Chapter 14 PDF

Name: Class: Date: Chapter 14 1. Though similar in their concerns about eating and gaining weight, individuals with bulimia differ from individuals with anorexia in that they _____, while those with anorexia do/a...

Name: Class: Date: Chapter 14 1. Though similar in their concerns about eating and gaining weight, individuals with bulimia differ from individuals with anorexia in that they _____, while those with anorexia do/are not. a. do not eat b. are within 10% of their normal weight c. are driven to thinness d. are secretive about their disorder ANSWER: b 2. Eating disorders are the ____ most common illness in adolescent females. a. second b. third c. fifth d. tenth ANSWER: b 3. Unlike most of the disorders of childhood and adolescence, the causes of eating disorders are disproportionately related to ____ influences. a. sociocultural b. biological c. familial d. psychological ANSWER: a 4. Which statement about picky eating in young childhood is true? a. Over a third of young children are described as picky eaters. b. Picky eating is more common among boys than girls. c. Picky eating in young childhood is clearly connected to the later emergence of eating disorders. d. Picky eating always leads to eating disorders. ANSWER: c 5. Which factor is LEAST characteristic of teens who develop eating problems (Graber et al., 1994)? a. Higher percentage of body fat b. Early pubertal maturation c. Poor academic achievement d. Concurrent psychological problems ANSWER: c 6. Which of the following is NOT necessarily a part of the binge-purge cycle? a. Tension and cravings b. Shame and disgust c. Strict monitoring of body weight Copyright Cengage Learning. Powered by Cognero. Page 1 Name: Class: Date: Chapter 14 d. Strict dieting ANSWER: c 7. Which of the following effects is LEAST likely to occur when an individual is malnourished? a. A loss of circadian rhythm b. A decrease in the release of growth hormone c. Dermatological changes d. Lethargy, apathy, and depression ANSWER: b 8. An individual’s balance of energy expenditure is referred to as their ____. a. set point b. metabolic rate c. circadian rhythm d. net caloric intake ANSWER: b 9. If fat levels decrease below our body’s normal range, the hypothalamus ____. a. produces less insulin b. triggers the proliferation of fat cells c. slows metabolism d. releases growth hormone ANSWER: c 10. Approximately 50% to 75% of growth hormone production occurs ____. a. prenatally b. after the onset of deep sleep c. during adolescence d. when eating ANSWER: b 11. Avoidant/restrictive food intake disorders in childhood are most characterized by ____. a. the eating of nonnutritive substances b. bingeing and purging to lose weight c. significant weight loss d. purposeful regurgitation of food ANSWER: c 12. Failure to thrive is more common among ____. a. girls b. children from disadvantaged environments Copyright Cengage Learning. Powered by Cognero. Page 2 Name: Class: Date: Chapter 14 c. adolescents d. individuals with mental retardation ANSWER: b 13. Early onset of feeding disorder is often associated with ____. a. intellectual disability b. parental overemphasis on food c. inadequate care giving d. poor metabolic control ANSWER: c 14. ____ has/have been identified as a specific risk factor for an infant’s eating or feeding disorder. a. Difficult temperament b. Poor metabolic control c. Parental psychopathology d. Maternal eating disorders ANSWER: d 15. A child who eats insects and wood chips is likely to be diagnosed with ____. a. feeding disorder of childhood b. rumination disorder c. failure to thrive d. pica ANSWER: d 16. Pica is often seen in individuals with ____. a. intellectual disability b. ADHD c. depression d. bulimia ANSWER: a 17. Pica among young children (without intellectual disability) often remits ____. a. when the child starts teething b. after the child experiences a bout of sickness due to eating something inedible c. when the child experiences increased stimulation d. once the child has the cognitive capacity to understand that certain substances are not edible ANSWER: c 18. Pica in the first and second years of life among otherwise normally developing infants and toddlers is likely due to ____. Copyright Cengage Learning. Powered by Cognero. Page 3 Name: Class: Date: Chapter 14 a. undiagnosed learning disorders b. hunger c. exploration d. underlying depression ANSWER: c 19. Failure to thrive is characterized by ____. a. serious digestion problems b. growth and eating problems c. overeating problems d. fear of getting fat ANSWER: b 20. Mothers of infants with failure to thrive have been found to be ____ than mothers of infants without failure to thrive. a. more insecurely attached b. lower in self-esteem c. older d. less intelligent ANSWER: a 