Abnormal Psychology An Integrative

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Chapter 8 - Eating and Sleep-Wake Disorders

1. Anne has anorexia nervosa and Julie has bulimia nervosa. What do both women have in common?
a. a desire to be beautiful
b. a desire to be adored and loved
c. an overwhelming urge to be thin
d. an aversion to eating
ANSWER: c

2. Dr. Anderson runs a support group for people with anorexia nervosa in a large city. Currently there are 100 people in
her group. About how many of Dr. Anderson’s group members will die from the disorder?
a. 2
b. 5
c. 20
d. 40
ANSWER: c

3. How does the death rate (including suicide) due to eating disorders compare to the death rates for other psychological
disorders?
a. It is lower than that of most psychological disorders.
b. It is the highest of all of the psychological disorders.
c. It is higher than that for any other psychological disorder except depression.
d. It is higher than that of most psychological disorders.
ANSWER: d

4. Hailey has just started showing signs of an eating disorder. What stage of development is Hailey likely in right now?
a. early childhood
b. late childhood
c. early adolescence
d. late adolescence
ANSWER: c

5. Which of the following is a key characteristic of people who develop eating disorders?
a. The come from socially disadvantaged environments.
b. They come from Eastern countries.
c. They are female.
d. They tend to be naturally slightly overweight.
ANSWER: c

6. Dr. Mukherjee conducts research on eating disorders. Which of the following will be typical of participants in Dr.
Mukherjee’s research?
a. lower intelligence and higher income
b. upper socioeconomic status
c. lower socioeconomic status
d. higher intelligence and higher income
ANSWER: b
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7. Amy and Laura both have bulimia nervosa. Amy uses laxatives whereas Laura does not. Based on the research by
Steiger and colleagues (2003), what characteristic does Amy likely have?
a. She is more depressed than Laura.
b. She is more aggressive than Laura.
c. She is more impulsive than Laura.
d. She is more obese than Laura.
ANSWER: c

8. What have researchers found are two factors that differ between people with bulimia who purge and those with bulimia
who do not purge?
a. the age of onset and the existence of comorbid depression
b. the average weight of the person and the age of onset
c. the socioeconomic class of the individual and comorbid depression
d. the male to female ratio and the age of onset
ANSWER: a

9. Jamie is a very competitive young woman from a high-achieving, wealthy family. She is very social and likes the fact
that she is quite popular. She believes that her popularity is dependent on her weight and body shape. Amy has a
boyfriend, but she worries that she may care more about their relationship than he does. Which of these features puts Amy
most at risk for an eating disorder such as bulimia?
a. her successful and wealthy family status
b. her competitive nature
c. her belief that her boyfriend cares less about the relationship than she does
d. her belief that her weight and body shape influence her popularity
ANSWER: d

10. Which of the following is the most serious medical consequence of bulimia?
a. potential tooth erosion
b. potential brain damage
c. potential electrolyte imbalance
d. potential intestinal disorders
ANSWER: c

11. Although for several years a prominent theory held that eating disorders were a way of expressing depression, what
does almost all evidence now indicate?
a. Depression follows bulimia and may be a reaction to it.
b. Depression may be a way of expressing displeasure with one’s body.
c. Very few people with bulimia suffer from depression.
d. Depression precedes bulimia.
ANSWER: a

12. Which of the following is NOT a medical complication related to bulimia?

a. sudden death
b. food refusal
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c. renal failure
d. calluses on the fingers
ANSWER: a

13. Melissa is a counsellor and runs a support group for women with bulimia who are receiving inpatient treatment at a
psychiatric facility. What percentage of women in her support group are likely to also have either social phobia or
generalized anxiety disorder?
a. 15 percent
b. 25 percent
c. 50 percent
d. 75 percent
ANSWER: d

14. What is the core feature of anorexia?

a. intentional weight loss reaching 15 percent less than expected body weight
b. rapid, intentional weight loss and the belief that more weight needs to be lost
c. an intense fear of obesity
d. food refusal
ANSWER: c

