chapter 7 abnormal psychology

A particularly perplexing clinical feature of anorexia nervosa is the A) individual's intense fear of gaining weight despite emaciation. B) person's concern over parental approval and acceptance. C) person's inability to articulate any food favorites.. D) patient's willingness to binge after long periods of starvation

A

Body mass index (BMI) is a way of expressing A) the ratio of height and weight to percent body fat. B) the threshold for abnormal weight loss. C) percent of body fat. D) both height and weight in one measure

D

Bulimia nervosa is more prevalent among females and tends to develop in A) less industrialized countries. B) families with more than 3 female children. C) late childhood and early adolescence. D) late adolescence or early adulthood

D

Margaret's appetite has decreased markedly over the course of the semester, resulting in a weight of 100 lbs. on her 5'9" frame. Her roommate has noticed that she tends to wear layers of clothing even in warm weather and frequently complains about her weight. If Margaret were referred for evaluation for an eating disorder, what percent of ideal body weight would be used as a criterion for excessive weight loss? A) 35% B) 50% C) 65% D) 85%

D

Which of the following is TRUE of both anorexia nervosa and bulimia nervosa? A) Both disorders involve periods of extreme overeating. B) Patients with both disorders complain of fear starvation. C) Both disorders involve a purging subtype. D) Both disorders are not found among older persons.

c

With respect to the treatment of eating disorders, DBT is to CBT as _____ is to _____. A) faulty thinking; emotional dysregulation B) unconscious conflict; faulty thinking C) emotional dysregulation; faulty thinking D) emotional dysregulation; unconscious conflict

c

Yolanda has been diagnosed as having an eating disorder involving "chewing and spitting." Given this information, what is the most likely formal diagnosis for her? A) Anorexia nervosa B) Bulimia nervosa C) Rumination disorder D) Restrictive eating disorder

c

Patients diagnosed as having the restricting subtype of anorexia nervosa control their weight exclusively through dieting.

f

According to the text, the DSM-IV system did not accurately capture eating disorders as they exist in the real world.

T

Anorexia nervosa has the highest associated rate of mortality of any DSM-5 disorder.

T

As early as the 19th century, Lasegue identified social and psychological factors associated with anorexia nervosa

T

Both shoplifting and impulsive spending are psychological features associated with bulimia nervosa.

T

Few people die from complications of bulimia nervosa

T

While anorexia nervosa is a disorder found before the 21st century binge eating disorder is a disorder of fairly recent origin

T

) It is generally accepted that research has demonstrated that eating disorders are partially influenced by genes

True

) It is generally believed that abnormal serotonin levels contribute to the expression of some personality features found in eating disorders.

True

Although there are some differences among approaches to treatment of each of the categories of eating disorders, normalization of eating behavior and weight is the primary goal of treatment for all of the disorders.

True

Applying cognitive behavioral treatment to eating disorders means a focus on faulty cognitions that reinforce eating and weight dysfunctions.

True

Bulimia nervosa as a disorder is characterized by more erratic and impulsive traits when compared to anorexia nervosa.

True

In recent times, more children and older persons are being diagnosed with the classic symptoms of anorexia nervosa

True

In those disorders included in the other specified feeding and eating disorders category, patients may use chewing and spitting out food as a form of weight control.

True

Research using animal models indicates that unlimited access to a physical activity and scheduled feedings may lead to overactivity and emaciation

True

Structural brain abnormalities have been found in both anorexia and bulimia nervosa patients; however, there is no research evidence that these differences were present before the onset of the illness

True

There is evidence to indicate a genetic predisposition makes an individual more vulnerable to behaviors such as dieting, and that sociocultural exposure triggers the eating disordered behavior.

True

According to the text, because the criteria for both anorexia and bulimia nervosa were very specific, A) prevalence estimates may increase with the new DSM-5 criteria. B) a diagnosis of either disorder captures accurate prevalence rates for anyone having an eating disorder. C) female prevalence rates for geriatric cases are overestimated in the U.S. population. D) we can be fairly confident that we have identified those needing treatment for an eating disorder.

A

An associated medical feature of anorexia nervosa that might explain the tendency to layer clothing even in mild temperatures is A) lowered body temperature. B) heightened blood pressure. C) increased heart rate. D) shallow breathing.

