Abnormal Psychology Test 3
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Chapter 9: Schizophrenia 03/06/2016 Alogia Anhedonia Anticipatory pleasure Asociality Avolition Blunted affect Brief psychotic disorder: Catatonia Clinical high-risk study Cognitive enhancement therapy (CET) Consummatory pleasure Delusional disorder Delusions: Dementia praecox Disorganized behavior Disorganized speech Disorganized symptoms Expressed emotion (EE): Familial high-risk study Grandiose delusions: hallucinations Ideas of reference: Loos associations (derailment): Negative symtoms Positive symptoms: Prefrontal cortex Schizoaffective disorder Schizophrenia Schizophreniform disorder Second-generation antipsychotic drugs Social selection hypothesis Social skills training Sociogenic hypothesis o Schizophrenia symptoms are often described in three broad domains: positive, negative, and disorganization. o Delusions are found among people with other diagnoses, including bipolar disorder, major depressive disorder with psychotic features and delusional disorder o Those with schizophrenia appear to have a deficit in anticipatory pleasure but not consummatory pleasure o DSM5 requires that the symptoms last at least 6 months; must include 1 month of acute episode or active phase (presence of at least two of delusions, hallucinations, disorganized speech, disorganized behavior, and negative symptoms) o Schizophrenia has a genetic component o The first neurotransmitter to receive substantial research attention was dopamine o Dopamine Theory: theory that schizophrenia is related to excess activity of the NT dopamine is based principally on the knowledge that drugs effective in treating schizophrenia reduce dopamine activity. o Other NTs – GABA, Glutamate o Postmortem studies of the brains of people with schizophrenia consistently reveal enlarged ventricles o Enlarged ventricles are not specific to schizophrenia, as they are evident in the CT scans of people with other disorders (bipolar with psychotic features) o Prefrontal cortex is important in schizophrenia o Additional research has found that people with schizophrenia have structural and functional abnormalities in the temporal cortex, including areas such as the temporal gyrus, hippocampus, amygdala, and anterior cingulate. o Chronic stress is associated with reductions in hippocampal volume o Possible cause of some observed brain abnormalities in schizophrenia is damage during gestation or birth o Higher rates of schizophrenia are found in lower socioeconomic status. o Ethnicity has a role in expressed emotion – different ethnicities show different amounts of EE in different ways (over involvement or negativity) and that effects different ethnicities in different ways o Lower IQ, poor social and motor skills, and more negative emotions as children seemed to correlate with later development of schizophrenia o Reduced Gray matter volume has been found in people with schizophrenia o Problem with treating schizophrenia is that the disease itself makes the person unable to realize they need treatment o First generation drugs for schizophrenia treated the positive and disorganized symptoms but had little to no effect on the negative symptoms o Common side effects of antipsychotics are sedation, dizziness, blurred vision, restlessness, sexual dysfunction, and even tremors of the fingers, shuffling gait, and drooling. o Narcoleptic malignant syndrome: side effect that occurs from antipsychotic drugs; can be fatal, are severe muscular rigidity with fever, increase BP/HR, and a coma may occur. o Clozapine started the development of second generation antipsychotics; had therapeutic gains for those who didn't respond well to first generation drugs Clozapine had its own set of side effects – impair the immune system functioning (decrease in white blood cell count), seizures, dizziness, fatigue, drooling, and weight gain o Olanzapine and risperidone are the other two second generation drugs o Second generation antipsychotics appear to be equally effective as first generation in treating positive and disorganized symptoms, and more effective in reducing negative symptoms. Also thought to improve cognition (attention, memory) o Combination of medication and psychosocial treatment predicted the best outcome o Research has shown that social skills training can help people with schizophrenia achieve fewer relapses, better social functioning, and a higher quality of life o Family therapies are used to: Educate about schizophrenia – specifically genetic or neurobiological factors that predispose some people to the illness. Help high-EE families learn how to control their inappropriate or ineffectual actions Inform about antipsychotic medication Blame avoidance and reduction Communication and problem solving skills within the family Social network expansion Hope for improvement o Maladaptive beliefs of some people with schizophrenia can in fact benefit from cognitive behavior therapy; CBT can reduce negative symptoms as well as positive and disorganized o Psychoeducation is an approach that seeks to educate people about their illness o Case manager was created as a new mental health specialty; they were able to connect people with schizophrenia with providers of whatever services they required. o Halfway houses are used for those who still cannot be fully independent; they are protected living units. Question 1 0.8 / 0.8 pts The lifetime prevalence of schizophrenia is around __________ percent. 