexy D. primary hypersomnia Answer: A 111. A sleep disorder characterized by chronic or persistent insomnia, not caused by another psychological or physical disorder or by the effects of drugs or medication, is ______. A. primary hypersomnia B. circadian-rhythm sleep disorder C. insomnia disorder D. cataplexy Answer: C 112. In terms of types of sleep problems, older people are more likely to complain of ________ while younger people complain more about ____________. A. waking frequently during the night; taking too long to get to sleep B. taking too long to get to sleep; waking frequently during the night C. aches and pains while they sleep; having too much wakeful energy at bedtime D. needing to go to the bathroom during the night; sleeping too long and too soundly Answer: A 113. The most commonly occurring sleep disorder is ______. A. hypersomnia B. sleep apnea C. narcolepsy D. insomnia disorder Answer: D 114. Insomnia disorder primarily affects ______. A. children B. adolescents C. young adults D. people over 40 Answer: D 115. Insomnia disorder applies to cases of ______. A. sporadic or occasional insomnia that last for no more than a few days at a time B. sporadic cases of occasional insomnia that recurs every few months C. persistent insomnia that can be accounted for by other psychological or physical disorders, or the effects of medicine D. persistent insomnia that cannot be accounted for by other psychological or physical disorders, or the effects of medicine Answer: D 116. The development of chronic insomnia is best explained by principles of ______. A. social learning B. classical conditioning C. operant conditioning D. psychodynamic theory Answer: B 117. A pattern of excessive sleepiness during the day that continues for a period of a month or longer is called ______. A. sleep apnea B. narcolepsy C. cataplexy D. hypersomnolence disorder Answer: D 118. "Sleep drunkenness" refers to ______. A. primary insomnia B. narcolepsy C. sleepwalking disorder D. hypersomnolence disorder Answer: D 119. Hypersomnolence disorder afflicts between ______ of the population. A. 1–2% B. 2–4% C. 5–10% D. 15–20% Answer: A 120. A disorder in which people suddenly fall asleep without warning at various times during the day is called ______. A. primary hypersomnia B. apnea C. cataplexy D. narcolepsy Answer: D 121. People typically sleep about ______ during a narcolepsy attack. A. 2 to 3 minutes B. 15 minutes C. 2 to 3 hours D. 6 to 8 hours Answer: B 122. Narcolepsy is diagnosed when attacks occur for a period of ______ or longer. A. 3 months B. 6 months C. 9 months D. 12 months Answer: A 123. People with narcolepsy go immediately into ______ sleep during a narcoleptic attack. A. stage 1 B. stage 2 C. stage 4 D. REM sleep Answer: D 124. Cataplexy is a key feature of ______. A. primary hypersomnia B. primary insomnia C. narcolepsy D. apnea Answer: C 125. Cataplexy typically follows ______. A. periods of prolonged sleep B. strong emotional reactions C. periods of intense concentration D. periods of deep relaxation Answer: B 126. A disorder involving a sudden loss of muscular control is called ______. A. sleep paralysis B. sleep apnea C. cataplexy D. primary hypersomnia Answer: C 127. People afflicted with narcolepsy often experience which of the following? A. high blood pressure B. obstructive sleep apnea C. sleep paralysis D. auditory hallucinations Answer: C 128. Narcolepsy with cataplexy affects between ______ out of 10,000 people in the general population. A. 1 and 2 B. 2 and 4 C. 16 and 32 D. 32 and 48 Answer: B 129. Narcolepsy affects ______. A. men and women equally B. men more than women C. women more than men D. young men and older women more than older men and younger women Answer: A 130. Which of the following is true of narcolepsy? A. Narcoleptic attacks are preceded by an aura. B. Narcoleptics typically have a history of asthma or panic disorder. C. Household accidents resulting from falls are common in people who have narcolepsy. D. Narcolepsy is related to a lack of adequate sleep during the night. Answer: C 131. The common type of breathing-related sleep disorder is ______. A. narcolepsy B. obstructive sleep apnea C. primary hypersomnia D. sleep paralysis Answer: B 132. A disorder involving complete or partial obstruction of breathing during sleep is ______. A. narcolepsy B. cataplexy C. obstructive sleep apnea D. hypersomnia Answer: C 133. Which of the following people is MOST likely to have obstructive sleep apnea? A. a 25-year-old male B. a 25-year-old female C. a 45-year-old male D. a 45-year-old female Answer: C 134. Which of the following people is MOST likely to have obstructive sleep apnea? A. a normal weight male B. a normal weight female C. an obese male D. an obese female Answer: C 135. Obstructive sleep apnea is related to which of the following? A. diabetes B. schizophrenia C. hypertension D. epilepsy Answer: B 136. Which of the following is true of obstructive sleep apnea? A. Its occurrence increases as people age, up until around the age of 30 years. B. A