15. What is most likely to cause people with bulimia NOT to seek treatment?
a. the fear of weight gain
b. the pride associated with efforts at weight loss
c. the denial of illness
d. the shame and secrecy
ANSWER: d

16. The textbook has identified two subtypes of anorexia nervosa. Which of the following occurs in the “restricting type”?
a. Individuals do not limit caloric intake but engage in excessive exercising and fitness regimes.
b. Individuals diet to limit calorie intake.
c. Individuals use purging and limit calorie intake.
d. Individuals rely on purging.
ANSWER: b

17. Morgan has an intense fear of being overweight. Although she talks a lot about food, she hardly eats. She also sees
herself as “fat,” despite the fact that her doctor says she is 20 percent underweight for her height, age, and bone structure.
Morgan exercises excessively and obsessively diets, despite being 7 kilograms lighter than her original dieting goal. What
condition does Morgan most likely have?
a. anorexia nervosa
b. binge-eating bulimia
c. nonpurging anorexia
d. bulimia nervosa
ANSWER: a

18. What is the most common medical complication of anorexia?

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a. cessation of menstrual cycle
b. electrolyte imbalance
c. increased heart rate
d. downy hair on limbs
ANSWER: a

19. Dr. Cowan treats women with anorexia but also specializes in treating another disorder that commonly co-occurs with
anorexia. What is that disorder MOST likely to be?
a. anxiety disorder
b. personality disorder
c. obsessive-compulsive disorder
d. depressive disorder
ANSWER: c

20. Amanda loses control when she eats and consumes great quantities of food, but she does not engage in any attempts to
compensate for her excess food intake. What condition does Amanda appear to have?
a. binge-eating anorexia
b. an eating disorder not otherwise specified
c. bulimia, nonpurging type
d. binge-eating disorder
ANSWER: d

21. George is 28 years old. He is obese, describes himself as a “compulsive overeater,” and has a history of depression
and unsuccessful attempts at weight loss. While George has repeated episodes of binge eating, he does not vomit
afterwards. What condition does George most likely have?
a. binge-eating anorexia
b. an eating disorder not otherwise specified
c. bulimia, nonpurging type
d. binge-eating disorder
ANSWER: d

22. Mike and George met recently and discovered they both have binge-eating disorder. Where did they most likely meet?
a. at the gym
b. at the pool
c. at a weight loss support group
d. at a weight room
ANSWER: c

23. Jody sometimes eats more than just about any other girl you know. What would you have to know to determine
whether she is bingeing?
a. the situations under which she eats a great deal
b. whether she is eating mostly junk foods or mostly healthy foods
c. the caloric intake of the foods
d. whether her eating habits are out of her control

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ANSWER: d

24. What is the most significant feature of bulimia?

a. purging
b. overeating
c. overeating followed by an urge to vomit
d. binge eating followed by compensatory behaviour
ANSWER: d

25. Susan, a woman of relatively normal weight, sometimes eats huge quantities of junk food and has no ability to stop
herself. She follows this habit with long periods of complete fasting. Based on this information, which of the following is
most likely to happen?
a. Susan will be diagnosed with binge-eating disorder.
b. Susan will not be diagnosed with any disorder because she is of normal weight.
c. Susan will not be diagnosed with bulimia because she is not purging.
d. Susan will be diagnosed with bulimia.
ANSWER: d

26. Which males are most likely to develop an eating disorder such as bulimia?
a. those who are depressed
b. those who are overweight
c. those who are homosexual or bisexual
d. those who are single and heterosexual
ANSWER: c

27. Which of the following helps to explain the increase in the incidence of anorexia and bulimia over the past 30 years?
a. Pharmaceutical companies have expanded their marketing of laxatives and diuretics.
b. There has been a decrease in the weight of both beauty pageant contestants and Playboy centrefolds.
c. There have been concurrent increases in the rate of depression.
d. There has been an increase in weight loss programs and fad diets.
ANSWER: b