3 5 1 7 Question 2 0.8 / 0.8 pts Symptoms of schizophrenia have been classified as positive, neutral, and negative. organized, disorganized, and negative. positive, negative, and disorganized. organized, positive, and negative. Question 3 0.8 / 0.8 pts An exaggerated sense of importance, power, knowledge, or identity is known as a hallucinations. grandiose delusions. none of these other answers are correct ideas of reference. Question 4 0.8 / 0.8 pts Sensory experiences in the absence of any relevant stimulation from the environment are called ideas of reference. flights of thought. delusions. hallucinations. Question 5 0.8 / 0.8 pts Among those with schizophrenia who suffer from delusions, a large majority experience delusions of impulses imposed by others. hallucinations with the delusions. thought broadcast. delusions of persecution. Question 6 0.8 / 0.8 pts Which of the following are examples of negative symptoms of schizophrenia? catatonic immobility, waxy flexibility difficulty concentrating, low intelligence, poor memory hallucinations and delusions flat affect, lack of initiative Question 7 0.8 / 0.8 pts James is struggling with schizophrenia. He also finds it difficult to experience pleasure from activities that he enjoyed before his symptoms began. This is an example of asociality. avolition. alogia. anhedonia. Question 8 0.8 / 0.8 pts James suffers from schizophrenia and flails his limbs wildly with excitement. This is most appropriately labeled as hallucinations. delusions. catatonia. mania. Question 9 0.8 / 0.8 pts Emil Kraepelin and __________ initially formulated the concept of schizophrenia. Sigmund Freud none of these other answers are correct Eugen Bleuler Jerome Welchup Question 10 0.8 / 0.8 pts Howard had a psychotic episode following the death of his wife. He had hallucinations in which he would hear her speaking to him, telling him to kill himself. Howard developed elaborate delusions about his ability to communicate with his wife’s spirit. Howard recovered from this episode after one week and had no further symptoms What DSM-5 diagnosis would fit Howard’s case? schizophrenia schizoaffective disorder schizophreniform disorder brief psychotic disorder Question 11 0.8 / 0.8 pts The concordance rate of schizophrenia for fraternal twins is about 75% 95% 12% 45% Question 12 0.8 / 0.8 pts In regard to studies identifying chromosomal locations of genes involved in schizophrenia, chromosomes 1, 2, 5, and 6 have been implicated in all of the studies to date. we now know that schizophrenia is a purely genetic disorder. there are a few locations that researchers are certainly involved in the disorder. the results of these studies are simply too varied to justify any firm conclusions. Question 13 0.8 / 0.8 pts Which of the following suggests that dopamine receptors are mainly related to positive (not negative) symptoms of schizophrenia? Antipsychotic drugs reduce only positive symptoms. MRIs of schizophrenics with positive symptoms show more receptors. Administering dopamine produces little increase in positive symptoms. Parkinson's Disease involves similar symptoms. Question 14 0.8 / 0.8 pts A consistent brain abnormality found among people with schizophrenia is interrupted tracts in the reticular formation. enlarged ventricles. frontal lobe enlargement. frontal lobe enlargement. Question 15 0.8 / 0.8 pts In people with schizophrenia, the amount of gray matter in the temporal and frontal cortexes is full of holes and lesions. less than normal. greater than normal. normal. Question 16 0.8 / 0.8 pts Which of the following have been proposed as likely contributors to the reductions in hippocampal volume observed in people with schizophrenia? anxiety and brain damage stress reactivity and a disrupted amygdala anxiety and limbic over-arousal stress reactivity and a disrupted HPA axis Question 17 0.8 / 0.8 pts According to the family theory of schizophrenia, a schizophrenogenic mother would be described as also having schizophrenia. carrying a recessive gene for schizophrenia. overly warm and subtly seductive. emotionally cold and domineering. Question 18 0.8 / 0.8 pts Research investigating the role of the family in schizophrenia best supports the schizophrenogenic mother theory. triangulation theory. expressed emotion theory. dopamine theory. Question 19 0.8 / 0.8 pts A problem with any kind of treatment for schizophrenia is that all therapies are upsetting to patients. they rarely help. some people with schizophrenia lack insight into their impaired condition and refuse any treatment at all the disorder is biologically based, so only medications can help. Question 20 0.8 / 0.8 pts A possible side-effect of antipsychotic medication used to treat schizophrenia is akathisia, constant aching of muscles. severe vertigo. the inability to remain still. severe confusion. Question 21 0.8 / 0.8 pts A recent comprehensive randomized controlled clinical trial of medication for schizophrenia compared four second-generation drugs and one first- generation drug against one another. Which of the following was NOT a finding of this study? The second-generation drugs were not more effective than the older, first-generation drugs. The second-generation drugs were much more effective than the older, first-generation drugs. Nearly three-quarters of the people stopped taking the medications before the 18 months of the study design had ended. The second-generation drugs did not produce fewer unpleasant side-effects. Question 22 0.8 / 0.8 pts Family therapy with families of individuals with schizophrenia commonly emphasizes education about schizophrenia. genetic counseling. discouraging inappropriate behavior. minimizing use of drugs. Question 23 0.8 / 0.8 pts After being discharged from the hospital, case management for people with schizophrenia does not reduce time spent in the hospital. is typically conducted by a team. all of these other answers are correct. improves social functioning. Question 24 0.8 / 0.8 pts One change in the diagnosis of Delusional Disorder is removal of the requirement that the delusions be “non-bizarre.” a change