sufferer may stop breathing several hundred times during the night without knowing it. C. It is more common in women than in men. D. Many of the sufferers had asthma during childhood. Answer: B 137. A circadian rhythm lasts about ______ hours. A. 6 B. 12 C. 24 D. 48 Answer: C 138. A 24-hour rhythm is known as a(n) ______ rhythm. A. ultradian B. infradian C. circadian D. meridian Answer: C 139. ______ sleep-wake disorder involves a mismatch between the sleep schedule demands of the person's environment and the person's internal sleep-wake cycle. A. Circadian rhythm B. Obstructive apnea C. Narcoleptic D. Night terrors Answer: A 140. Which of the following is true of circadian rhythm sleep-wake disorder? A. It is synonymous with “jet lag.” B. It can lead to the development of hypertension. C. It can indirectly result from frequent changes in time zones and work shifts. D. It appears to have a genetic base. Answer: C 141. Disorders involving abnormal behaviors or physiological events taking place during sleep or during the threshold between wakefulness and sleep are called ______. A. Parasomnias B. Mesosomnias C. Endosomnias D. Dyssomnias Answer: A 142. Which of the following is a parasomnia? A. arousal disorder B. narcolepsy C. circadian rhythm sleep disorder D. delayed sleep phase preference Answer: C 143. Intense episodes, usually among children, of sitting up during deep sleep, appearing frightened, showing signs of extreme arousal, talking, thrashing wildly, but remaining asleep, and remembering nothing of the episode the next morning are typical of ______. A. nightmare disorder B. sleep terror disorder C. circadian rhythm sleep disorder D. sleepwalking disorder Answer: B 144. Sleep terrors are ______ intense than nightmares and usually occur in ______ sleep. A. less, non-REM B. more, non-REM C. less, REM D. more, REM Answer: B 145. Sleep terror disorder affects more ______ and is usually outgrown during ______. A. boys, childhood B. girls, childhood C. boys, adolescence D. girls, adolescence Answer: C 146. Which of the following people is most likely to have sleep terror disorder? A. a male child B. a female child C. a male adult D. a female adult Answer: A 147. Sleep terror disorder afflicts between ______ percent of children. A. 1 and 6 B. 6 and 11 C. 11 and 16 D. 16 and 21 Answer: A 148. Sleep terror disorder afflicts about ______ percent of adults. A. 2 B. 5 C. 10 D. 20 Answer: A 149. Repeated episodes in which a sleeper arises from bed and walks around the house while remaining fully asleep are typical of ______. A. nightmare disorder B. sleep terror disorder C. circadian rhythm sleep disorder D. sleepwalking disorder Answer: D 150. Which of the following is true of sleepwalking episodes? A. They tend to occur during the first stages of sleep. B. They appear to involve the enactment of a dream. C. They are more common in adults than in children. D. Repeated episodes can cause significant personal distress. Answer: D 151. Which of the following is true of sleepwalking? A. It appears to be caused by an overactive reticular activating system in the brain. B. It is dangerous to wake a sleepwalker. C. When they awaken the next morning, sleepwalkers typically have little, if any, memory of the sleepwalking episode. D. Sleepwalkers often recall vivid contents of a dream if awakened while sleepwalking. Answer: C 152. Sleepwalking disorder afflicts between ______ percent of children. A. 1 and 5 B. 6 and 10 C. 11 and 15 D. 16 and 20 Answer: A 153. ______ involves repeated episodes of acting out one’s dreams during REM sleep in the form of vocalizing parts of the dream or thrashing about. A. Nightmare disorder B. Sleep terror disorder C. Rapid eye movement sleep behavior disorder D. Sleepwalking disorder Answer: C 154. ______ involves recurrent awakenings from sleep because of frightening dreams. A. Nightmare disorder B. Sleep terror disorder C. Circadian rhythm sleep disorder D. Sleepwalking disorder Answer: A 155. ______ of the adult population experiences intense nightmares that could be diagnosed as nightmare disorder. A. It is unknown as to what percentage B. Less than one percent C. Ten percent D. Five percent Answer: A 156. Nightmares are associated with ______. A. lack of exercise B. eating too much before going to bed C. traumatic experiences D. depletion of serotonin Answer: C 157. __________ is associated with nightmares. A. Lack of exercise B. Eating too much before going to bed C. Stress D. Depletion of dopamine Answer: C 158. Nightmares occur during ______ sleep. A. stage 1 B. stage 2 C. stage 4 D. REM Answer: D 159. REM sleep periods become ______ and dreams become ______ intense during the latter half of sleep. A. shorter, less B. longer, less C. shorter, more D. longer, more Answer: D 160. The most common method of treating sleep disorders in the United States is through ______. A. behavior modification techniques B. psychosurgical techniques C. sleep medications D. stress-reduction techniques Answer: C 161. Sleep medications used to combat sleep disorders