28. What percent of Playboy centrefolds met the weight criteria for anorexia between 1979 and 1988?
a. 10 percent
b. 15 percent
c. 20 percent
d. 25 percent
ANSWER: b

29. How can we tell that the media’s message to be thin is aimed clearly at women?
a. in the fact that overweight men are two to five times more common as television characters than are
overweight women
b. in the fact that there are relatively few “physical appearance” competitions for men
c. in the fact that there are significantly more thin women in popular magazines than thin men

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d. in the fact that most men prefer to date thin women
ANSWER: a

30. The increase in the incidence of eating disorders such as anorexia and bulimia has been referred to as a “collision
between our culture and our physiology.” What does this mean?
a. People are fed up with being told how they should look.
b. People have become too dependent on media determinations of beauty.
c. Media standards of beauty are increasingly unattainable for the average woman.
d. Dieting has become a fad that has been taken to an extreme.
ANSWER: c

31. According to Forestell and colleagues (2004), what are undergraduate women most critical of when making
evaluations of physical attractiveness?
a. women’s body fat
b. women’s overall weight
c. women’s waist size
d. women’s hip size
ANSWER: d

32. When men are asked to identify the ideal male body, what do they typically select?
a. a body weight that is heavier than the weight females think is most attractive
b. a body weight that is the same as their own weight
c. a body weight that is lighter than the weight females think is most attractive
d. a body weight that is roughly 7 kilograms lighter than their own weight
ANSWER: a

33. According to Polivy and Herman, what does the “false hope syndrome” refer to?
a. an unrealistic belief that weight loss can be maintained
b. the goal to exercise excessively, which will help shed unwanted weight
c. the belief that losing weight will make one into a person that others admire and love
d. when initial success at losing weight is reinforced by others and it leads to unrealistic goals for further weight
loss
ANSWER: d

34. In their twin study of eating disorders, what did Livesley and colleagues (2005) find to have a partial genetic
component?
a. concern with external appearances
b. body dissatisfaction and dieting tendencies
c. purging and concern for overeating
d. distorted body image
ANSWER: c

35. In their cross-cultural study of eating disorders, Gupta and colleagues (2001) found that the drive for thinness and
body dissatisfaction did not differ between Canadian and Indian women. However, there were cultural differences. What
were they?
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a. differences in compensatory practices after bingeing, such as purging
b. differences in the acceptability of eating disorders
c. differences in the areas of the body most related to body satisfaction
d. differences in the frequency of bingeing behaviour
ANSWER: c

36. What do genetic influences on eating disorders most likely involve?

a. a specific gene for each actual eating disorder
b. inherited, nonspecific personality traits that may make development of an eating disorder more likely
c. multiple genes interacting in ways not yet determined that directly produce eating disordered behaviour
d. recessive genes
ANSWER: b

37. Mandy has activity anorexia. What does Mandy do on a daily basis?
a. She restricts food except for meals with family members to keep up an illusion that she does not have a
problem.
b. She uses excessive physical activity to take away the desire to eat food.
c. She uses excessive physical activity to decrease the metabolic rate, resulting in abnormal weight loss.
d. She uses excessive physical activity to relieve feelings of hunger.
ANSWER: b

38. What appears to be the role of biology in the development of bulimia and/or anorexia?
a. Biology does not play a role.
b. Biology plays a limited role.
c. Biology plays a significant role.
d. biology plays a much stronger role than environment.
ANSWER: b

39. Which of the following young women appears to be most at risk for developing an eating disorder?
a. Maya, whose parents are both constantly dieting
b. Jane, whose family is perfectionistic, successful, and eager to maintain harmony
c. Emily, whose mom and dad recently divorced
d. Tess, whose family emphasizes achievement, support, and communication
ANSWER: b