in the duration requirement for the delusions to one year. addition of the requirement that the delusions be “non-bizarre.” the specifier that the delusions cannot be erotomanic. Question 25 0.8 / 0.8 pts In the DSM-5, Attenuated Psychosis Syndrome is now combined into the Brief Psychotic Disorders diagnosis. included in section III (conditions needing further research). moved to the Trauma-Related Disorders chapter. included in the Schizophrenia Spectrum and Other Psychotic Disorders chapter. Addiction Amphetamines Antabuse Caffeine Cocaine Controlled drinking Crack Cross-dependent Delirium tremens (DTs) Detoxification Ectasy Fetal alcohol syndrome (FAS) Flashback Hallucinogen Hashish Heroin Hydrocodone LSD Marijuana MDMA Methadone Methamphetamine Nicotine Nitrous oxide Opiates Oxycodone PCP Secondhand smoke Stimulants Substance use disorders Tolerance Withdrawal o o o Of the currently illegal drugs, marijuana was the most frequently used o Alcohol remains the most used substance o DSM4 had two broad categories: substance abuse and substance dependence but there were problems with separating the categories (low reliability); DSM5 just made one category of substance use disorder. o Meeting six or more of the diagnostic criteria is considered severe substance use disorder o Criteria are: (2 or more must be met) Failure to meet obligations Repeated use in situations where physically dangerous Repeated relationship problems Continued use despite problems caused by substance ‘tolerance withdrawal efforts to reduce/control don’t work much time spent trying to obtain it social hobbies/work activities get reduced or given up on craving is strong o Alcohol use disorder A person may feel anxious, depressed, weak, restless, unable to sleep, muscle tremors during withdrawal Alcohol use is often associated with other drug use- mainly smoking More men than women have problems with alcohol but varies by age Dependence more prevalent among Native Americans and Hispanics; least among Asian Americans and African Americans Alcohol use disorders are comorbid with several personality disorders, mood disorders, schizophrenia, and anxiety disorders Short term: stimulates GABA (inhibitory NT), increase serotonin and dopamine levels (source of pleasurable effects), inhibits glutamate receptors (cause cognitive effects-slowed thinking) Long term: impairs digestion of food and absorption of vitamins; cirrhosis of liver; damage to endocrine glands, brain and pancreas, heart failure, erectile dysfunction, hypertension, stroke, capillary hemorrhages Light drinking related to lower risk of coronary heart disease and stroke; benefits could be physiological or psychological or an interaction of the two. o Tobacco Use disorder Smoking remains the single most preventable cause of premature death in US and other parts of the world Question 1 0.8 / 0.8 pts The DSM-5 has added __________ to the criteria for pathological substance abuse. desire for high feelings none of these other answers are correct risky behavior craving for substance Question 2 0.8 / 0.8 pts Carlos suddenly stopped taking amphetamines after prolonged abuse of the drug. He became very ill and died. His death is an example of severe withdrawal symptoms. synergistic effects. substance dependence. substance abuse. Question 3 0.8 / 0.8 pts Among college students, binge drinking is more common in the prevalence of binge drinking is equal in men and women. men. women. state schools versus private schools. Question 4 0.8 / 0.8 pts The initial effect of alcohol is anxiety producing. pleasurable feeling. depressive. sedating. Incorrect Question 5 0 / 0.8 pts Which of the following statements is true? The National Institute on Alcohol Abuse and Alcoholism has concluded that mild drinking is harmless for pregnant women. The National Institute on Alcohol Abuse and Alcoholism counsels total abstention from alcohol consumption during pregnancy as the safest course. All fetuses exposed to alcohol will have cognitive problems later in life. Research indicates that moderate drinking has no effect on the fetus. Question 6 0.8 / 0.8 pts Which of the following are medical problems associated with long-term cigarette smoking? cancer of the larynx cancer of the esophagus all of these other answers are correct emphysema Question 7 0.8 / 0.8 pts Marijuana comes from the __________ plant. cannabis sativa marija cannabis cannabis hempa cannabis marija Question 8 0.8 / 0.8 pts Which of the following is mentioned in the text as a complicating factor in interpreting findings from studies of the effects of marijuana? Many users are polydrug abusers. Its problems were recognized only recently. Marijuana contains many compounds. Effects vary widely with potency and dose. Question 9 0.8 / 0.8 pts The benefit of marijuana when used for chronic illnesses is primarily to prevent additional infection. improve attention and maintain medication adherence. reduce nausea for patients undergoing chemotherapy. increase immune function. Question 10 0.8 / 0.8 pts After the effects of heroin wear off, the user typically feels drowsy. a heightened sense of awareness. becomes extremely hungry. experiences a letdown, often almost a stupor. Question 11 0.8 / 0.8 pts Jolynn took a drug that caused the following symptoms: she felt wide-awake and friendly, and had no interest in lunch despite not having eaten since the night before. After taking a second dose of the drug, she became nervous and confused and developed a severe headache. Which of the following drugs did Jolynn probably take? marijuana alcohol amphetamines barbiturates Question 12 0.8 / 0.8 pts In the 1980s a new form of cocaine in rock-crystal form was introduced and called freebase. amphetamine. crack. methamphetamine. Question 13 0.8 / 0.8 pts After taking a certain