are most often ______. A. antianxiety drugs B. antidepressant drugs C. major tranquilizers D. analgesics Answer: A 162. Sleep medications primarily work by increasing the activity of ______. A. serotonin B. GABA C. norepinephrine D. acetylcholine Answer: B 163. Research has found that when used for the short-term treatment of insomnia, sleep medications do which of the following? A. increase the amount of REM sleep B. increase dopamine production in the brain C. increase respiration rate D. increase the total length of sleep Answer: D 164. Which of the following is a problem associated with the use of tranquilizers to combat Insomnia? A. Tranquilizers tend to increase REM sleep. B. Tranquilizers may reduce the amount of GABA available in the brain. C. Tranquilizers can cause night sweats. D. Tranquilizers can result in rebound insomnia following discontinuation of the drug. Answer: D 165. Regular use of drugs such as benzodiazepines to combat insomnia lead to ______. A. neither tolerance nor dependence B. tolerance, but not dependence C. dependence, but not tolerance D. tolerance and dependence Answer: D 166. Regular use of prescription sleep medications produces ______. A. neither physiological nor psychological dependence B. physiological, but not psychological, dependence C. psychological, but not physiological, dependence D. both physiological and psychological dependence Answer: D 167. Stimulants are often used to treat people with ______. A. sleepwalking disorder B. narcolepsy C. primary insomnia D. sleep terror disorder Answer: B 168. Psychological approaches to treating sleep disorders have been largely limited to treating ______. A. primary hypersomnia B. sleepwalking disorder C. insomnia disorder (primary insomnia) D. night terror disorder Answer: C 169. The type of psychological approach which has become predominant in the treatment of sleep disorders is ______. A. social learning therapy B. cognitive-behavior therapy C. psychoanalysis D. humanistic therapy Answer: B 170. The psychological intervention for primary insomnia that has been used to treat it most successfully is ______ therapy. A. psychodynamic B. humanistic C. cognitive-behavioral D. Gestalt Answer: C 171. A behavioral technique for combating insomnia that involves changing the environment associated with sleeping is known as ______. A. rational restructuring B. response cost C. aversive conditioning D. stimulus control Answer: D 172. To combat her insomnia, Nichole decides to stop using her bed for any other activities (such as reading, eating, or tossing and turning, etc.). From now on she will use it only for sleeping, and she will limit the time she spends in bed trying to fall asleep to no more than 10 to 20 minutes at a time. Her approach is typical of ______. A. rational restructuring B. response cost C. aversive conditioning D. stimulus control Answer: D 173. A cognitive technique for substituting logical, sensible alternatives for self-defeating, maladaptive thoughts or beliefs is ______. A. rational restructuring B. response cost C. aversive conditioning D. stimulus control Answer: A 174. Which of the following is a recommended technique to help you fall asleep better at night? A. Go to bed only when you feel sleepy. B. Drink several glasses of wine. C. Exercise late in the evening before bedtime. D. Watch TV or read in bed. Answer: A True-False Questions 175. In a nation of plenty, some people deliberately starve themselves — sometimes to death. Answer: True 176. Anorexia nervosa and bulimia nervosa are becoming increasingly rare in the United States. Answer: False 177. Anorexia nervosa is much more common than bulimia nervosa. Answer: False 178. Anorexia nervosa is far more common in women than in men. Answer: True 179. Though others see them as “skin and bones,” young women with anorexia still see themselves as too fat. Answer: True 180. The addition of body fat associated with puberty is natural in early adolescence. Answer: True 181. Individuals with the binge eating/purging type of anorexia tend to have problems with impulse control. Answer: True 182. Cardiac problem with anorexia can include high blood pressure. Answer: False 183. A person with bulimia typically relies on strenuous exercise as a strategy for purging. Answer: False 184. A DSM-5 diagnosis of bulimia nervosa requires that binge-eating episodes occur at an average frequency of at least once a week for three months. Answer: True 185. Individuals with bulimia nervosa are usually of normal weight. Answer: True 186. Sociocultural theorists believe that media images of ultrathin models and performers increase body dissatisfaction and may lead to disordered eating behavior Answer: True 187. BMI is a measure of waist to weight ratio. Answer: False 188. Eating disorders are less common in non-Western countries that the United States. Answer: True 189. Investigators expect that the prevalence of eating disorders in young women of color will rise with increased exposure to Eurocentric concepts of feminine beauty. Answer: True 