PSYC 3082 Ch. 8: Eating Disorders and Sleep-Wake Disorders
what percentage of the population is affected by narcolepsy
0.03-0.16%
what are the three major types of eating disorders
1. bulimia nervosa 2. anorexia nervosa 3. binge-eating disorder
what are 3 key features in anorexia nervosa
1. decreased body weight 2. intense fear of obesity 3. disturbance in body image
what the 5 dyssmomnia disorders
1. insomnia disorder 2. hypersomnia disorder 3. narcolepsy 4. breathing related sleep disorders 5. circadian rhythm disorder
what are the three breathing related sleep disorders
1. obstructive sleep apnea hypopnea 2. central sleep apnea 3. sleep related hypoventilation
most individuals with bulimia nervosa are within _______% of normal body weight
10%
what percentage of children experience nightmares regularly
10-50%
___% below expected body weight is found in anorexia nervosa
15
It is estimated that ______ of individuals with eating disorders die as a result of the disorder, with as many as 50% of those deaths coming from ______.
20%; suicide
The typical age of onset for anorexia nervosa and bulimia nervosa is ______, with younger cases of anorexia tending to begin at ______ and younger cases of bulimia tending to begin at ______.
20; 15; 10
In a study comparing the genetic contribution to eating disorders, researchers found that in ___% of identical twin pairs both twins had bulimia nervosa, while that number was ___% of fraternal twin pairs. Although this does not rule out the influence of environmental and sociocultural factors, it does present compelling evidence for a genetic contribution to these conditions.
23; 9
according to the DSM-5 criteria for hypersomnolence disorder: the hypersomnolence occurs at least _________ times per week for at least ________ months
3 times per week for at least 3 months
a person is considered obese when their BMI is _____ or greater
30
genes are thought to account for about _______% of the equation in causation of obesity
30%
a person is considered obese if their BMI is what
30+
what percentage of adults report daytime sleepiness consistent with insomnia disorder
35%
what is percentage of US adults are obese
37.5%
Because societal messages promoting thinness as ideal for girls are received even in early childhood, your authors note that by the age of ________ years as many as 20% of girls report that they are trying to lose weight.
9
what percentage of adults experience nightmares regularly
9-30%
sleep paralysis
A brief period after awakening when they can't move or speak that is often frightening to those who go through it
nightmare
A frightening and anxiety-provoking dream occurring during rapid eye movement sleep. The individual recalls the bad dream and recovers alertness and orientation quickly.
College men and women were asked to rate their assessment of what is an attractive body size and what is an ideal body size in both men and women. Read the following statements and select which best reflects the findings of this very important study.
Women rated the ideal female body size the smallest, while men's assessment of an attractive woman's size was considerably larger.
Both anorexia nervosa and bulimia nervosa are characterized by
a fear of gaining weight and losing control over eating habits.
sleep walking
a parasomnia that involves leaving the bed during NREM sleep
Bulimia nervosa is characterized by
a recurrent pattern of eating large amounts of food followed by attempts to compensate for the amount of calories consumed.
cataplexy
a sudden loss of muscle tone
according to the DSM-5 criteria for narcolepsy hypocretin deficiency is not observed in the context of
acute brain injury, inflammation, or infection
when is the onset for narcolepsy
adolescence
when is the onset of bulimia nervosa
adolescents
A later stage of Alice's enhanced cognitive-behavioral treatment (CBT-E) for bulimia will likely involve
altering dysfunctional thoughts about body shape, weight, and eating
what are the medical consequences of anorexia nervosa
amenorrhea dry skin brittle hair and nails sensitivity to or intolerance of cold temperatures lanugo cardiovascular problems
anorexia nervosa
an eating disorder characterized by recurrent food refusal, leading to dangerously low body weight
bulimia nervosa
an eating disorder involving recurrent episodes of uncontrolled excessive eating followed by compensatory purges
what is the chief characteristic of all eating disorders
an overwhelming all-encompassing desire to be thin
what has the highest mortality of any psychological disorder
anorexia nervosa
what is one of the most deadly mental disorders
anorexia nervosa
Errol as bulimia nervosa and is currently receiving treatment for it. His clinician has read the existing research on the use of medications and has found that a particular type of drug is of use during the bingeing and purging cycle of this disorder. Which of the following types of medication will Errol be asked to take?