drug, Hal began feeling that time was passing very slowly, and he began having profound thoughts about the nature of time and the universe. While this first experience was at first deeply moving, leading to feelings of elation, the next time Hal tried this drug, he felt anxious and depressed. What drug did Hal probably take? marijuana cocaine heroin ecstasy Question 14 0.8 / 0.8 pts Recent research suggests that the tendency to smoke may be controlled in part by a brain area that regulates both serotonin and dopamine. a gene that regulates the reuptake of dopamine. baseline levels of serotonin. a deficiency in dopamine. Question 15 0.8 / 0.8 pts Recent research has found that alcohol lessens negative emotions and lessens positive emotions in response to anxiety provoking situations. increases negative emotions and lessens positive emotions in response to anxiety provoking situations. increases positive emotions in response to anxiety provoking situations. increases negative and positive emotions. Question 16 0.8 / 0.8 pts Research has suggested that in cultures or social contexts where heavy drinking is considered normal, men in the lower social classes are more likely to become alcoholics. women are less likely to become alcoholics than women in cultures where drinking is discouraged. there are higher consumption rates. there are lower consumption rates. Question 17 0.8 / 0.8 pts The treatment goal of Alcoholics Anonymous is to achieve abstinence from drinking. to learn to drink socially without becoming drunk. to help people cope with their spouse’s or parent’s drinking. to change public perceptions of alcohol and alcoholism. Question 18 0.8 / 0.8 pts Jared is receiving guided self-change therapy for his alcohol abuse. Accordingly, he is also learning strategies for controlling his behaviors associated with drinking, as well as actual drinking. In such a program, which of the following would NOT be a factor? Utilizing an empathic, supportive approach Calculating the amount of money spent on alcohol per year Achieving recognition that he has become completely powerless over alcohol The encouragement of minor behavioral changes (e.g., not driving past bars) Question 19 0.8 / 0.8 pts The goal of scheduled smoking is to help smokers quit abruptly by scheduling a ‘stop smoking’ day in advance. gradual reduction in nicotine intake. controlled smoking, in which smoking continues but much more moderately. identification of triggers associated with smoking. Question 20 0.8 / 0.8 pts A first step for treating people dependent on drugs is helping them identify why they began to use drugs. committing to abstinence. helping them understand why the drug is not good for them. detoxification. Question 21 0.8 / 0.8 pts Why do some believe that the new prescription drug Suboxone is a superior treatment for heroin dependence? Individuals do not have to visit a clinic to receive this medication The effects last longer than methadone All of these other answers are correct It is only mildly addictive Question 22 0.8 / 0.8 pts Which disorder in the DSM-5 includes marijuana? Cannabis use disorder Hallucinogen use disorder Stimulant use disorder Alcohol use disorder Question 23 0.8 / 0.8 pts Which of the following strategies has been used to “prevent” drug use by children and adolescents? All of these are preventive strategies. Correction of beliefs and expectations. Inoculation against mass media messages. Peer-pressure resistance training. Question 24 0.8 / 0.8 pts Which of the following statements is FALSE concerning electronic cigarettes? They are battery operated. All these statements are true. They are made of plastic or metal and are filled with liquid nicotine that is mixed with other chemicals and often with flavors They are less harmful than smoking because of the lower levels of nicotine and tar in secondhand smoke. Incorrect Question 25 0 / 0.8 pts A new disorder in the Substance Use and Addictive Disorders DSM-5 chapter is Sex Addiction Substance Abuse with Psychological Dependence Gambling disorder Internet Gaming Disorder o anorexia nervosa o binge eating disorder o body mass index (BMI) o bulimia nervosa o obese o Anorexia Nervosa o amenorrhea is the loss of menstrual period and was once used as a diagnostic criteria for anorexia nervosa but now realized as unreliable o DSM5 criteria for anorexia nervosa: Restriction of food that leads to very low body weight; body weight is significantly below normal Intense fear of weight gain or repeated behaviors that interfere with weight gain Body image disturbance o The severity ratings are based on BMI o People with anorexia overestimate their own body size and choose a thin figure as their ideal o Men with eating disorders didn’t differ from men without eating disorders when pointing out their ideal male body type. However, men with eating disorders overestimated with own body size considerably o Two subtypes of anorexia – restricting type (severely limiting food intake) and binge-eating/purging type (regularly binge eats and purges) o Anorexia typically begins in early to middle teenage years, often after an episode of dieting and the occurrence of a life stress o It is at least 10x more frequent in women than in men o Most likely reflects the greater cultural emphasis on women’s beauty o It is frequently comorbid with depression, OCD, specific phobias, panic disorder, and various personality disorders. o Blood pressure often falls, heart rate slows, kidney and GI problems develop, bone mass declines, skin dries out, nails become brittle, hormone level changes, and mild anemia. o Bulimia Nervosa o DSM defines a binge as having two characteristics: involves eating excessive amount of food and involves a feeling of losing control over eating. o Criteria for bulimia nervosa: Recurrent