190. People with anorexia nervosa may restrict their food intake in a misguided attempt to relieve upsetting emotions by seeking mastery or control over their bodies. Answer: True 191. Childhood sexual abuse is associated with an increased risk of developing bulimia. Answer: True 192. People who struggle with bulimia tend to think in dichotomous or “black or white” terms. Answer: True 193. Most eating disorders develop in nurturing, conflict-free families. Answer: False 194. Drugs used to treat depression may help curb bulimic binges. Answer: True 195. Eating disorders are relatively easy to treat. Answer: False 196. Hospitalization is almost always necessary for the effective treatment of anorexia or bulimia. Answer: False 197. A combination of antidepressants and cognitive-behavior therapy has proven to be the ideal treatment for bulimia. Answer: False 198. Obesity has become a national epidemic. Answer: True 199. Obesity is one of the most common psychological disorders in the United States. Answer: False 200. Around the world, there are as many people overweight as underfed. Answer: True 201. As a result of all the money and effort spent on weight loss products and programs, America’s collective waistlines are stabilizing. Answer: False 202. When you lose weight, your body starts putting the brakes on the rate at which it burns calories. Answer: True 203. Obese people lose fat cells when they diet. Answer: False 204. Obese people have no more fat cells than people who are not obese. Answer: False 205. Poorer people also exercise less regularly than more affluent people do. Answer: True 206. Incidence of obesity is highest among people of lower socioeconomic status. Answer: True 207. Most dieters eventually gain back the weight they lose. Answer: True 208. BED is more common than either anorexia or bulimia. Answer: True 209. Many Americans commonly suffer from sleep attacks in which they suddenly fall asleep without warning. Answer: False 210. Narcolepsy is sometimes referred to as “sleep drunkenness.” Answer: False 211. People with obstructive sleep apnea repeatedly fall asleep without warning. Answer: False 212. Some people literally gasp for breath hundreds of times during sleep without realizing it. Answer: True 213. Most people who have sleep terrors fall back to sleep and remember nothing of them when they awaken. Answer: True 214. Persons with rapid eye movement sleep behavior disorder may suddenly kick or flail their arms, potentially causing injuries to themselves or their bed partner. Answer: True 215. Nightmares generally occur during REM sleep. Answer: True 216. The most common method for treating sleep disorders in the United States is hypnosis. Answer: False 217. There is little evidence of long-term benefits of drug therapy for insomnia after the use of the drugs ceases. Answer: True 218. Psychological approaches have been successfully used to treat every major sleep disorder except insomnia. Answer: False 219. Exercising heavily just before bedtime can help eliminate insomnia. Answer: False Essay Questions 220. Describe the features of anorexia and bulimia and the medical complications associated with each. Answer: Features of Anorexia and Bulimia and Associated Medical Complications Anorexia Nervosa: Anorexia nervosa is characterized by an intense fear of gaining weight and a distorted body image, leading to severe food restriction and weight loss. There are two subtypes: the restricting type and the binge-eating/purging type. Features: • Severe Restriction of Food Intake: Individuals consume very few calories, often following rigid diets and exercising excessively. • Intense Fear of Gaining Weight: Despite being underweight, individuals have a persistent fear of becoming fat. • Distorted Body Image: They see themselves as overweight even when they are dangerously thin. • Amenorrhea: In females, the absence of menstruation is common due to extreme weight loss. Medical Complications: • Cardiovascular Problems: Including bradycardia, hypotension, and arrhythmias. • Bone Density Loss: Leading to osteoporosis and an increased risk of fractures. • Muscle Weakness: Due to malnutrition and lack of protein. • Gastrointestinal Issues: Including constipation and bloating. • Electrolyte Imbalances: Which can cause severe complications, including heart failure. • Lanugo: The growth of fine body hair as the body tries to keep warm. • Infertility: Due to hormonal imbalances. Bulimia Nervosa: Bulimia nervosa involves recurrent episodes of binge eating followed by compensatory behaviors such as vomiting, excessive exercise, or the misuse of laxatives and diuretics. Features: • Binge Eating: Consuming large amounts of food in a short period, often in secret. • Compensatory Behaviors: To prevent weight gain, individuals may induce vomiting, misuse laxatives, fast, or exercise excessively. • Normal Weight Range: Unlike anorexia, individuals with bulimia are usually within a normal weight range or may be slightly overweight. • Preoccupation with Body Shape and Weight: Similar to anorexia, but with more variability in weight. Medical Complications: • Electrolyte Imbalances: Especially hypokalemia, which can lead to cardiac arrhythmias and sudden death. • Gastrointestinal Problems: Including esophagitis, gastroesophageal reflux disease (GERD), and chronic sore throat. • Dental Issues: Such as enamel erosion and tooth decay from frequent vomiting. • Swollen Salivary Glands: Particularly the parotid glands, due to repeated vomiting. • Gastrointestinal Ruptures: Rare but potentially fatal complications like esophageal or gastric rupture. 