21. Studies have found that failure to thrive may affect physical growth in childhood but does not affect future ____. a. psychological health b. physical growth c. eating patterns d. cognitive functioning ANSWER: d 22. Obesity is a ____. a. chronic medical condition b. disorder of weight regulation c. failure of willpower d. childhood-onset mental disorder ANSWER: a 23. Obesity is usually defined in terms of a body mass index above the _____ percentile. a. 60th b. 70th c. 80th d. 95th ANSWER: d Copyright Cengage Learning. Powered by Cognero. Page 4 Name: Class: Date: Chapter 14 24. Approximately ____ of American children are obese. a. 1 in 4 b. 1 in 5 c. 1 in 6 d. 1 in 7 ANSWER: c 25. Obesity ____ is strongly related to obesity in ____. a. in infancy; later childhood b. in infancy; adolescence c. in childhood; adulthood d. at any time during the course of development; adulthood ANSWER: c 26. Obese children are a risk factor for later ____ disorders. a. mood b. anxiety c. eating d. substance ANSWER: c 27. The relationship between preadolescent obesity and the later emergence of eating disorders is likely due to ____. a. biological abnormalities that underlie both conditions b. the teasing that obese children experience from their peers c. an underlying psychiatric condition d. an urge to stop eating ANSWER: b 28. A protein that plays a major role in some genetic cases of obesity is called ____. a. lutein b. peptin c. leptin d. tyrosine ANSWER: c 29. Treatment methods to help children who are obese to lose weight should emphasize ____. a. demanding exercise regimens b. strict caloric reduction/restriction c. avoidance of food cues d. active, less sedentary routines ANSWER: d Copyright Cengage Learning. Powered by Cognero. Page 5 Name: Class: Date: Chapter 14 30. For some teens, particularly girls, excessive efforts to control eating may be a misguided effort to ____. a. punish parents b. manage the stress and physical changes c. punish themselves d. regress back to the oral stage of development ANSWER: b 31. In the early 1900s, the treatment for anorexia was ____. a. psychodynamic psychotherapy b. hypnotherapy c. removal from home and forced feeding d. family therapy ANSWER: c 32. Which of the following is NOT a characteristic of anorexia? a. Loss of appetite b. Fear of gaining weight c. Denial of being too thin d. Refusal to maintain minimal normal body weight ANSWER: a 33. The DSM-5 specifies two subtypes of anorexia based on ____. a. percentage of weight loss b. methods used to limit caloric intake c. presence or absence of comorbid depression d. family dynamics ANSWER: b 34. In comparison to persons with bulimia, those with binge eating/purging type of anorexia ____. a. eat the same amount of food but purge more thoroughly b. eat relatively small amounts of food and purge more consistently c. binge only on healthy foods d. purge more inconsistently ANSWER: b 35. In comparison to the binge eating/purging type, individuals with restricting anorexia tend to ____. a. be more impulsive b. have stronger family histories of obesity c. have more labile moods d. lose weight through diet Copyright Cengage Learning. Powered by Cognero. Page 6 Name: Class: Date: Chapter 14 ANSWER: d 36. In comparison to the restricting type, individuals with the binge eating/purging type of anorexia tend to ____. a. be more controlled and rigid b. be more obsessive c. have less mood problems d. eliminate the food quicker ANSWER: d 37. Which of the following statements relating to bulimia is true? a. Anorexia is more common than bulimia. b. The DSM-5 subdivides bulimia into two types: purging type and restrictive type. c. Approximately, one-third of individuals with bulimia engage in purging. d. No specific quantity of food constitutes a binge. ANSWER: d 38. Binge eating typically follows changes in _______. a. school routines b. weight gain c. interpersonal stress d. family eating patterns ANSWER: c 39. The most common compensatory technique after an episode of binge eating among clinical samples is ____. a. fasting b. vomiting c. exercise d. laxatives ANSWER: b 40. Vomiting is used by people with bulimia to ____. a. prevent weight gain b. avoid bacteria c. gain attention d. act independently ANSWER: a 41. Young women who have dietary-depressive pattern of bulimia differ from women with only the dietary pattern, as those with the dietary-depressive subtype display ____. a. less eating pathology b. more social impairment Copyright Cengage Learning. Powered by Cognero. Page 7 Name: Class: Date: Chapter 14 c. less psychiatric comorbidity d. more anorexic symptoms ANSWER: b 42. Mild binge eating is characterized by how many episodes of binge eating? a. At least one a day b. Four to seven episodes per week c. At least one episode per month d. One to