episodes of binge eating Recurrent compensatory behaviors to prevent weight gain, for example – vomiting Body shape and weight are extremely important for self evaluation. o People with bulimia ingest enormous quantities of food during binges, often more than what a person eats in an entire day o DSM5 diagnosis requires that episodes of bingeing and compensatory behavior occur at least once a week for 3 months o Typically begins in late adolescence/early adulthood o Is comorbid with numerous other diagnoses – depression, personality disorders, anxiety disorders, substance use disorders, and conduct disorders o Associated with many physical side effects – menstrual irregularities, potassium depletion, changes in electrolytes, irregular heart beat, tissue tearing in stomach and throat o Binge Eating disorder o This disorder includes recurrent binges (one time per week for at least 3 months), lack of control during the bingeing episodes, and distress about bingeing o Criteria for binge eating: Recurrent episodes At least one of the three following: eating more quickly than usual, eating until over full, eating large amounts even if not hungry, eating alone due to embarrassment about large food quantity, feeling bad after binge No compensatory behavior is present o More prevalent than anorexia or bulimia o Comorbid with mood disorders, anxiety disorders, ADHD, conduct disorder and substance use disorder o Physical consequences are obesity, increased risk of type 2 diabetes, cardiovascular problems, chronic back pain, headaches, anxiety, depression, IBS, sleep problems o Etiology o Eating disorders run in families o Additional evidence suggests that common genetic factors may account for relationship between certain personality characteristics (negative emotionality and constraint with eating disorders) o The hypothalamus has been proposed to play a role in anorexia (regulation of cortisol) o Binges of people with bulimia or binge eating disorder could result from a serotonin (usually promotes satiety) deficit that causes them not to feel full after they eat o Fear of fatness and body-image disturbance as the motivating factors that powerfully reinforce weight loss o People with anorexia experience many negative emotions but also experience positive emotions involving weight loss or avoiding eating. o Concerns about body shape and weight predicted restrained eating, which in turn predicted an increase in binge eating across 5 years of follow-up assessments. o The onset of eating disorders is typically preceded by dieting and other concerns about weight, supporting the idea that social standards stressing the importance of thinness play a role in the development of these disorders. o Women’s bodies are often viewed through a sexual lens; in effect, women are defined by their bodies, whereas men are esteemed more for their accomplishments. o Bulimia nervosa appears to be more common in industrialized societies o Somewhat greater incidence of eating disturbances and body dissatisfaction among white women than black women, but differences in actual eating disorders, particularly bulimia do not appear to be as great. o People with anorexia as having been perfectionistic, shy, and compliant before the onset of the disorder o The description of people with bulimia includes the additional characteristics of histrionic features, affective instability, and outgoing social disposition. o Treatment o Because comorbid with depression, bulimia is often treated with various antidepressants o The immediate goal of psych treatment is to help the person gain weight in order to avoid medical complications o Psych treatment for anorexia can also involve CBT o Family therapy is another form of psychological treatment for anorexia and is based on the notion that interactions among members of the patients family can play a role in treating the disorder. o The overall goal of treatment in bulimia is to develop more typical eating patterns. o Interpersonal therapy (IPT) has also been used for bulimia o A different approach to treating eating disorders involves prevention o Psychoeducational approaches o Deemphasizing sociocultural influences o Risk factor o 1. Starting with the DSM-4, eating disorders were listed as a. somatic disorders b. psychological factors affecting medical condition c. a separate diagnostic category d. disorders beginning in childhood or adolescence 2. In the DSM-4, _____ was viewed as a condition requiring further study, but in the DSM-5 it has its own diagnostic category. a. Obsessive eating disorder b. Binge eating disorder c. Rumination disorder d. Pica 3. Anorexia nervosa implies that those with the disorder become uninterested in food, while the reality is that: a. They are repulsed by food b. They like to watch other people eat food c. They truly are not interested in food d. They are preoccupied with food 4. When pointing to their ideal body type, men with eating disorders chose body type that were a. smaller than what the average male chose b. larger than what the average male chose c. they could not report what the difference was d. the same size as what the average male chose 5. Anorexia nervosa typically begins in: a. adolescence b. late adulthood c. early childhood d. early adulthood 6. Regina visits her family physician. Her weight is 90lbs, although she believes she is overweight. She “snacks” on laxatives, and restricts her eating to one small meal a day, after which she exercises for two hours. Her physical exam is likely to reveal that she has a. calcium deposits b. fibroid tumors c. improved muscle tone d. lowered heart rate and BP 7. During binge episodes, many bulimics a. feel very satisfied b. feel a great sense of control c. experience a feeling of being out of control d. none of these answers 