221. Discuss the causal factors involved with anorexia and bulimia. Answer: Causal Factors Involved with Anorexia and Bulimia Biological Factors: • Genetics: There is evidence of a hereditary component to eating disorders, with a higher prevalence among first-degree relatives. • Neurobiology: Neurotransmitter imbalances, particularly involving serotonin and dopamine, are implicated in eating disorders. Abnormalities in brain regions that regulate hunger and satiety (e.g., hypothalamus) may also play a role. Psychological Factors: • Personality Traits: Perfectionism, obsessive-compulsiveness, and low self-esteem are commonly associated with anorexia and bulimia. • Trauma and Stress: A history of trauma, abuse, or significant life stress can contribute to the development of eating disorders. • Body Image Disturbance: Unrealistic standards of beauty and body image dissatisfaction are central to both disorders. Sociocultural Factors: • Cultural Ideals: Societal pressure to be thin, often perpetuated by media and fashion industries, can contribute to body dissatisfaction and disordered eating behaviors. • Peer Influence: Peer pressure and the desire for social acceptance can lead to dieting and unhealthy weight control practices. Environmental Factors: • Family Dynamics: Families with high levels of conflict, criticism, or overemphasis on appearance and weight may increase the risk of eating disorders. • Dieting and Weight Control Practices: Early dieting and weight control behaviors are significant risk factors, particularly in adolescents. 222. State your opinion and the basis for your opinion on whether or not Barbie should be banned. Answer: Opinion on Whether Barbie Should Be Banned Opinion: Barbie should not be banned, but the brand should continue to evolve to promote diversity and realistic body standards. Basis for Opinion: • Positive Changes: Mattel, the maker of Barbie, has made strides in recent years by introducing dolls with diverse body types, ethnic backgrounds, and careers, promoting a more inclusive and realistic image. • Educational Value: Barbie can serve as a tool for imaginative play and can inspire children to envision diverse futures for themselves. Banning the doll entirely overlooks its potential positive impacts. • Parental Guidance: It is essential for parents to provide context and guidance to children, helping them understand that Barbie is a toy and not a standard to strive for. • Cultural Shift: Rather than banning, continued cultural shifts toward promoting body positivity and diversity in media can mitigate any negative influence Barbie might have. 223. Discuss the treatment of anorexia and bulimia. What methods hold the most promise? Answer: Treatment of Anorexia and Bulimia: Promising Methods Anorexia Nervosa: Treatment Methods: 1. Medical Stabilization: Initial treatment often involves addressing acute medical issues related to malnutrition and stabilizing the patient. 2. Nutritional Rehabilitation: Developing a structured eating plan to restore healthy weight and nutrition. This may involve working with a dietitian. 3. Psychotherapy: • Cognitive-Behavioral Therapy (CBT): Focuses on changing distorted thoughts and behaviors related to food, body image, and self-worth. • Family-Based Therapy (FBT): Particularly effective for adolescents, involving family members in the treatment process to support the individual's recovery. • Interpersonal Therapy (IPT): Addresses underlying interpersonal issues that may contribute to the eating disorder. Promising Methods: • FBT has shown significant success in treating adolescents with anorexia, emphasizing the role of the family in supporting recovery. Bulimia Nervosa: Treatment Methods: 1. Cognitive-Behavioral Therapy (CBT): The most widely researched and effective treatment for bulimia. It focuses on identifying and changing dysfunctional thoughts and behaviors related to bingeing and purging. 2. Medications: Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) like fluoxetine, can help reduce binge-purge cycles and treat co-occurring depression or anxiety. 3. Nutritional Counseling: Developing a regular, balanced eating plan to break the cycle of bingeing and purging. 