three episodes weekly ANSWER: d 43. Which disorder has become increasingly widespread during this age of abundant fast food and obesity? a. Reduced eating disorder b. Bulimia c. Anorexia d. Binge eating disorder ANSWER: d 44. Binge eating disorder (BED) differs from bulimia in that individuals with BED ____. a. do not feel a loss of control while binge eating b. eat over 1,000 calories in one sitting c. do not have compensatory behaviors d. have lower self-esteem ANSWER: c 45. Studies have estimated the prevalence of anorexia among adolescents at ____. a. 0.2% b. 0.3% c. 7% d. 14% ANSWER: b 46. Which statement about gender differences in relation to eating disorders is true? a. Young men with eating disorders generally have different clinical features than young women. b. Men show more of a drive for thinness than women. c. Men show less of a preoccupation with food than women. d. Men place more emphasis on personal attractiveness than women. ANSWER: c 47. Most commonly, individuals with anorexia ____. a. die from starvation Copyright Cengage Learning. Powered by Cognero. Page 8 Name: Class: Date: Chapter 14 b. overcome their disorder completely c. become overweight in their late twenties d. restore to a normal weight but then relapse ANSWER: d 48. The onset of bulimia ____. a. typically occurs in late adolescence b. typically occurs in mid-adolescence to late adolescence c. typically occurs in adulthood d. may occur at any time after the onset of puberty (no particular time is more likely than others) ANSWER: b 49. Follow-up studies of patients with bulimia indicate that between ____ of patients show full recovery over several years. a. 10% and 15% b. 20% and 25% c. 30% and 45% d. 50% and 75% ANSWER: d 50. Which of the following is a predictor of full recovery for individuals with bulimia? a. Higher social class b. Older age at onset c. Family history of alcohol abuse d. Less weight gain ANSWER: a 51. The neurotransmitter that has been most focused on as a possible cause of eating disorders is ____. a. dopamine b. GABA c. serotonin d. norepinephrine ANSWER: c 52. Scientists have found biochemical similarities between people with eating disorders and those with ____. a. ADHD b. social phobia c. schizophrenia d. obsessive–compulsive disorder ANSWER: d Copyright Cengage Learning. Powered by Cognero. Page 9 Name: Class: Date: Chapter 14 53. Which factor has been linked to the development of eating disorders? a. Parental supervision b. Sexual abuse c. Single-parent family d. Low socioeconomic status ANSWER: d 54. According to research, __________ appear to be at greater risk for behavioral symptoms of eating disorders. a. homosexual men b. homosexual women c. heterosexual men d. bisexual individuals ANSWER: a 55. Cross-cultural evidence for eating disorders suggests that _________________. a. bulimia, and not anorexia, is mainly a Western phenomenon b. anorexia, and not bulimia, is mainly a Western phenomenon c. both bulimia and anorexia appear mostly in Western countries d. both bulimia and anorexia occur commonly worldwide ANSWER: a 56. Which of the following is considered a perpetuating factor of eating disorders? ? a. Obsession with food b. Starvation symptoms and reaction from others c. Dieting to increase feelings of self-worth and self-control d. Dissatisfaction with body weight and body shape ANSWER: b 57. Which of the following disorders is LEAST likely to co-occur with eating disorders? a. Depression b. Anxiety c. Obsessive–compulsive disorder d. ADHD ANSWER: d 58. A common link between depression and eating disorders may be ____. a. high impulsivity b. poor emotion regulation c. excessive anger d. inability to focus ANSWER: b Copyright Cengage Learning. Powered by Cognero. Page 10 Name: Class: Date: Chapter 14 59. ____ is the initial treatment of choice for children and adolescents with anorexia who are living at home. a. Temporary removal from the home b. Family-based therapy c. Psychopharmacology d. Individual psychotherapy ANSWER: b 60. The most effective current treatment for bulimia is ____. a. insight-oriented psychotherapy b. family therapy c. psychopharmacology d. cognitive–behavior therapy ANSWER: d 61. How may present-day societal messages regarding females’ roles contribute to the development of eating disorders? ANSWER: Societal norms and media’s focus on thinness and attractiveness are partly to blame for weight consciousness among pre-teen girls (Bell & Dittmar, 2011; Nouri, Hill, & Orrell-Valente, 2011). In addition, normal concerns about weight and appearance can either be reduced or increased by the comments of parents, friends, and romantic partners. The effects of the early parent–child relationship on fundamental biological processes such as eating and growth patterns are of paramount importance (Corning et al., 2010). 