40. What has research indicated regarding the effectiveness of drug treatments for adult patients with anorexia nervosa?
a. Anti-anxiety medications have found to be effective.
b. Medications have not been found to be effective.
c. Antidepressants have found to be effective.
d. Antipsychotic medications have been found to be effective.
ANSWER: b

41. Alissa has bulimia. She asked her doctor whether there are any medications that she can take to help her manage the
disorder. Her doctor stated that:
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a. antidepressants can be effective
b. benzodiazepine can be effective
c. antipsychotic medications can be effective
d. medications have not been found to be effective for the treatment of bulimia
ANSWER: a

42. Jessica is 13 and has begun a cycle of binging and purging. Her doctor is so concerned that he has prescribed a
medication for her that has been shown to help other people with eating disorders. What medication did he prescribe?
a. a placebo
b. an antidepressant
c. a benzodiazepine
d. Ritalin
ANSWER: b

43. What would an early stage of cognitive-behavioural treatment for bulimia most likely involve?
a. inpatient treatment
b. family therapy
c. small, frequent meals
d. antidepressant medication
ANSWER: c

44. Which of the following is an important aspect of the cognitive-behavioural approach to the treatment of bulimia?
a. changing the type and frequency of reinforcement associated with being an identified patient
b. ending the “false hope syndrome”
c. changing the patient’s dysfunctional thoughts and attitudes about body shape, weight, and eating
d. helping the patient’s family learn new ways of interacting with each other and with the patient
ANSWER: c

45. Which of the following describes the effectiveness of cognitive-behavioural treatment for bulimia?
a. Cognitive-behavioural therapy is not effective in the short or long term.
b. Cognitive-behavioural therapy is effective in the short term but not the long term.
c. Cognitive-behavioural therapy is effective in the long term but not the short term.
d. Cognitive-behavioural therapy is effective in the short and long term.
ANSWER: d

46. If given the choice between cognitive-behavioural therapy (CBT), behaviour therapy (BT), and interpersonal therapy
(IPT) for the treatment of bulimia for a friend, which would be the best choice based on available research?
a. CBT is the best choice.
b. IPT is the best choice.
c. IPT or BT are both good choices.
d. CBT or IPT are both good choices.
ANSWER: d

47. How long does it typically take for interpersonal therapy (IPT) for bulimia to be optimally effective?
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a. one month
b. two months
c. six months
d. one year
ANSWER: a

48. Which of the following is the most effective treatment approach in gaining rapid control of bulimia, and maintaining
these gains over the long term?
a. addressing family interactions and communication patterns
b. addressing family functioning and self-esteem
c. addressing dysfunctional thoughts and the actual disorder’s behaviours
d. addressing dysfunctional thoughts and family functioning
ANSWER: c

49. According to research by Smith and colleagues (1992), Agras and colleagues (1997), and others, which of the
following is critical to sustaining weight loss in obese patients?
a. increasing self-esteem
b. using antidepressants
c. starting a regular exercise program
d. stopping binge eating
ANSWER: d

50. Which type of therapy should be used as a first step for people who binge eat?
a. drug therapy
b. cognitive-behavioural therapy
c. self-help groups
d. interpersonal therapy
ANSWER: c

51. Caitlin has just been admitting to a psychiatric facility to be treated for anorexia. What will be the first goal in
Caitlin’s treatment plan?
a. weight gain
b. motivation to change
c. resuming normal menstrual cycles
d. acceptance that there is a problem
ANSWER: a

52. Jill has been in treatment for anorexia for the past two months. Over this time, she has gained weight to the point
where her weight is in the average range for a woman of her height. What does the fact that she gained weight fairly
quickly in treatment mean?
a. It means she is probably in need of little, if any, further treatment.
b. It means her prognosis for a full recovery is very good.
c. It means little in terms of how likely she is to be successful in the long term.
d. It means she has completed the most difficult part of her treatment.