A

An inappropriate compensatory behavior may be defined as A) any action taken to counteract a binge or avoid weight gain. B) only those actions taken to avoid binge eating. C) any ritualistic behavior used to avoid thinking about bingeing. D) a healthy course of action taken to counteract negative consequences of bingeing.

A

Animal studies have revealed that one part of the brain influential in appetite and weight control is the A) hypothalamus. B) adrenal glands. C) pituitary gland. D) olfactory epithelium.

A

Epidemiological estimates of the prevalence of anorexia nervosa reveal that approximately 1 in _______ girls or women will suffer from it at some point in their lives. A) 1,000 B) 100 C) 10,000 D) 100,000

A

Females are ____ more likely to develop anorexia nervosa than are males. A) 3 times B) 5 times C) 6 times D) 9 times

A

Select the statement below that is TRUE of amenorrhea and the diagnosis of anorexia nervosa in the DSM-5. A) Amenorrhea need not be present for anorexia nervosa to be diagnosed. B) Research demonstrates meaningful differences in diagnosis between females who do and do not menstruate. C) Amenorrhea must be present for an anorexia nervosa diagnosis. D) Menstruation must occur monthly but for briefer periods than usual for a diagnosis of anorexia nervosa.

A

The heritability of anorexia nervosa and bulimia nervosa indicates that there appears to be A) a genetic component to both disorders. B) no direct genetic link to the disorders. C) genes that are solely responsible for the disorders. D) genes that are dominant over environmental influences in producing the disorder

A

The most important personality trait found in cases of anorexia nervosa is A) perfectionism. B) conscientiousness. C) agreeableness. D) responsibility

A

Unlike overeating too much of a favorite food, people with bulimia nervosa A) consume a large amount of food in a short period of time and use compensatory behaviors. B) consume a large quantity of food in a brief period of time but do not use laxatives. C) do not have trouble stopping when they feel full. D) feel more control over their eating because they have compensatory behaviors to regulate weight gain.

A

When subthreshold forms of bulimia nervosa are included, prevalence estimates of the disorder range from ___ to ___ percent of the female population in westernized countries. A) 5; 6 B) 7; 8 C) 10; 20 D) 12;15

A

Which of the following most accurately describes the use of laxatives as a compensatory strategy in bulimia nervosa? A) It is an ineffective strategy for avoiding weight gain. B) It is a safe and effective means of maintaining one's desired weight. C) Few persons diagnosed with the disorder actually use them. D) Research indicates that it leads to retention of electrolytes in one's system.

A

) Clinicians use the ________ in determining the weight status of their clients. A) caloric weight index (CWI) B) body mass index (BMI) C) weight to height ratio (WHR) D) body weight ratio (BWR)

B

Adolescence and young adulthood are typical periods of risk for eating disorders in that individuals who are perfectionistic, prone to worry, and stressed by change may A) resist unwanted interventions by parents or other authority figures. B) find developmental milestones to be triggers for the disorder. C) use regurgitation as a passive-aggressive tactic for control. D) develop phobias centering on specific food groups

B

Among young women in today's culture, anorexia nervosa is generally interpreted as A) self-denial in order to attain a state of euphoria. B) an attempt to achieve an ideal state of thinness. C) a wish for parental attention. D) a need to remain childlike in body build

B

Biweekly for the last year, Beverly has experienced irresistible urges to eat two gallons of ice cream and a bag of chocolate chip cookies. However, she manages to work off her calories using an exercise regimen that includes two hours of treadmill activity followed by a four-mile jog. Although she manages to avoid weight gain when she goes into her "binge modes," she complains of feeling out of control during these binges. Beverly exhibits symptoms of A) obsessive-compulsive eating disorder. B) bulimia nervosa. C) anorexia nervosa. D) a binge eating disorder.

B

Select the statement that is FALSE regarding anorexia nervosa. A) Victims weigh less than 85% of their ideal body weight. B) It is rarely associated with mortality. C) Younger patients do not have normal developmental weight gains. D) Cases may be found throughout history.

B

Three consecutive months of ___________has been removed from the official diagnosis of anorexia nervosa in the DSM 5 because it was determined that no meaningful differences occurred between individuals with anorexia nervosa who do and do not menstruate. A) weight loss B) amenorrhea C) purging D) denial of emaciation

B

Which of the following is TRUE of the course of anorexia nervosa as a disorder? A) It usually develops during early adolescence and tends to be short-lived. B) It may often include periods of relapse and remission. C) It rarely includes a crossover into bulimia nervosa. D) It does not have long-term health consequences for the patient.