antidepressant
what is the medical treatment for cataplexy
antidepressants
what drug treatments can be used to treat bulimia nervosa
antidepressants can help reduce purging behavior and binging
Research on bulimia nervosa suggests that it most often co-occurs with:
anxiety disorders
what psychological disorders are associated with bulimia nervosa
anxiety disorders mood disorders; particularly depression substance abuse
when does anorexia nervosa usually develop
around early adolescence
People with anorexia nervosa are just as fearful as people with bulimia nervosa of gaining weight and losing control over their eating habits. However, people with bulimia are _____________ of their diet.
ashamed
to be diagnosed with bulimia nervosa, binge-eating and inappropriate compensatory behaviors both occur at least __________________ for _____________
at least once a week for three months
Eden is classified as being morbidly obese. Her body mass index is well over 40, and she is experiencing a variety of physical symptoms related to her body size. Her physician has been gently encouraging her to lose weight for years, but Eden has ignored this advice. Now that her weight is causing extreme pain in her hips, knees, and ankles and is interfering with her life, Eden has decided to do something about the problem. Which of the following interventions will be the most effective at helping her lose weight and keep it off?
bariatric surgery
what is the last step to obesity treatment
bariatric surgery
what treatment approach for obesity is becoming increasingly popular for individuals with a BMI greater than 40
bariatric surgery
what is the third step to obesity treatment
behavior modification programs
what is the medical treatment for insomnia
benzodiazepines and over the counter sleep medications
what are the two disordered eating patterns seen in obesity
binge eating and night eating syndrome
what are the key features of bulimia nervosa
binges a feeling of lack of control over what and how much is being eaten compensatory behaviors
according to the DSM-5 criteria for narcolepsy the presence of one of what two things are needed for a diagnosis
brief episodes of sudden bilateral loss of muscle tone with maintained consciousness (cataplexy) precipitated by laughter or joking spontaneous grimaces or jaw opening episodes with the tongue thrusting or a global hypotonia, without any obvious emotional triggers
Dr. Thompson sees a patient with a chubby face, calluses on her fingers, and small scars on the back of her hand. Tests indicate that the patient weighs slightly more than her expected weight and that she has an electrolyte imbalance. The patient reports that she is having persistent constipation and that she feels as if her heart has been skipping beats. These symptoms are consistent with:
bulimia nervosa
parasomnias
Abnormal behaviors such as nightmares or sleepwalking that occur during sleep.
what is one of the most common psychological disorders on college campuses
bulimia nervosa
Why is it that people who work overnight shifts on a regular basis may have a higher risk of developing circadian rhythm sleep disorder?
Because the part of the brain that controls our sleep cycles is directly connect to our eyes and is affected by the light in our surroundings.
what are three psychological treatments used to treat binge eating disorder
CBT similar to that used for bulimia interpersonal psychotherapy self help techniques
night eating syndrome
Consuming a third or more of daily food intake after the evening meal and getting out of bed at least once during the night to have a high-calorie snack. In the morning, individuals with night eating syndrome are not hungry and do not usually eat breakfast. These individuals do not binge during their night eating and seldom purge.
sleep terrors
Episodes of apparent awakening from sleep, accompanied by signs of panic, followed by disorientation and amnesia for the incident. These occur during nonrapid eye movement sleep and so do not involve frightening dreams.
Millicent sits up in bed several times a week, shouting and crying as if she is terrified. Her mother takes her to the pediatrician who suggests that she is having night terrors. Upon hearing this, Millicent's father says, "This is probably just caused by nightmares. She'll grow out of it!" Is Millicent's father correct?
He is half right. Millicent is not having nightmares because sleep terrors occur during NREM sleep, but the typical treatment is to wait and see if the terrors go away on their own. Only if they do not will additional treatment be needed.
Jody regularly engages in binge-eating episodes, and clearly suffers from an eating disorder. How would you determine if her diagnosis should be bulima nervosa or binge-eating disorder?