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ANSWER: c

53. What do clinicians usually suggest is the most difficult part of treatment for anorexia, and the part of treatment where
many anorexics are NOT successful?
a. admitting that there is a problem and agreeing to begin treatment
b. changing their attitudes regarding body and self-image
c. accepting counselling for their childhood traumas
d. initial weight gain
ANSWER: b

54. Because patients with anorexia nervosa are often difficult to treat, which of the following does research suggest to be
an important area of assessment?
a. their readiness to change
b. their willpower
c. their anxiety over becoming obese
d. their negative expectations about change
ANSWER: a

55. What is the long-term prognosis for people treated for anorexia or bulimia?
a. Both anorexia and bulimia patients typically make a full and long-term recovery after treatment.
b. Patients with anorexia who receive treatment tend to have a better prognosis than patients with bulimia.
c. Patients with bulimia tend to have a better prognosis than patients with anorexia.
d. Treatment for both types of eating disorders tends to work in the short term only.
ANSWER: c

56. In their preventive study of eating disorders in young adolescent girls, what did Killen and colleagues (1994) find to
be one of the most powerful factors for predicting later symptoms of eating disorders?
a. negative and dysfunctional attitudes about food and eating
b. low self-esteem
c. early concern about being overweight
d. high levels of competitiveness
ANSWER: c

57. What was the outcome of a study that attempted to increase body-image satisfaction and reduce dieting for Grade 6
girls?
a. Changes were noted only in girls who were identified as being at high risk before the study.
b. Increased body-image satisfaction and reduced dieting attitudes were immediately noticed and maintained up
until the next year.
c. Changes to increased body-image satisfaction were initially noted in the control group as well as the
intervention group.
d. The initial increased body-image satisfaction and reduced dieting attitudes and benefits were not maintained
one year after the intervention.
ANSWER: d

58. Compared to people who sleep normally, what are people who do not get enough sleep most likely to experience?
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a. more health problems and more frequent hospitalization
b. a reduced number of hours of sleep per night in early adulthood and increases in hours of sleep in middle
adulthood
c. more physical health problems but normal levels of productivity
d. weight loss
ANSWER: a

59. How much sleep do healthy adults need each night?

a. It depends on the individual.
b. They get more than eight hours.
c. They get between seven and eight hours.
d. They get under six hours.
ANSWER: a

60. Joe has recently started having a great deal of difficulty falling asleep. In addition, he frequently wakes up during the
night and has trouble falling back to sleep once awakened. What has most likely caused Joe’s sleep problems?
a. medical conditions
b. a diagnosable sleep disorder
c. either medical or psychological conditions
d. psychological concerns
ANSWER: c

61. Raz just spent 10 hours asleep. How much of that time did he likely spend dreaming?
a. 2 hours
b. 3 hours
c. 4 hours
d. 5 hours
ANSWER: b

62. What type of sleep do we typically awaken from when we wake up in the morning?
a. deep, slow-wave sleep
b. REM sleep, during a dream
c. Stage 2 sleep, where we were just dozing and thinking
d. deep, slow-wave sleep, during a dream
ANSWER: b

63. Which of the following sleep disorders is accurately described?

a. parasomnia—not getting enough REM sleep
b. parasomnia—difficulties in getting enough sleep
c. dyssomnia—sleepwalking and nightmares
d. dyssomnia—difficulties in getting enough sleep
ANSWER: d

64. How is the most comprehensive evaluation of sleep performed?

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a. by a polysomnographic evaluation
b. by an electromyographic evaluation
c. by an electroencephalographic evaluation
d. by an actigraphic evaluation
ANSWER: a

65. While a patient sleeps, which of the following is NOT collected in the data of a polysomnographic evaluation?
a. muscle movements
b. respiration
c. brain waves
d. metabolic rate
ANSWER: d

66. John reports not feeling refreshed and rested even though he has slept the whole night. What type of disorder might
John be suffering from?
a. primary insomnia
b. some type of parasomnia
c. a disorder not related to sleep
d. some type of dyssomnia
ANSWER: d