B

Which of the following statements is TRUE of the binge eating/purging subtype of anorexia nervosa? A) Both binge eating and purging must be present for the diagnosis to be made. B) Binge eating, purging, or both may be present for the disorder to be diagnosed. C) Binge eating is often accompanied by excessive exercise. D) Binge eating need only occur once to meet the diagnostic criterion

B

Kaylyn suffers from anorexia nervosa. She induces vomiting. This is called A) bingeing. B) emaciation. C) purging. D) restricting

C

The use of laxatives in bulimia nervosa may lead to edema, dehydration, electrolyte imbalances, and A) chronic fluid retention. B) severe intermittent bouts of gastritis. C) irreversible bowel dysfunction. D) permanent irregular heartbeats.

C

__________ disorders often precede the development of anorexia nervosa and consequently may place a person at particular risk for the expression of the disorder. A) Developmental B) Personality C) Anxiety D) Substance abuse

C

The example cited in the text of saints starving themselves out of devotion is A) an illustration of the binge-purge cycle. B) not considered a historical form of anorexia nervosa. C) not a case of anorexia nervosa because it involves a religious context. D) an example of the impact of context on symptom expression in an illness.

D

A sense of loss of control over eating during binge episodes is not required for a diagnosis of bulimia nervosa.

F

Persons diagnosed as having bulimia nervosa are different from persons labeled as having anorexia nervosa in that the former are less impulsive

F

Subthreshold conditions of anorexia nervosa are not associated with problems in social or occupational functioning

F

Although initial promising research pointed to chromosome 10 as a "hot spot" in both bulimia nervosa and obesity, subsequent research has failed to confirm this relationship

False

Anorexia nervosa is fairly prevalent in childhood but bulimia nervosa before puberty is uncommon.

False

Evidence from studies of eating disorders in humans reveals the presence of consistent hypothalamic abnormalities

False

In almost all cases, BED appears to be time-limited and part of a passing phase

False

The case of twins Michaela and Samantha Kendall presented in your text demonstrates that a hostile environment may be a sole determinant of an eating disorder in some cases

False

For binge eating disorder, epidemiologic data indicate A) increased risk for the disorder among members of the lower socioeconomic classes. B) the same findings as revealed in the study of anorexia and bulimia nervosa. C) children of women with binge eating disorders are not at higher risk for the disorder. D) more differences in prevalence exist across racial and ethnic groups

a

Key symptoms of bulimia nervosa include recurrent episodes of binge eating, a feeling of being "out of control" during binge eating episodes, and A) inappropriate strategies for weight control. B) amnesia for food consumption. C) a fear of running out of food. D) a desire to maintain a state of starvation.

a

Obese people with binge eating disorder differ from obese persons without the disorder in that the former A) are more likely to have associated depression and anxiety disorders. B) report more frequent purging episodes. C) report a later onset of both obesity and dieting. D) recall less fluctuation in weight throughout their lives.

a

Overall, research indicates that the most effective approach in the treatment of anorexia nervosa is A) use of a multidisciplinary team. B) nutritional counseling. C) family systems counseling. D) behavior modification.

a

Select the statement below that is FALSE regarding binge eating disorder. A) It was only recently accepted as a formal psychiatric diagnosis. B) It lacks the compensatory behaviors of bulimia nervosa. C) Little is known about associated mortality or morbidity rates. D) It may be a chronic condition.

a

Sexual abuse histories among patients with bulimia nervosa are A) more common than typically seen in the family histories of anorexic patients. B) less common than one would expect from the histories of anorexic patients. C) no more common than among other psychological disorders. D) not documented well enough to be able to assess a prevalence rate.

a

The only FDA-approved drug for an eating disorder is fluoxetine, and it is prescribed for A) bulimia nervosa. B) anorexia nervosa. C) eating disorder not otherwise specified. D) bingeing.