8. As compared to anorexia nervosa, the diagnosis of bulimia nervosa is associated with a. higher mortality rate b. lower mortality rates c. equal mortality rates d. none of these are correct 9. which of the following is defined, in part, by the absence of purging? a. binge eating disorder b. bulimia nervosa c. anorexia nervosa d. purging occurs in all these conditions 10. bulimia nervosa typically begins in: a. late adulthood b. early or middle adolescence c. childhood d. late adolescence or early adulthood 11. the physical consequence associated with binge eating disorder includes all of the following EXCEPT: a. kidney failure b. cardiovascular problems c. joint/muscle problems d. breathing problems 12. If your sister has anorexia nervosa and you are female, a. you are over ten times more likely to have anorexia nervosa b. you are over 20 times more likely to have anorexia nervosa c. you are over 2 times more likely to have anorexia nervosa d. there is no greater risk to you for developing anorexia nervosa 13. Research regarding the role of the hypothalamus in anorexia nervosa indicates that a. the hypothalamus is damaged in most individuals with anorexia b. hypothalamus dysfunction is the most likely explanation for the fact that people with anorexia do not experience hunger c. the hypothalamus appears to be overactive in people with anorexia, leading to binge eating d. dysfunction in the hypothalamus does not seem to be an important factor in anorexia 14. Recent research has begun to focus on the role of ____ in eating behavior. a. Estrogen b. Norepinephrine c. Dopamine d. Epinephrine 15. Bingeing in a person with anorexia nervosa is most likely to happen a. After family conflict b. After struggling with the disorder for at least one year c. None of these answers d. After a lapse in a strict diet 16. Which of the following statements is true regarding gender differences in eating disorders? a. adequate prevalence data on ED has not been collected for men because men are reluctant to disclose disordered eating patterns b. women are more likely to have bulimia, while men are more likely to have anorexia c. women are more likely to have both bulimia and anorexia than men d. men are more likely to have bulimia, while women are more likely to have anorexia 17. Eating disorders are more common in women who are a. less educated b. urban c. white d. single 18. the textbook authors assert that psychologists need to consider what when evaluating the personalities of people with anorexia and bulimia? a. Psychosocial stressors are more important to assess than personality b. Personality shouldn’t be important when trying to understand an eating disorder c. How friendly they are d. Severe restriction of food intake can have powerful effects on personality and behavior 19. A recent study in eating disorders has been a. child abuse and the link to disorders b. actual eating habits c. associated fears such as phobias or other anxiety disorders d. concerns with self-focused attention 20. Adelaide, who has bulimia, is being treated solely with fluoxetine (Prozac). If she stops taking the drug, she will most likely a. maintain normal eating patterns over a long term b. become obese c. develop anorexia nervosa d. relapse 21. The principal form of psychological treatment for anorexia nervosa is a. reinforcing appropriate eating behaviors b. social skills training c. providing a safe inpatient environment d. family therapy 22. Successful treatment of bulimia nervosa often results in a. academic gains b. modest weight gain c. reduced psychological problems d. improved family and social relations 23. Studies show that those with eating disorders ____ more than the average person. a. Focus on food-related words b. Stay at home c. Go to restaurants d. Ruminate over their problems 24. The new DSM-5 diagnostic criteria for anorexia nervosa include each of the following except: a. Amenorrhea b. Restriction of food leading to very low body weight c. Fear of weight gain d. Distorted body image 25. In anorexia nervosa ______ is the most central feature. a. Refusal to eat b. Purging leading to very low body weight c. Restriction of food that leads to very low body weight d. Emergence of lanugo e. e. delayed ejaculation f. desire phase g. erectile disorder h. excitement phase i. exhibitionistic disorder j. female orgasmic disorder k. female sexual interest/arousal disorder l. fetishistic disorder m. frotteuristic disorder n. gender dysphoria o. genito-pelvic pain/penetration disorder p. incest q. male hypoactive sexual desire disorder r. orgasm phase s. paraphilic disorders t. pedophilic disorders u. penile plethysmograph v. premature ejaculation w. resolution phase x. sexual dysfunctions y. sexual masochism disorder z. sexual response cycle aa. sexual sadism disorder ab. spectator role ac.vaginal plethysmograph ad. voyeuristic disorder o Sexual Response Cycle: Desire phase – sexual interest or desire, often associated with sexually arousing fantasies or thoughts Excitement phase – increased blood flow to the genitalia Orgasm phase Resolution phase – relaxation and sense of well-being o DSM5 divides sexual dysfunctions into three categories: those involving sexual desire, arousal, and interest; orgasmic disorders; and disorder involving sexual pain o Dysfunction should be persistent and recurrent and should cause clinically significant distress or problems with functioning. o DSM5 criteria for female sexual interest/arousal disorder (at least three diminished or absence) Interest in sexual activity Erotic thoughts or fantasies Initiation of sexual activity and responsiveness to partner’s attempts to initiate Sexual excitement/pleasure during 75% of sexual encounters Sexual interest/arousal elicited by any internal or external erotic cues Genital