67. If a person spends 10 percent of “bed time” awake, what is their sleep efficiency?
a. 10
b. 40
c. 60
d. 90
ANSWER: d

68. How are sleep disorders diagnosed?

a. according to the quantity of sleep vs. the amount of sleep time the individual believes is desirable
b. according to the quality and quantity of sleep and polysomnographic results
c. according to the quality and quantity of sleep as well as daytime sequelae
d. according to the clinical experience of the clinician
ANSWER: c

69. What does the term “primary” in the diagnosis of primary insomnia refer to?
a. the fact that two co-occurring disorders are not present
b. the fact that the sleep disorder is a major cause of other medical or psychiatric conditions that the individual is
experiencing
c. the fact that the sleep disturbance is not due to another medical or psychiatric condition
d. the fact that the person has never been diagnosed with insomnia before
ANSWER: c

70. What does a typical case of insomnia involve?

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a. an individual who has difficulty initiating or maintaining sleep
b. an individual who does not sleep at all
c. an individual who sleeps all night but still feels like he or she has been awake for hours
d. an individual who frequently sleepwalks
ANSWER: a

71. Fred has been having a great deal of trouble initiating and maintaining sleep. He guesses that he is sleeping about three
hours each night, and complains that he feels terrible during the day. In addition, Fred has always experienced some
anxiety but it recently increased tremendously. How can we characterize Fred’s experience?
a. It is extremely common since sleep problems can be both a cause and a result of anxiety.
b. It indicates that the insomnia is a result of the anxiety rather than a cause of the anxiety.
c. It makes the diagnosis of primary insomnia incorrect.
d. It increases our confidence that primary insomnia is the correct diagnosis.
ANSWER: a

72. When are sleep problems considered a disorder?

a. when the individual is spending less than 50 percent of the time spent lying in bed actually being asleep
b. when the individual experiences daytime fatigue
c. when the sleep problems are accompanied by symptoms of depression and/or anxiety
d. when the individual experiences discomfort or impairment because of it
ANSWER: d

73. How are alcohol and sleep related?

a. Alcohol may help initiate sleep and enhance ongoing sleep, but it leads to addiction if used as a sleep aid.
b. Alcohol may help initiate sleep, but it interrupts ongoing sleep and can be the cause of a sleep disorder.
c. Alcohol increases REM sleep.
d. Alcohol increases total sleep time in an effective manner but continued use produces tolerance, which negates
this beneficial effect.
ANSWER: b

74. Carrie has insomnia and her doctor thinks that a biological factor is contributing to the problem. What might that
biological factor be?
a. higher body temperature
b. low body weight
c. percentage of body fat
d. genetics
ANSWER: a

75. People who have unrealistic expectations such as “I must sleep a full eight hours every night, or I will be unable to
function” are more likely to experience insomnia. What does this example show might influence insomnia?
a. cognition
b. early learning
c. self-fulfilling prophecy
d. cultural norms

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ANSWER: a

76. Rose has been taking over-the-counter sleeping pills for several weeks because of the disrupted sleep patterns she
experienced from frequent international travelling. When she stopped the medication, she experienced difficulty falling
and staying asleep. What do we call this condition?
a. primary hypersomnia
b. primary insomnia
c. primary dyssomnia
d. rebound insomnia
ANSWER: d

77. Which of the following is it NOT necessary to rule out before a clinician can diagnose hypersomnia?
a. family history of similar sleep problems
b. current medical conditions that would account for the symptoms
c. insomnia
d. sleep apnea
ANSWER: a

78. Which of the following is NOT something people with narcolepsy commonly experience?
a. cataplexy
b. hypnagogic hallucinations
c. hypnapompic hallucinations
d. sleep paralysis
ANSWER: c

79. Bill suffers from narcolepsy. In which of the following situations is he is most likely to experience cataplexy?
a. when placed in a physical environment with little sun or light
b. immediately upon waking up after a long, restful sleep
c. while jumping up and cheering for his favourite team
d. under hypnosis
ANSWER: c