a

The rates at which binge eating disorder occurs in the general population make it the ___________________________ of all eating disorders in DSM-5. A) most frequently occurring B) least frequently occurring C) most dangerous D) most socially acceptable form

a

) Compared with anorexia nervosa patients, persons diagnosed with bulimia nervosa have A) a higher risk of mortality. B) a lower risk of mortality. C) no risk of mortality. D) an equal risk of mortality.

b

) In bulimia nervosa, erosion of dental enamel and callouses on the backs of the hands A) is predictive of a suicide attempt among younger women. B) are among some of the ways the disorder is hard on the body. C) discriminates acute from chronic symptom expression of purging. D) has been found to be an unreliable indicator of self-induced vomiting

b

A treatment that focuses on emotional dysregulation and sees problem eating behaviors as attempts to manage unpleasant emotional states is A) family therapy B) dialectical behavior therapy C) interpersonal psychotherapy D) supportive psychotherapy

b

Christina is a middle school student going through puberty before her female classmates. Consequently, she may be at A) lower risk for developing dissatisfaction with her body. B) greater risk for developing an eating disorder. C) less risk for being underweight. D) greater risk for being sexually abused.

b

Select the cognitive-behavioral treatment element below that is most effective in promoting behavioral change among persons with eating disorders. A) training in diaphragmatic breathing B) increasing self-esteem C) altering thinking patterns D) reducing family enmeshment

c

Epidemiologic data on eating disorders A) suggest that eating disorders are more prevalent among black women than white women in the U.S. B) do not provide us with a clear picture of the racial and ethnic distribution of the disorders. C) indicate that American Indian females have a disproportionately high rate of eating disorders compared to Hispanic females. D) suggest that anorexia nervosa among black women is underreported.

b

In approaching the treatment of anorexia nervosa, a multidisciplinary team first A) opens family channels of communication. B) addresses weight restoration. C) confronts the patient about his/her denial. D) identifies conflict areas in childhood.

b

In persons with anorexia nervosa, abnormalities in serotonin levels may contribute to the expression of A) introversion. B) perfectionism. C) passive-aggressive behavior. D) treatment resistance

b

Marina complains of feeling out-of-control after eating a slice of toast. In an eating disorders paradigm, this behavior would be termed a(n) A) objective binge. B) subjective binge. C) brief binge. D) psychological binge

b

Select the statement below that is TRUE of bulimia nervosa. A) The incidence of the disorder has gradually declined over the last 10 years. B) It is a more "modern" phenomenon than anorexia nervosa. C) It is found more frequently in rural areas. D) It does not appear to be a culture-bound phenomenon

b

There is controversy in the research concerning the incidence of anorexia nervosa in our country; some studies report stable rates, while others report an increase. This discrepancy may be explained by the way in which studies were conducted or A) attrition rates in studies. B) the fact that many people never seek treatment. C) improvements in screening tools for the disorder. D) the underestimate of males having the disorder

b

Unlike anorexia nervosa, bulimia nervosa is A) a visible eating disorder. B) an invisible eating disorder. C) life-threatening. D) found in women only

b

Willie enjoys eating in the university cafeteria because it features an all-you-can-eat buffet. He prefers to wait until most people have dined before entering the facility because he feels awkward about the amount he consumes. Willie usually eats until he feels uncomfortable, although he does not purge. He is most likely to have which of the following disorders? A) Bulimia nervosa B) Binge-eating disorder C) Eating disorder not otherwise specified D) Anorexia nervosa—binge eating type

b

) Inpatient treatment for anorexia nervosa may be required for persons at 75% of their expected body weight. In addition, consideration is given to medical complications, failure to improve with outpatient treatment, and A) the person's age. B) the family's willingness to engage with the multidisciplinary team. C) suicide attempts or plans. D) the chronicity of the disorder

c

A common personality trait in both anorexia and bulimia nervosa is A) rule-boundedness. B) introversion. C) perfectionism. D) conscientiousness

c

Compared to those diagnosed with anorexia nervosa, patients with bulimia nervosa are more likely to engage in A) exhibitionistic behaviors. B) high-risk sexual behavior. C) alcohol and drug abuse. D) self-mutilating behaviors such as "cutting."

c

Elton John and Diana, Princess of Wales, whose cases are presented in the text, both suffered from A) anorexia nervosa. B) alcohol abuse. C) bulimia nervosa. D) drug abuse

c

In bulimia nervosa, binges are usually terminated because the person runs out of food, is interrupted by someone, or A) a strong gag reflex starts. B) feels satiated. C) experiences a strong urge to purge. D) becomes violently ill.