62. Why does dieting sometimes lead to overeating? ANSWER: Decreasing caloric intake reduces a person’s metabolic rate, which allows fat to remain in the cells so that weight loss is, in fact, impeded. This failure to lose weight sets the stage for a vicious cycle of increased commitment to dieting and vulnerability to binge eating. Psychological consequences also contribute to this cycle by creating what some researchers call the “false hope syndrome”—an initial commitment to change one’s appearance leads to short-term improvements in mood and self-image, but this hope declines as feelings of failure and loss of control increase (Polivy & Herman, 2005). Loss of control may lead to binge eating, and purging is seen as a way to counteract the perceived effects of binge eating on weight gain. 63. Why is it often difficult to lose weight? ANSWER: In effect, people who gain or lose weight will experience metabolic changes that strive to bring the body back to its natural weight. If fat levels decrease below our body’s normal range, the brain (specifically, the hypothalamus) compensates by slowing metabolism. We begin to feel lethargic, we increase our sleep, and our body temperature decreases slightly to conserve energy (which is why many persons with anorexia complain of being cold). In this state of relative deprivation, uncontrollable urges to binge are common because our bodies are telling us that they need more food than they are getting to function properly. Similarly, the body fights against weight gain by increasing metabolism and raising body temperature in an effort to burn off extra calories. (Admittedly, this valiant effort is seldom enough to conquer the force of holidays and other feasts.) Because of its responsivity to change, researchers often compare the body’s set point to the setting on a thermostat that regulates room temperature. When room temperature falls below a certain range, the thermostat automatically sends a signal to the heating system to increase the heat level until it again reaches the established temperature setting. Human bodies respond similarly to deviations in body weight by turning their metabolic “furnace” up or down (Wilkin, 2010). Copyright Cengage Learning. Powered by Cognero. Page 11 Name: Class: Date: Chapter 14 64. Twelve-month old Dean has been diagnosed with failure to thrive. You have been asked to formulate a general treatment plan. What might you include in your treatment plan and why? ANSWER: Because the mother–child relationship during the early stages of attachment is critical, eating disorders shown by infants and young children may be symptomatic of a fundamental problem in this relationship (Lyons-Ruth et al., 2014). Thus, treatment regimens involve a detailed assessment of feeding behavior and parent–child interactions, such as smiling, talking, and soothing, while allowing the parents to play a role in the infant’s recovery (Atalay & McCord, 2011; Linscheid, 2006). 65. What are some of the danger signals that an individual may have anorexia? ANSWER: The refusal to maintain a minimally normal body weight, an intense fear of gaining weight, a significant disturbance in the individual’s perception, and experiences of his or her own size. 66. Discuss three risks that are associated with infant and early childhood feeding disorders. ANSWER: Drive for thinness is a key motivational variable that underlies dieting and body image, among young females in particular, whereby the individual believes that losing more weight is the answer to overcoming her troubles and to achieving success (Philipsen & Brooks-Gunn, 2008). However, such behavior creates the negative side effects of weight preoccupation, concern with appearance, and restrained eating, which increase the risk of an eating disorder (Touyz, Polivy, & Hay, 2008). Disturbed eating attitudes describe a person’s belief that cultural standards for attractiveness, body image, and social acceptance are closely tied to one’s ability to control diet and weight gain. 67. Why are eating disorders in infants and young children often considered symptomatic of a problem in the mother– child relationship? ANSWER: A prominent controversy concerns the significance of emotional deprivation (lack of love) and malnutrition (lack of food), especially for failure to thrive. Investigators have argued that the infant with FTT, for example, has been deprived of maternal stimulation and love, which results in emotional misery, developmental delays, and eventually, physiological changes. In one study, mothers of infants diagnosed with FTT were found to be more insecurely attached than mothers of normal infants. These mothers also were more passive and confused and either became intensely angry when discussing past and current attachment relationships or dismissed the attachments as unimportant and noninfluential (Benoit, Zeanah, & Barton, 1989). Children who have suffered from FTT as a result of early abuse exhibit poorer outcomes 20 years later than children whose failure to thrive resulted from neglect, lack of parenting, or feeding difficulties (Iwaniec, Sheddon, & Allen, 2003). 