80. While suddenly and unexpectedly falling asleep during normal waking hours, Sarah experiences vivid hallucinations
of being in a horrible car crash. The experience is so realistic that she actually feels physical sensations as if the
hallucination was real. What is Sarah’s most likely diagnosis?
a. hypersomnia
b. sleep apnea
c. narcolepsy
d. a psychotic disorder
ANSWER: c

81. Which of the following individuals is most likely to be suffering from obstructive sleep apnea?
a. Ming, a 32-year-old male who recently suffered head trauma in a car accident
b. Harpreet, an 88-year-old female with cerebral vascular disease

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c. Karen, a 64-year-old overweight female
d. John, a 64-year-old overweight male
ANSWER: d

82. Research with Doberman pinschers and Labrador retrievers, who also inherit the disorder, has contributed to specific
genetic models of which of the following?
a. narcolepsy
b. insomnia
c. REM sleep disturbances
d. sleep apnea
ANSWER: a

83. Simon sometimes wakes up feeling that there are other people in the room, but he is unable to move or say anything.
What is Simon most likely experiencing?
a. sleep paralysis and hypnagogic hallucinations associated with narcolepsy
b. hypnagogic hallucinations associated with hypersomnia
c. cataplexy associated with narcolepsy
d. sleep paralysis and hypnagogic hallucinations associated with hypersomnia
ANSWER: a

84. What is obstructive sleep apnea characterized by?

a. interruption of air flow without cessation of respiratory activity
b. central nervous system disorders and trauma
c. complete cessation of respiratory activity for brief periods
d. interruption of air flow and brief cessation of respiratory activity
ANSWER: a

85. What are two factors that help regulate our natural sleep/wake cycles?
a. light and psychological factors
b. melatonin and light
c. psychological factors and melatonin
d. melatonin and serotonin
ANSWER: b

86. Jack has always been the “early to bed and early to rise” type of person. Which type of circadian rhythm does he
demonstrate?
a. premature sleep phase
b. delayed sleep phase
c. advanced sleep phase
d. average sleep phase pattern
ANSWER: c

87. You predict that the person in a case study related to insomnia was older based on the prescription the person was
given. What was that prescription most likely to be?

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a. benzodiazepines
b. nonmedical treatments
c. stimulants
d. antidepressants
ANSWER: a

88. Why are antidepressant medications sometimes used to treat narcolepsy?

a. because antidepressant medications promote progressive muscle relaxation
b. because these medications suppress REM sleep, which that can trigger cataplexy
c. because the anti-anxiety properties of these medications reduce narcolepsy
d. because narcolepsy is often caused by depression
ANSWER: b

89. In addition to medication and mechanical devices, what other medical treatment is used for severe sleep apnea?
a. surgery
b. progressive relaxation
c. changing the patient’s sleep schedule
d. exercise of the neck muscles
ANSWER: a

90. When attempting to “reset the biological clock” of an individual with a circadian rhythm sleep disorder, what is it
generally best to do?
a. Keep the person awake for several days in a row.
b. Leave the patient’s bedtime alone and change the duration of sleep.
c. Make the patient’s bedtime earlier.
d. Make the patient’s bedtime later.
ANSWER: d

91. Given what we know about classical conditioning and learning through association, what do sleep experts generally
recommend?
a. They recommend learning as much as possible about all of the various sleep disorders.
b. They recommend spending a bit of time thinking about sleep before going to bed.
c. They recommend using the bed for sleep and sex only.
d. They recommend that patients reward themselves every time they sleep the recommended number of hours the
previous night.
ANSWER: c

92. What does the term “stimulus control” refer to when discussing sleep?
a. using the bedroom only for sleeping and for sex
b. keeping noise to a minimum during the sleeping hours
c. quietly listening to the radio while trying to fall asleep
d. decorating the bedroom in neutral shades and a minimum of furniture
ANSWER: a