c

Jenna is a young adolescent and has been diagnosed with anorexia nervosa. Most likely, her recovery and treatment will address issues related to independence, trust, and A) separation anxiety. B) emotional freedom. C) establishing romantic relationships. D) assertiveness.

c

Karen Carpenter, a pop icon of the 1970's whose case is presented in the text, died from complications of anorexia nervosa. Which subtype of the disorder was evident in her story? A) Bingeing/Purging B) Restricting C) Purging D) Bingeing

c

Outcome research estimates tell us that ______ percent of patients diagnosed with bulimia nervosa achieve full or partial remission. A) 10 B) 20 C) 50 D) 80

c

Overeating behavior without regular inappropriate compensatory behaviors are characteristic of which of the following? A) Bulimia nervosa B) Anorexia nervosa C) Binge eating disorder D) Purge eating disorder

c

) What structural brain abnormalities have researchers discovered in patients with anorexia nervosa when they are ill? A) Decreased hypothalamus size B) Decreased ventricle size C) Frontal lobe lesions D) Loss of gray matter and reduced brain mass

d

47) As compared to individuals with anorexia nervosa, individuals with bulimia nervosa are more A) rigid. B) perfectionistic. C) obsessive. D) impulsive.

d

Alejandra has been diagnosed with anorexia nervosa. Her dinner last night consisted of 3 celery sticks, a spoonful of hummus, half of a slice of pita bread, and a cup of tea. Feeling full and bloated after eating, Alejandra decided to work out on the treadmill for 40 minutes. Which of the following anorexia nervosa subtypes accurately describes her condition? A) Binging B) Dieting C) Purging D) Restricting

d

Among men, the incidence of bulimia nervosa might be underestimated because A) men are hesitant to admit having struggles with their weight. B) little, if any, research has been conducted on men who have eating disorders. C) the disorder is masked by alcohol and other substance abuse problems. D) men prefer exercise to purging or other compensatory behaviors

d

Anorexia nervosa may be a lethal disorder resulting in death from the effects of starvation or from A) breathing difficulties. B) stomach cancer. C) amenorrehea. D) suicide.

d

Approximately _____ percent of those diagnosed with bulimia nervosa have another psychiatric disorder at some point in their lives. A) 20 B) 50 C) 70 D) 80

d

At least 75% of all persons diagnosed with anorexia nervosa have a comorbid risk of A) bipolar disorder. B) substance abuse disorder. C) major depressive disorder and posttraumatic stress disorder. D) an anxiety disorder and major depressive disorder

d

Certain segments of the population have higher rates of anorexia nervosa than others. Which of the following segments would potentially have the highest rates of the disorder? A) Females from suburban homes B) Workers in service industries C) Daughters of divorced parents D) Workers in the entertainment industry

d

For bulimia nervosa to be diagnosed, binge eating must have occurred A) daily for a period of two months or more. B) daily for a period of three months or more. C) at least weekly for a period of two months or more. D) at least weekly for a period of three months or more.

d

Patterns of binge eating may vary among those diagnosed with bulimia nervosa. Bingeing may occur from occasionally to A) weekly. B) daily. C) hourly. D) multiple times per day.

d

Psychological features often associated with anorexia nervosa include A) anxiety and personality disorders. B) anxiety and childhood disorders. C) depression and somatoform disorders. D) depression and anxiety

d

Relatives of persons with anorexia nervosa or bulimia nervosa have an increased risk for eating disorders _____ times that of persons with no familial history of these disorders. A) 3 B) 5 C) 8 D) 10

d

Salvador Minuchin, who investigated patterns of family dysfunction among patients with eating disorders, identified "enmeshment" as A) a family's willingness to maintain the sick status of the affected member. B) familial attempts to cover up the family member's illness. C) the overidentification of family members with the therapist. D) overinvolvement of all family members in the affairs of one member.

d

Which of the following statements is FALSE regarding eating disorders among females? A) They may result from increased pressure to attain the thin ideal. B) They may result from the influence of hormones on appetite and weight regulation. C) They may be diagnosed more frequently because of sex biases in the diagnostic criteria. D) They are more likely than males to engage in binge eating disorders

d