4. Dialectical Behavior Therapy (DBT): Useful for individuals with severe emotion regulation issues, focusing on developing healthy coping strategies. Promising Methods: • CBT is the gold standard for treating bulimia, with robust evidence supporting its effectiveness in reducing symptoms and preventing relapse. Conclusion The treatment of anorexia and bulimia requires a comprehensive and individualized approach, addressing both the psychological and physical aspects of the disorders. While there are effective treatments available, ongoing research and development of new therapeutic methods are essential to improve outcomes and support long-term recovery for individuals with these complex conditions. 224. Describe the features of binge-eating disorder and how it differs from bulimia. Answer: Features of Binge-Eating Disorder (BED) : Binge-eating disorder is characterized by recurrent episodes of eating large quantities of food, often quickly and to the point of discomfort. Key features include: 1. Recurrent Binge-Eating Episodes : Episodes involve eating significantly more food in a specific period than most people would eat under similar circumstances. These episodes occur at least once a week for three months. 2. Lack of Control : During binge episodes, individuals feel a lack of control over their eating. 3. Distress : There is significant distress regarding binge eating. 4. Absence of Compensatory Behaviors : Unlike bulimia, there are no regular use of compensatory behaviors (e.g., vomiting, excessive exercise) to counteract the binge eating. 5. Associated Behaviors : Binge eating is often accompanied by feelings of guilt, shame, or disgust, and individuals may eat alone to hide their behavior. 6. Impact on Health : BED is often associated with obesity and related health issues, such as diabetes, hypertension, and cardiovascular disease. Differences from Bulimia Nervosa : • Compensatory Behaviors : The primary difference is that individuals with bulimia engage in compensatory behaviors (e.g., purging, fasting, excessive exercise) after binge eating, while those with BED do not. • Body Weight : Individuals with bulimia are often of normal weight or slightly overweight, whereas those with BED are more likely to be overweight or obese. • Frequency of Episodes : Both disorders involve recurrent binge-eating episodes, but the presence of compensatory behaviors distinguishes bulimia from BED. 225. What factors contribute to the imbalance between energy intake and expenditure that underlies obesity? Answer: Factors Contributing to Energy Imbalance : 1. Diet : • High-Calorie Foods : Increased consumption of high-calorie, low-nutrient foods and beverages, including fast food, sugary drinks, and snacks. • Portion Sizes : Larger portion sizes leading to higher caloric intake. 2. Physical Activity : • Sedentary Lifestyle : Decreased physical activity due to sedentary jobs, increased screen time, and reduced opportunities for physical exercise. • Lack of Exercise : Insufficient engagement in regular physical exercise. 3. Genetics : • Genetic Predisposition : Certain genetic factors can increase the likelihood of weight gain and obesity. • Metabolism : Genetic variations affecting metabolism and the efficiency of energy use. 4. Environmental Factors : • Built Environment : Lack of access to safe places for physical activity, such as parks and recreational areas. • Food Environment : Availability and marketing of unhealthy food options. 5. Psychological Factors : • Emotional Eating : Eating in response to emotions such as stress, anxiety, or depression. • Binge Eating : Patterns of binge eating contribute to excess calorie consumption. 6. Socioeconomic Factors : • Income and Education : Lower income and education levels are associated with higher obesity rates due to limited access to healthy foods and recreational activities. • Cultural Factors : Cultural attitudes and beliefs about food and body weight. 7. Biological Factors : • Hormonal Imbalances : Conditions such as hypothyroidism or polycystic ovary syndrome (PCOS) that affect metabolism. • Sleep Deprivation : Poor sleep patterns can disrupt hormonal balance and appetite regulation. 226. Discuss socioeconomic differences in obesity and the possible reasons for those differences. Answer: Socioeconomic Differences in Obesity : Obesity prevalence tends to be higher among individuals with lower socioeconomic status (SES). Several factors contribute to this disparity: 1. Access to Healthy Foods : • Food Deserts : Low-SES areas often lack access to affordable, healthy food options, leading to higher consumption of processed and high-calorie foods. • Cost of Healthy Foods : Healthy foods such as fresh fruits, vegetables, and lean proteins are often more expensive than unhealthy options. 2. Education and Awareness : • Nutritional Knowledge : Lower levels of education are associated with less knowledge about nutrition and healthy eating habits. • Health Literacy : Reduced health literacy can affect individuals' ability to make informed choices about diet and exercise. 3. Physical Activity Opportunities : • Recreational Facilities : Low-SES neighborhoods may have fewer parks, gyms, and recreational facilities. • Safety Concerns : Higher crime rates in some low-SES areas can limit outdoor physical activity due to safety concerns. 