68. Outline and describe the dangers of obesity in children and adolescents. ANSWER: Obesity can affect a child’s psychological and physical development significantly. Obese children and adolescents are five times more likely than healthy children to experience an impaired quality of life, similar to children with cancer. Individuals with obesity risk many health concerns, including cardiovascular problems, diabetes, and elevated cholesterol and triglycerides. Obesity in children is a risk factor in the later emergence of eating disorders, and it is strongly correlated with teasing by peers, which leads to dissatisfaction with appearance and body image. Finally, obesity is a major factor in reducing life expectancy in Western society. 69. Distinguish between anorexia and bulimia, both in terms of their major features as well as their associated characteristics. In what ways are these two eating disorders similar? ANSWER: Although the word anorexia literally means “loss of appetite,” that definition is misleading because the person with this disorder rarely suffers appetite loss. Weight loss is accomplished deliberately through a very restricted diet, purging, and/or exercise. Although many persons occasionally use these methods to lose weight, the individual with anorexia intensely fears obesity and pursues thinness relentlessly. The DSM-5 Copyright Cengage Learning. Powered by Cognero. Page 12 Name: Class: Date: Chapter 14 specifies two subtypes of anorexia based on the methods used to limit caloric intake. In the restricting type, individuals seek to lose weight primarily through diet, fasting, or excessive exercise; in the binge eating/purging type, the individual regularly engages in episodes of binge eating or purging, or both. Compared with persons with bulimia, those with the binge eating/purging type of anorexia eat relatively small amounts of food and commonly purge more consistently and thoroughly. Of the two major forms of eating disorders afflicting adolescents and young adults, bulimia nervosa is far more common than anorexia. The DSM-5 diagnostic criteria listed in Table 14.2 note that the primary hallmark of bulimia is binge eating. Because most of us overeat certain foods at certain times, you may ask, “What exactly is a binge?” As noted in the criteria, a binge is an episode of overeating that must involve (1) an objectively large amount of food (more than most people would eat under the circumstances) and (2) lack of control over what or how much food is eaten. No specific quantity of food constitutes a binge—the context of the behavior that must also be considered. The second important part of the diagnostic criteria involves the individual’s attempts to compensate somehow for a binge. Compensatory behaviors are intended to prevent weight gain following a binge episode and include self-induced vomiting, fasting, exercising, and the misuse of diuretics, laxatives, enemas, or diet pills. 70. What are the commonalities among males and females who have eating disorders as well as the differences each have regarding body ideals? ANSWER: There is increased recognition that eating disorders are more common among young men than was originally believed. Males also are subjected to powerful media images although perhaps not to the same extent as females. The increasingly muscular male body ideal may be contributing to body dissatisfaction, disordered eating, and harmful weight-control or body-building behaviors (Smolak & Stein, 2010). Young men with eating disorders show some of the same clinical features as young women with eating disorders. However, young men show less of a preoccupation with food or a drive for thinness; rather, they want to be more muscular than they actually are and more muscular than the average male body (Olivardia et al., 2004). In addition, young men and boys are more likely to engage in excessive exercising and overeating, whereas young women and girls are more likely to engage in purging behaviors, to report loss of control while eating, and to try to reduce their caloric intake (von Ranson & Wallace, 2014). 