If it is bulimia nervosa, Jody's binge-eating episodes will be followed by some sort of compensatory behaviors to get rid of the calories she consumed. If it is binge-eating disorder, she will not.
what are the drawbacks to using benzodiazepines to treat insomnia
can cause excessive sleepiness dependency and abuse rebound insomnia with prolonged use increased likelihood of sleep walking related problems
Some people who have narcolepsy experience a sudden loss of muscle tone, a condition called ________. This can be very dangerous, as a person can hurt themselves during such episodes.
cataplexy
what are 4 distinguishing characteristics of narcolepsy
cataplexy sleep paralysis hypnagogic hallucinations hypocretin deficiency
amenorrhea
cessation of menstruation
what is the second step to obesity treatment
commercial self-help programs
central sleep apnea
complete cessation of respiratory activity for brief periods of time
insomnia disorder
condition in which insufficient sleep interferes with normal functioning
sleep related hypoventilation
decrease in airflow without complete pause in breathing resulting in increased carbon dioxide levels
Which of the following potentially fatal medical conditions is not a known consequence of the electrolyte imbalances that can occur as a result of repeated vomiting that is often associated with bulimia nervosa?
development of lanugo
lanugo
downy hair on limbs and cheeks
when do nightmares occur
during REM sleep
what are the two major types of sleep disorders
dyssomnias and parasomnias
Donte has been having difficulty with sleeping and feeling rested lately. His doctor decides to send him for a polysomnographic evaluation to assess different physical functions that are occurring during his sleep time. One of them, called an ________, will measure the eye movements that take place during his sleep and this will help determine whether or not he is entering a REM stage while he sleeps and, if so, for how long.
electrooculogram
what psychological processes contribute to the cause of obesity
emotional regulation, impulse control, attitudes and motivation toward eating and responsiveness to the consequences of eating
The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) also distinguishes between two specific types of bulimia nervosa. For a clinician to indicate the presence of the nonpurging type of bulimia nervosa, a patient must exhibit __________________ to compensate for calories consumed.
excessive exercise
insomnia is often associated with unrealistic
expectations about sleep
true or false Fatty foods and technology are not to blame for the obesity epidemic in the United States.
false
true or false Antidepressants help individuals overcome anorexia but have no effect on bulimia.
false
true or false Individuals with night eating syndrome consume at least half their daily intake after their evening meal.
false
true or false One study showed that males consider a smaller female body to be more attractive than women do.
false
Jiang has been in treatment for anorexia nervosa for the past two months. Her treatment has consisted of many different features, including helping her to gain weight to get back into a health range, family therapy, and individual psychotherapy. Jiang has participated willingly in all of these aspects of her treatment. Which of them will be the best predictor of long-term recovery from anorexia nervosa?
family therapy
the majority of individuals with bulimia nervosa are
female
what gender is more likely to be affected by insomnia
females twice as often as men
behavioral and cognitive interventions in the treatment of anorexia target
food, weight, body image, thoughts and emotion
nightmare disorder
frequently being awakened by extended and extremely frightening dreams that cause significant distress and impaired functioning
how does genetics cause obesity
genes influence the number of fat cells a person has, the likelihood of fat storage, satiety, and activity levels
When you get in bed for the night, I want you to picture yourself in a hammock by the beach. Close your eyes, listen to the surf, and feel your body lightly sway in the hammock. Once you are relaxed in your hammock, begin to envision yourself meditating in the hammock and relieving stress. this is an example of what type of therapy used to treat sleep disorders
guided imagery relaxation
people are considered to have insomnia if they
have trouble falling asleep at night, if they wake up frequently or too early and can't go back to sleep, or if they sleep a reasonable number of hours but are still not rested the next day
Linh is receiving treatment for a dyssomnia. What symptom did Linh likely describe so her doctor could determine an appropriate treatment strategy?