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93. What does “sleep hygiene” refer to?
a. lifestyle behaviours that facilitate or interfere with sleep
b. the purity of a person’s melatonin level
c. the effects of the physical environment of the bedroom on sleep
d. the use of medications to induce sleep
ANSWER: a

94. Which type of treatment has the best long-term success for treating sleep disorders in older adults?
a. drug therapy
b. drug therapy combined with psychological treatments
c. psychological treatments
d. self-help treatments
ANSWER: c

95. What do we call abnormal events such as nightmares, sleep terrors, and sleepwalking that occur during sleep or during
the twilight time between sleep and waking?
a. REM disorders
b. catalepsy
c. parasomnias
d. dyssomnias
ANSWER: c

96. Children sometimes experience intense episodes of sitting up during deep sleep, appearing frightened, showing signs
of extreme arousal, talking, thrashing wildly, and then remembering nothing of the episode the next morning. What do
such episodes indicate?
a. sleepwalking disorder
b. sleep terror disorder
c. REM disorders
d. nightmare disorder
ANSWER: b

97. When do sleep terrors and sleepwalking generally occur?

a. during NREM sleep
b. during twilight stages between sleep and waking
c. during REM sleep
d. after some severe daytime stressor
ANSWER: a

98. Joan is a six-year-old child who cries out in the middle of the night, appearing frightened and inconsolable. Her
parents are unable to comfort her during these episodes, and Joan has no memory of the event in the morning. What does
Joan appear to be experiencing?
a. temporary amnesia
b. dyssomnia
c. sleep terrors

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d. nightmares
ANSWER: c

99. What is one approach to successfully reducing the frequency of sleep terrors?
a. Make sure that the child is very tired before going to bed.
b. Wake the child during the attack.
c. Make sure the child does not eat one hour before bedtime; diet matters.
d. Use scheduled awakenings to briefly awaken the child before an attack occurs.
ANSWER: d

100. Which of the following does NOT characterize sleepwalking?

a. occurrence primarily in children
b. no memory of the sleepwalking event
c. occurrence during the deepest stage of sleep
d. acting out a dream
ANSWER: d

101. In what ways do anorexia and bulimia patients tend to be similar, and in what ways do they differ? Make certain to
include similarities and differences in the symptoms of the disorders as well as the dysfunctional thoughts typically
associated with each disorder.
ANSWER: Student responses will vary.

102. Discuss the evidence that eating disorders such as anorexia and bulimia are largely the result of culture and society.
ANSWER: Student responses will vary.

103. Eating disorders such as anorexia and bulimia are generally “blamed” on culture and society. At the same time, there
appears to be a genetic influence as well. Explain how culture and genetics may interact in the development of anorexia
and bulimia.
ANSWER: Student responses will vary.

104. Describe the typical treatment goals and treatment methods implemented for bulimia nervosa.
ANSWER: Student responses will vary.

105. Describe the typical treatment goals and treatment methods implemented for anorexia patients.
ANSWER: Student responses will vary.

106. Anxiety and primary insomnia often co-exist in a “chicken and egg” cycle, where it seems impossible to determine
whether the anxiety is causing the sleep disorder or the sleep disorder is causing the anxiety. Describe the process of how
anxiety and primary insomnia might interact within a patient. Why would it be difficult to determine which came first?
ANSWER: Student responses will vary.

107. Describe the narcolepsy-related phenomena of sleep paralysis and hypnagogic hallucinations. Discuss their possible
relationship to UFO experiences.
ANSWER: Student responses will vary.

108. Describe the problems associated with using medications such as benzodiazepines as a treatment for primary
insomnia.
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ANSWER: Student responses will vary.

109. Describe the psychological treatments that are generally used for the treatment of primary insomnia.
ANSWER: Student responses will vary.

110. What are the differences between nightmares and sleep terrors? Describe what we know about sleep terrors,
including the age at which it generally occurs and how it has been treated?
ANSWER: Student responses will vary.

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