or nongenital sensations during 75% sexual encounters o DSM5 criteria for male hypoactive sexual desire disorder Sexual fantasies and desires, as judged by the clinician, are deficient or absent o DSM5 criteria for erectile disorder (75% of sexual occasions) Inability to attain an erection Inability to maintain an erection for completion of sexual activity Marked decrease in erectile rigidity interferes with penetration or pleasure. o DSM5 for sexual dysfunction disorders specify that symptoms must last 6 months. o Women are more likely than men to report at least occasional concerns about their level of sexual desire. o The prevalence of erectile disorder increases greatly with age. o DSM5 criteria for female orgasmic disorder (75% of occasions): Marked delay, infrequency, or absence of orgasm Markedly reduced intensity of orgasmic sensations o DSM5 criteria for premature ejaculation Tendency to ejaculate during partnered sexual activity within 1 minute of penile insertion on at least 75% of sexual occasions o DSM5 criteria for delayed ejaculation Marked delay, infrequency, or absence of orgasm on at least 75% of sexual occasions o DSM5 criteria for genito-pelvic pain/penetration disorder (persistent/recurrent difficulties with at least one of following) Inability to have vaginal/penetration during intercourse Marked vulvar, vaginal or pelvic pain during vaginal penetration or intercourse attempts Marked fear or anxiety about pain or penetration Marked tensing of the pelvic floor muscles during attempted vaginal penetration o Biological causes of sexual dysfunctions can include diseases such as diabetes, MS, and spinal cord injury; heavy alcohol use before sex; chronic alcohol dependence; and heavy cigarette smoking o Psychological factors can be part of the reason as well – childhood sexual abuse or rape, depression, anxiety, broad relationship problems, negative cognitions (worries about pregnancy, AIDS), concerns with the partner or self o Treatments: Anxiety reduction and psychoeducation – systemic exposure, systemic desensitization, in vivo desensitization, skills training Change attitudes and thoughts – counter destructive tendency to think of one’s performance or attractiveness Communication training with partners directed masturbation – for orgasmic disorder medications – testosterone therapy, antidepressents, PDE-5 o DSM5 criteria for fetishistic disorder For at least 6 months – recurrent and intense sexually arousing fantasies, urges, or behaviors involving the use of nonliving objects or nongenital body parts Causes significant distress or impairment in functioning The sexually arousing objects are not limited to articles of clothing used in cross-dressing or to devices designed to provide tactile genital stimulation, such as a vibrator o The attraction is experienced as involuntary and irresistible o DSM5 criteria for pedophilic disorder For at least 6 months, recurrent and intense, sexually arousing fantasies, urges or behaviors involving sexual contact with prepubescent child Person has acted on these urges or the urges and fantasies cause marked distress or interpersonal problems Person is at least 16 years old and 5 years older than the child o Pedophilic disorder is diagnosed only when adults act on their sexual urges toward children, or when the urges reach the frequency or intensity to be distressing to the person or those close to them. o DSM5 Criteria for Voyeuristic disorder For at least 6 months, recurrent and intense sexually arousing fantasies, urges, or behaviors involving the observation of unsuspecting others who are naked, disrobing, or engaged in sexual activity Person has acted on these urges with non-consenting person, or the urges and fantasies cause marked distress or interpersonal problems o DSM5 criteria for exhibitionistic disorder For at least 6 months, recurrent, intense, and sexually arousing fantasies, urges, or behaviors involving showing one’s genitals to an unsuspecting person Person has acted on these urges to a non-consenting person, or the urges and fantasies cause clinically significant distress or interpersonal problems o DSM5 criteria for frotteuristic disorder For at least 6 months, recurrent and intense and sexually arousing fantasies, urges, or behaviors involving touching or rubbing against a non-consenting person Person has acted on these urges to a non-consenting person, or the urges and fantasies cause clinically significant distress or interpersonal problems o DSM5 criteria for sexual sadism disorder For at least 6 months, recurrent and intense and sexually arousing fantasies, urges, or behaviors involving physical or psychological suffering of another person Causes clinically significant distress or impairment in functioning or the person has acted on these urges with a non-consenting person o DSM5 criteria for sexual masochism disorder For at least 6 months, recurrent and intense and sexually arousing fantasies, urges, or behaviors involving the act of being humiliated, beaten, bound, or made to suffer Causes marked distress or impairment in functioning o Etiology Alcohol decreases the ability to inhibit impulses, and accordingly, incidents of pedophilic disorder, voyeuristic disorder, and exhibitionistic disorder often occur in the context of alcohol use Men who engage in paraphilias that involve nonconsenting women may have hostile attitudes and a lack of empathy toward women o Treatments Cognitive behavior therapy Biological treatments – hormones, SSRI antidepressents Incorrect Question 1 0 / 0.8 pts In contrast to the general Victorian view of the late 1800s and early 1900s, many people in the contemporary Western world believes that __________ of sexual expression may contribute to some problems. an excess the amount inhibition the type Question 2 