having trouble staying asleep at night
how do physiological processes cause obesity
hormonal regulation of appetite play a large role in the initiation and maintenance of eating
although not formally considered a disorder in the DSM-5 obesity is included in a discussion on eating disorders because of its
impact on social and psychological functioning
purging techniques
in bulimia nervosa, the self-induced vomiting and laxative abuse used to compensate for excessive food intake
what is one of the most common sleep disorders
insomnia disorder
medical treatments for people with ____________________ often include one of several benzodiazepines, ideally of the _______________ category, to reduce daytime sleepiness
insomnia; short acting
paradoxical intention
involves instructing people to perform behaviors opposite of a desired outcome in order to create a paradox in which the anxiety surrounding falling asleep is reduced
guided imagery relaxation
involves the use of imagery or meditation to induce relaxation at bedtime
insomnia is only diagnosed as a sleep disorder if
its not better diagnosed by a different condition (like anxiety disorder)
what are the different types of circadian rhythm sleep disorders
jet lag type shift work type delayed sleep type advanced sleep type familial type irregular sleep-wake type non-24 hour sleep-wake type
insomnia is often associated with a belief that
lack of sleep with be more disruptive than it actually is
hypersomnolence disorder may manifest as
long nights of sleep or frequent napping
what is the treatment for nightmare disorder
may involve antidepressants and/or relaxation training
what is often associated with insomnia
medical and/or psychological conditions
what is the medical treatment for breathing related sleep disorders
medications, weight loss, or mechanical devices
disorder of arousal
motor movements and behaviors that occur during NREM sleep including incomplete awakening, sleep walking, or sleep terrors
Jaclyn's dad is sometimes awakened by his daughter's screams. He runs to Jaclyn's room to comfort her and is eventually able to calm her down. Jaclyn usually explains that she was being chased by a big, one-eyed, purple monster. The events typically happen after watching scary movies with friends diagnose the sleep problem
nightmares
are individuals with anorexia nervosa ever satisfied with their weight loss
no
do individuals with anorexia nervosa seek treatment
no
Jack has made a serious commitment to his diet for more than a month but continues to gain weight. He has no memory of eating but noticed that food is always missing from the refrigerator. diagnose the sleep problem
nocturnal eating syndrome
obstructive sleep apnea hypopnea
occurs when airflow stops despite continued activity by the respiratory system
Individuals with night eating syndrome tend to consume more than ______ of their daily calorie intake after their evening meal.
one third
explain how CBT is used to treat bulimia nervosa
patient is taught the physical consequences of binge eating and purging as well as the ineffectiveness of vomiting and laxative abuse for weight control later stages focus on altering dysfunctional thoughts and attitudes about body shape, weight, and eating coping strategies for resisting the impulse to binge and/or purge are also developed
binge-eating disorder
pattern of eating involving distress inducing binges not followed by purging behaviors
what are the medical treatments for circadian rhythm sleep wake disorders
phase delays, phase advances, the use of very bright light
dyssomnias
problems in getting to sleep or in obtaining sufficient quality sleep
how does technological advancement contribute to the cause of obesity
promotes an inactive sedentary lifestyle
explain cognitive behavioral therapy for insomnia
psychoeducation about sleep changing beliefs about sleep extensive monitoring using sleep diary practicing better sleep related habits
__________________ is often a component of treating a person with a sleep disorder because drug therapy is often not an ideal long-term solution
psychological treatment
in bulimia nervosa compensation is almost always through ___________
purging techniques
Ramiro has a problem getting to his morning classes in college, and it has been going on for more than half of the semester. Although he goes to bed by 11 pm every night, he often does not wake up until at least 9 am, and on these days he misses his 8 am course. His roommate has suggested just dropping the course and signing up for later classes, but Ramiro is bothered because he usually does not feel well-rested even after a night of so much sleep. Which of the following is accurate for Ramiro's case?
ramiro should be diagnosed with hypersomnolence disorder
according to the DSM-5 criteria for narcolepsy the disorder is characterized by recurrent
recurrent periods of irrepressible need to sleep, lapsing into sleep, or napping occurring within the same day, at least three times per week over the past three months
according to the DSM-5 criteria for hypersomnolence disorder: self reported excessive sleepiness despite a main sleep period lasting at least 7 hours, with at least one of what symptoms?
recurrent periods of sleep or lapses into sleep within the same day a prolonged main sleep episode of more than 9 hours per day that is non-restorative difficulty in being fully awake after abrupt awakening
sleep hygeine
refers to daily patterns of behavior that involve good sleep habits, including developing a regular time to go to bed and time to wake up, abstaining from drinking caffeine six hours before going to bed, and not exercising in the hours before going to bed
binge
relatively brief episode of uncontrolled, excessive consumption, usually of food or alcohol
all forms of treatment for sleep disorders have the common goal of
restoring a person's sleep to a healthy level
what are the medical consequences of the self-induced vomiting seen in bulimia nervosa
salivary gland enlargement which gives the face a chubby appearance erosion of dental enamel tears in the esophagus electrolyte imbalance which can result in cardiac arrhythmias, seizures, and kidney failure
For a person to be diagnosed with bulimia nervosa, two aspects of binge eating must be observed. Of the following scenarios, select the one that includes both aspects: Scenario 1: Erin is attempting to eat a 72-ounce steak in under 30 minutes, with success resulting in a free meal. After 15 minutes, she feels in control of the pace of eating and that she just might be able to eat the whole steak. Scenario 2: Alex has already eaten a hamburger with four patties, a chocolate shake, and an order of french fries. He is now eating a second order of french fries, uncontrollably shoving handfuls of them in his mouth.