71. Discuss what is meant in the recent research that indicated that anorexia may not be a culture-bound syndrome and that bulimia may be considered a culture-bound syndrome. ANSWER: Anorexia has been observed in Western countries as well as every non-Western region of the world, suggesting that anorexia may not be a “culture-bound” syndrome as once believed (Sohl, Touyzl, & Surgenor, 2006). It is becoming increasingly clear that eating disorders do not always manifest the same way in different cultures. In Hong Kong, for example, studies suggest that anorexia may be divided into fat- phobic and non-fat-phobic subtypes and that questionnaires used in Western countries to assess eating disorders may not be sufficiently sensitive to detect the Chinese non-fat-phobic subtype (Lee, Lee, & Leung, 1998). However, the cross-cultural evidence for bulimia and BED outside of a Western context tells a different story. Keel and Klump’s (2003) review of culture and eating disorders found no studies reporting the presence of bulimia in individuals who have not been exposed to Western ideals. Epidemiological data for bulimia in non-Western nations suggest that bulimia has a lower prevalence than anorexia in these countries, and even when it is found in non-Western nations, it is not found in the absence of Western influence. A meta-analysis examining the role of ethnicity and culture in the development of eating disturbances found few differences across ethnic groups for bulimia (Wildes & Emery, 2001). These findings seem to suggest that bulimia is a culture-bound syndrome, arising predominantly in Western regions of the world or in places where individuals probably or definitely have been exposed to Western ideals and culture (Anderson-Fye, 2009). 72. Discuss predominant treatments for obesity in children. ANSWER: Childhood obesity prevention and intervention efforts focus on the child’s health as well as the family’s Copyright Cengage Learning. Powered by Cognero. Page 13 Name: Class: Date: Chapter 14 resources. Proper nutrition, not necessarily dieting, is recommended by pediatricians. Emphasis on family functioning is critical, as this relates to eating patterns and choices. Efforts to curb childhood obesity often focus on addressing parents’ knowledge of nutrition and increasing children’s physical activity levels. 73. In what ways may family members contribute to the development of an eating disorder? ANSWER: From the very start, researchers and clinicians have placed considerable importance on the role of the family, and parental psychopathology in particular, in considering causes of eating disorders. They have argued that alliances, conflicts, or interactional patterns within a family may play a causal role in the development of eating disorders among some individuals (Minuchin, Rosman, & Baker, 1978). Accordingly, a teen’s eating disorder may be functional in that it directs attention away from basic conflicts in the family to the teen’s more obvious (symptomatic) problem. Evidence has confirmed that families with members who have eating disorders report worse family functioning than control families, although a typical pattern of family dysfunction is not evident (Holtom-Viesel & Allan, 2014). 74. Describe how cognitive–behavioral therapy might be used to treat an individual with an eating disorder. ANSWER: The goals of CBT are to modify abnormal cognitions on the importance of body shape and weight and to replace efforts at dietary restraint and purging with more normal eating and activity patterns (Poulsen et al., 2014; Touyz et al., 2008). CBT for the treatment of bulimia includes several components. Patients are first taught to self-monitor their food intake and bingeing and purging episodes, as well as any thoughts and feelings that trigger these episodes. This is combined with regular weighing; specific recommendations on how to achieve desired goals, such as the introduction of avoided foods and meal planning, designed to normalize eating behavior and curb restrictive dieting; cognitive restructuring aimed at habitual reasoning errors and underlying assumptions relevant to the development and maintenance of the eating disorder; and regular review and revision of these procedures to prevent relapse. 75. What interventions are used for bulimia, and are they successful? ANSWER: As noted, the most effective current therapies for bulimia involve CBT delivered individually or by involving the family unit (Rutherford & Couturier, 2007; Wilson et al., 2007). Cognitive–behavioral therapists change eating behaviors by rewarding or modeling appropriate behaviors, and by helping patients change distorted or rigid thinking patterns that may contribute to their obsession. CBT has become the standard treatment for bulimia, and it forms the theoretical base for much of the treatment for anorexia (Chavez & Insel, 2007). This evidence-based treatment is appropriate for patients whose age does not mandate family therapy and whose symptoms are moderate to severe. Copyright Cengage Learning. Powered by Cognero. Page 14