4. Work Environment : • Sedentary Jobs : Individuals in low-SES jobs may have more sedentary work environments with fewer opportunities for physical activity. • Work Hours : Long or irregular work hours can limit time for exercise and meal preparation. 5. Stress and Mental Health : • Chronic Stress : Financial instability and other stressors associated with low SES can contribute to overeating and weight gain. • Mental Health : Higher rates of mental health issues in low-SES populations can lead to emotional eating and less physical activity. 6. Healthcare Access : • Preventive Care : Limited access to healthcare can result in fewer opportunities for preventive care and early intervention for weight management. • Treatment Options : Low-SES individuals may have less access to weight loss programs, nutrition counseling, and other obesity treatments. 227. Describe the features of insomnia disorder, hypersomnolence disorder, narcolepsy, breathing-related sleep disorder, and circadian rhythm sleep-wake disorder. Answer: Insomnia Disorder : • Symptoms : Difficulty initiating or maintaining sleep, waking up too early, and inability to return to sleep. • Impact : Causes significant distress or impairment in social, occupational, or other important areas of functioning. • Duration : Symptoms occur at least three times per week and persist for at least three months. Hypersomnolence Disorder : • Symptoms : Excessive daytime sleepiness despite getting a normal amount of sleep at night. Prolonged nighttime sleep (more than 9 hours) that is not restorative. • Impact : Difficulty waking up, napping frequently, and feeling excessively tired throughout the day. • Duration : Symptoms occur at least three times per week and persist for at least three months. Narcolepsy : • Symptoms : Recurrent episodes of an irrepressible need to sleep, lapsing into sleep, or napping occurring within the same day. Cataplexy (sudden loss of muscle tone), sleep paralysis, and hypnagogic/hypnopompic hallucinations. • Duration : Symptoms occur at least three times per week for at least three months. Breathing-Related Sleep Disorders : • Types : Includes obstructive sleep apnea hypopnea, central sleep apnea, and sleep-related hypoventilation. • Symptoms : Repeated episodes of interrupted breathing during sleep, loud snoring, gasping, and excessive daytime sleepiness. • Impact : Leads to fragmented sleep, resulting in poor sleep quality and daytime impairment. Circadian Rhythm Sleep-Wake Disorder : • Symptoms : Misalignment between the individual’s internal sleep-wake cycle and the external environment. Difficulty falling asleep or waking up at desired times. • Types : Includes delayed sleep phase type, advanced sleep phase type, irregular sleep-wake type, non-24-hour sleep-wake type, and shift work type. • Impact : Significant distress or impairment in social, occupational, or other important areas of functioning due to sleep disruption. Conclusion Understanding and addressing these diverse conditions and factors related to eating disorders, obesity, and sleep disorders is crucial for effective treatment and prevention strategies. Each condition requires tailored approaches to ensure that individuals receive appropriate care and support. 228. Describe the features of the major types of parasomnias: nightmare disorder, sleep terror disorder, and sleepwalking disorder. Answer: Features of the Major Types of Parasomnias: Nightmare Disorder, Sleep Terror Disorder, and Sleepwalking Disorder Nightmare Disorder: • Symptoms: Recurrent, vivid, and disturbing dreams that typically involve threats to survival, security, or physical integrity. These nightmares usually occur during the REM (rapid eye movement) stage of sleep. • Awakening: Individuals often wake up abruptly from the nightmare, feeling scared or anxious but usually fully alert and able to recall the content of the dream. • Impact: Causes significant distress or impairment in social, occupational, or other important areas of functioning. Nightmares may lead to anxiety about going to sleep and result in sleep deprivation. • Prevalence: More common in children but can occur in adults, particularly those with post-traumatic stress disorder (PTSD) or other anxiety disorders. Sleep Terror Disorder (Night Terrors): • Symptoms: Episodes of intense fear, screaming, and autonomic arousal (e.g., rapid heart rate, sweating, dilated pupils) that occur during non-REM sleep, typically in the first third of the night. • Awakening: Individuals are usually difficult to awaken during an episode and often have little or no memory of the event the next morning. • Behavior: May involve sitting up in bed, thrashing around, or running as if trying to escape. The person may appear confused or inconsolable. • Impact: Episodes can be frightening for family members or bed partners. Frequent episodes can disrupt sleep and cause daytime sleepiness or impairment. Sleepwalking Disorder (Somnambulism): • Symptoms: Repeated episodes of rising from bed during non-REM sleep and walking around. During an episode, the individual has a blank, staring face and is relatively unresponsive to others. • Behavior: Activities can range from sitting up in bed and looking around to more complex behaviors like walking, leaving the house, or driving. • Awakening: Individuals are typically difficult to arouse during an episode and, upon awakening, have little or no memory of the event. • Impact: Episodes can be dangerous due to the risk of injury from accidents. Chronic sleepwalking can lead to sleep disruption and daytime fatigue. 