scenario 2 Both Erin and Alex are eating a large amount of food, but Alex's uncontrollably shoving handfuls of french fries in his mouth is an example of a lack of control over eating. Erin's feeling that she has control over the pace of her eating is a sign of actually having control
what is the first step to obesity treatment
self directed weight loss programs
describe the reciprocal relationship that prompts the inclusion of sleep disorders in the realm of abnormal psychology
sleep difficulties may create disordered patterns of behavior or be the result of a psychological disorder
narcolepsy
sleep disorder involving sudden and irresistible sleep attacks
circadian rhythm sleep disorder
sleep disturbances resulting in sleepiness or insomnia, caused by the body's inability to synchronize its sleep patterns with the current pattern of day and night
hypersomnolence disorder
sleep dysfunction involving an excessive amount of sleep that disrupts normal routines
Sho-jen's parents hear her piercing screams on many nights and rush to comfort her, but she does not respond. During these episodes, her heart rate is elevated, and her pajamas are soaked in sweat. When she gets up the next day, she has no memory of the experience. diagnose the sleep problem
sleep terrors
the mortality rates for obesity are close to those associated with
smoking
why is anorexia nervosa considered to be one of the most deadly mental disorders
starving the body borrow energy from internal organs, leading to organ damage
which statement characterizes dyssomnias? statement 1: I repeatedly cannot fall asleep until 3:00 AM. This only makes for a tired day at work and frustration when I am desperately trying to fall asleep at night. statement 2: I often wake from a vivid nightmare about an hour before I have to get up. The nightmares always seem to encompass a long period and usually involve me running for my life.
statement 1
what is the medical treatment for hypersomnia and narcolepsy
stimulants
cataplexy seen in narcolepsy is usually preceded by
strong emotion
cataplexy seen in narcolepsy results from
sudden onset of REM sleep
Approximately 20% to 30% of anorexia nervosa-related deaths are due to ________, which is 50 times higher than the risk of death from the same cause in the general population.
suicide
bariatric surgery
surgical approach to extreme obesity, usually accomplished by stapling the stomach to create a small stomach pouch or bypassing the stomach through gastric bypass surgery
In comparing the effectiveness of enhanced cognitive-behavioral therapy (CBT-E) with psychoanalytic psychotherapy (PPT) for patients with bulimia nervosa, which of the following statements is the most accurate?
the CBT-E patients showed significantly higher rates of recovery at 5 months (when CBT-E concluded) and 2 years (when PPT concluded).
Megan has recently been diagnosed with an eating disorder. Which of the following likely does not play a key role in driving Megan's disordered behavior?
the desire to attract a mate
True or false Obesity is the single most expensive health problem in the United States, surpassing both smoking and alcohol abuse
true
true or false Professionally directed behavior modification programs represent the most successful treatment for obesity.
true
true or false Attention must be focused on dysfunctional attitudes about body shape in anorexia, or relapse will most likely occur.
true
true or false Biological limitations, as well as the societal pressure to use diet and exercise to achieve nearly impossible weight goals, contribute to the number of people with anorexia and bulimia.
true
true or false Cognitive-behavioral treatment (CBT) and interpersonal psychotherapy (IPT) are both successful treatments for bulimia nervosa, although CBT is the preferred method.
true
true or false Many young women with eating disorders have a diminished sense of personal control and confidence in their own abilities, are perfectionists, and/or are preoccupied with how they appear
true
breathing related sleep disorders
Sleep disruption leading to excessive sleepiness or insomnia, caused by a breathing problem such as interrupted (sleep apnea) or labored (hypoventilation) breathing.
Serena has had anorexia nervosa since she was a teenager. Now in her mid-twenties, which of the following behaviors would she be most likely to demonstrate?
Sally hoards food in her room, and although she doesn't eat it, she looks at it from time to time.
hyponagogic hallucinations
vivid sensory phenomena that occur during the onset of sleep
what is the initial goal in treating anorexia
weight restoration
who is most likely to develop anorexia nervosa
white females from middle to upper class families