0.8 / 0.8 pts Which of the following is NOT a subcategory of paraphilia in the DSM-5? exhibitionistic disorder sexual arousal disorder transvestic disorder fetishistic disorder Question 3 0.8 / 0.8 pts Which age group has the highest number of new HIV cases being diagnosed each year? 25-29 30-34 15-19 20-24 Question 4 0.8 / 0.8 pts Homosexuality was listed as a disorder in the DSM until the 1990s 1970s 1980s 1950s Question 5 0.8 / 0.8 pts Which of the following diagnoses is among the most debated in the DSM-5? female sexual arousal disorder sexual aversion disorder gender dysphoria vaginismus Question 6 0.8 / 0.8 pts Which of the following is NOT a phase in the sexual response cycle? anticlimax resolution desire excitement Question 7 0.8 / 0.8 pts Barbara is concerned about her husband’s premature ejaculation, which occurs before she reaches orgasm. From her perspective, which of the following phases of the sexual response cycle is problematic in Barbara’s husband? excitement resolution desire orgasm Question 8 0.8 / 0.8 pts Female orgasmic disorder is defined as lack of orgasm and no desire. lack of orgasm despite normal sexual excitement and stimulation. orgasm during masturbation only, if at all. lack of orgasm without direct clitoral stimulation. Question 9 0.8 / 0.8 pts In men, a persistently deficient or absent sexual fantasies and desires is called __________ in the DSM-5. hyperactive sexual desire disorder asexuality disorder none of these other answers are correct male hypoactive sexual desire disorder Question 10 0.8 / 0.8 pts Sexual desire can be affected in part by certain medications such as SSRIs. anger towards one’s partner. all of these other answers are correct communication problems. Question 11 0.8 / 0.8 pts Masters and Johnson found that many individuals who have sexual dysfunction were college-educated. had negative views of sexuality. had low socioeconomic status. were encouraged to express their sexuality at a young age. Question 12 0.8 / 0.8 pts Directed masturbation is often used for excessive sexual appetite. to train individuals who have difficulty achieving orgasm. as a means for redirecting attention from inappropriate sexual stimuli. as part of a program of treatment for sex offenders. Question 13 0.8 / 0.8 pts Viagra, a medication for improved erectile function, acts primarily by inhibiting the response of the serotonin system. stimulating the amygdala in the limbic system. increasing the level of dopamine, which is associated with sexual arousal. relaxing smooth muscles, allowing increased blood flow to the penis. Question 14 0.8 / 0.8 pts Dan can become sexually aroused only when he is wearing women’s clothing. He especially enjoys having sexual relations with his wife while he is wearing her garments. Which of the following diagnoses would fit Dan’s case? voyeuristic disorderj exhibitionistic disorder transsexualism transvestic disorder Question 15 0.8 / 0.8 pts The incest taboo is virtually universal in human societies. is limited to Western societies. produces guilt in the assailant. generalizes to pedophilic urges. Question 16 0.8 / 0.8 pts Frotteuristic disorder involves the sexually oriented touching of an unsuspecting person. none of these other answers are correct. incestuous behavior. the exposing of oneself to others to achieve sexual stimulation. Question 17 0.8 / 0.8 pts A behavioral hypothesis regarding the etiology of paraphilias is based on __________ theory. modeling classical conditioning Oedipal systematic desensitization Question 18 0.8 / 0.8 pts Carlos had a shoe fetish that he wished to overcome. His therapist had him view slides of shoes while giving him mild electric shocks. This is an example of electroconvulsive shock therapy (ECT). orgasmic reorientation. systematic desensitization. aversion therapy. Question 19 0.8 / 0.8 pts Which of the following disorders is most likely to develop in the aftermath of rape? masochistic personality disorder posttraumatic stress disorder bipolar disorder paranoid personality disorder Question 20 0.8 / 0.8 pts All of the following are reasons why women often do not report rapes EXCEPT fearing that people will think she has a paraphilia. considering rape to be a private and personal matter. fearing that the rapist or his family and friends may seek revenge. believing the police would be of little assistance. Question 21 0.8 / 0.8 pts Sexual attraction to prepubescent children is known as _________________. Pedophilic disorder Exhibitionistic disorder Sexual aversion disorder Sexual aggression disorder Question 22 0.8 / 0.8 pts Which of these diagnoses does not include a criterion specifying that the victim be non-consenting? Exhibitionistic disorder Voyeuristic disorder Sexual masochistic disorder Frotteuristic disorder Question 23 0.8 / 0.8 pts The criteria for premature ejaculation specify that ejaculation must occur within _______ minute(s) during at least _____ % of sexual occasions. 5, 50 5, 75 1, 50 1, 75 Question 24 0.8 / 0.8 pts Tyler has noticed that over the course of his last two years of graduate school, he has been experiencing very little sexual desire. He states that he rarely, if ever, fantasizes about sex. If Tyler finds this distressing, the most likely diagnosis would be Male sexual interest/desire disorder. Male hypoactive sexual desire disorder. Erectile dysfunction. Inhibited sexual desire disorder. Incorrect Question 25 0 / 0.8 pts All of the following are criteria in the DSM-5 diagnosis for erectile disorder EXCEPT duration of symptoms for at least three months. inability to maintain an erection for completion of sexual activity. decrease in penile rigidity interferes with pleasure or penetration. symptoms do not resolve with the use of medications.
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