229. Discuss pharmacological and psychological treatments of sleep disorders. Detail the concerns surrounding the use of sleep medications. Answer: Pharmacological and Psychological Treatments of Sleep Disorders and Concerns Surrounding the Use of Sleep Medications Pharmacological Treatments: 1. Benzodiazepines: • Examples: Temazepam, triazolam. • Uses: Short-term treatment of insomnia and anxiety-related sleep disturbances. • Concerns: Risk of dependence, tolerance, and withdrawal symptoms. Can cause drowsiness, dizziness, and cognitive impairment. 2. Non-Benzodiazepine Hypnotics: • Examples: Zolpidem (Ambien), eszopiclone (Lunesta), zaleplon (Sonata). • Uses: Short-term treatment of insomnia. • Concerns: Similar risks to benzodiazepines but generally considered to have a lower potential for dependence. Can cause next-day drowsiness, dizziness, and unusual behaviors (e.g., sleep-driving). 3. Melatonin Receptor Agonists: • Examples: Ramelteon (Rozerem). • Uses: Treatment of insomnia, particularly for difficulties with sleep onset. • Concerns: Generally well-tolerated, but can cause dizziness and fatigue. No significant risk of dependence. 4. Antidepressants: • Examples: Trazodone, mirtazapine. • Uses: Off-label treatment of insomnia, particularly when associated with depression or anxiety. • Concerns: Can cause daytime drowsiness, weight gain, and other side effects. Risk of drug interactions. 5. Over-the-Counter Options: • Examples: Antihistamines (e.g., diphenhydramine), melatonin supplements. • Uses: Short-term treatment of mild insomnia. • Concerns: Can cause next-day drowsiness and cognitive impairment. Long-term efficacy and safety are less established. Psychological Treatments: 1. Cognitive-Behavioral Therapy for Insomnia (CBT-I): • Techniques: Includes sleep restriction, stimulus control, cognitive restructuring, relaxation training, and sleep hygiene education. • Effectiveness: Considered the gold standard for chronic insomnia, with lasting benefits and no risk of dependence. 2. Relaxation Techniques: • Examples: Progressive muscle relaxation, guided imagery, mindfulness meditation. • Uses: Reduce anxiety and stress, improve sleep onset and quality. • Effectiveness: Can be effective, particularly when combined with other treatments. 3. Sleep Hygiene Education: • Techniques: Promotes habits such as maintaining a consistent sleep schedule, creating a comfortable sleep environment, and avoiding caffeine and electronics before bed. • Effectiveness: Useful as a component of broader treatment plans, particularly for mild sleep disturbances. 4. Biofeedback: • Techniques: Uses electronic monitoring to help individuals gain control over physiological functions such as muscle tension and heart rate. • Effectiveness: Can be beneficial for reducing anxiety and improving sleep quality. Concerns Surrounding the Use of Sleep Medications: • Dependence and Withdrawal: Risk of developing physical and psychological dependence on sleep medications, particularly with benzodiazepines and non-benzodiazepine hypnotics. • Tolerance: Over time, individuals may require higher doses to achieve the same effect, leading to increased risk of side effects. • Side Effects: Common side effects include drowsiness, dizziness, cognitive impairment, and increased risk of falls, particularly in older adults. • Behavioral Risks: Some medications can cause unusual behaviors, such as sleepwalking, sleep-driving, and engaging in other activities while not fully awake. • Short-Term Use: Sleep medications are generally recommended for short-term use due to the risks of long-term dependence and side effects. Chronic insomnia is better managed with psychological treatments like CBT-I. Conclusion Understanding and effectively treating sleep disorders requires a comprehensive approach that considers both pharmacological and psychological methods. While medications can provide short-term relief, psychological treatments such as CBT-I offer sustainable, long-term solutions without the associated risks of dependence and side effects. Awareness of the potential concerns surrounding sleep medications is essential for making informed treatment decisions and ensuring the safety and well-being of individuals with sleep disorders. Test Bank for Abnormal Psychology in a Changing World Jeffrey S. Nevid, Spencer A. Rathus, Beverly Greene 9780205965014, 9780135821688, 9780134458311, 9780205961719, 9780130052162
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