eating and sleep/wake disorders

Question 1

What are Feeding and Eating Disorders according to the DSM-5-TR?

Answer 1

A persistent disturbance of eating or eating-related behavior that results in altered consumption or absorption of food and significantly impairs physical health or psychosocial functioning.

Question 2

What is Pica?

Answer 2

Persistent eating of non-nutritive, nonfood substances for at least one month, inappropriate for developmental level and not culturally acceptable.

Question 3

What are common non-nutritive substances consumed in Pica?

Answer 3

• Paper
• Paint
• Coffee grounds

Question 4

At what ages is Pica most commonly observed?

Answer 4

Most common among children and has an elevated rate among pregnant women.

Question 5

What potential medical complications can arise from Pica?

Answer 5

• Intestinal obstruction
• Lead poisoning
• Other medical complications

Question 6

What characterizes Anorexia Nervosa?

Answer 6

Restriction of energy intake causing significantly low body weight, intense fear of gaining weight, and disturbance in self-evaluation.

Question 7

What are the specifiers used in diagnosing Anorexia Nervosa?

Answer 7

• Type (restricting or binge-eating/purging)
• Course (in partial or full remission)
• Severity (based on current BMI)

Question 8

What psychological conditions often co-occur with Anorexia Nervosa?

Answer 8

• Depression
• Anxiety disorders (especially obsessive-compulsive disorder)

Question 9

What are the initial treatment goals for Anorexia Nervosa?

Answer 9

• Restore a healthy weight
• Address physical complications

Question 10

What role does cognitive behavior therapy (CBT) play in treating Anorexia Nervosa?

Answer 10

It helps establish regular eating patterns, eliminate body-checking, and replace problematic thinking.

Question 11

What is Family-Based Treatment (FBT) for Anorexia Nervosa?

Answer 11

An outpatient intervention for adolescents focusing on parental control of nutritional rehabilitation and gradual return of control to the adolescent.

Question 12

What are common medical complications of Anorexia Nervosa?

Answer 12

Malnutrition and extreme weight loss affecting nearly all major organ systems, potentially leading to death.

Question 13

What defines Bulimia Nervosa?

Answer 13

Recurrent episodes of binge eating with a sense of lack of control, inappropriate compensatory behaviors, and excessive self-evaluation influenced by body shape and weight.

Question 14

What are the criteria for diagnosing Bulimia Nervosa?

Answer 14

Binge eating and compensatory behavior must occur at least once a week for three months.

Question 15

What medical complications can arise from Bulimia Nervosa?

Answer 15

• Dental erosion
• Gastroesophageal reflux
• Electrolyte imbalance causing heart arrhythmias

Question 16

What treatments are commonly used for Bulimia Nervosa?

Answer 16

• Nutritional rehabilitation
• Cognitive behavior therapy (CBT)
• Enhanced cognitive-behavior therapy (CBT-E)
• Interpersonal therapy (IPT)
• Family-based treatment (FBT)

Question 17

What is Enhanced Cognitive Behavior Therapy (CBT-E)?

Answer 17

A transdiagnostic intervention that addresses the core psychopathology shared among eating disorders, focusing on maintaining individual symptoms.

Question 18

What is the focus of the first phase in Family-Based Treatment (FBT) for Bulimia Nervosa?

Answer 18

Disrupting bingeing, purging, and establishing healthy eating.

Question 19

What does telepsychology aim to achieve in treating Bulimia Nervosa?

Answer 19

To produce positive results comparable to face-to-face interventions.

Question 20

True or False: Individuals with Bulimia Nervosa are generally less motivated to change their behaviors than those with Anorexia Nervosa.

Answer 20

False

Question 21

What type of motivation has been shown to predict better treatment outcomes for individuals with eating disorders?

Answer 21

Autonomous (intrinsic) motivation.

Question 22

Fill in the blank: Anorexia Nervosa often co-occurs with _______.

Answer 22

[depression or anxiety disorders]

Question 23

What are the long-term recovery rates for patients with Anorexia Nervosa compared to Bulimia Nervosa at the 22-year follow-up?

Answer 23

• 62.8% of patients with Anorexia
• 68.2% of patients with Bulimia

Question 24

What evidence exists regarding the effectiveness of SSRIs in treating Bulimia Nervosa?

Answer 24

Effective for alleviating comorbid depression and reducing binge eating and purging.

Question 25

What are some of the phases in Enhanced Cognitive Behavior Therapy (CBT-E)?

Answer 25

* Engaging the patient in treatment * Reviewing progress * Addressing overevaluation of shape and weight * Maintaining progress and reducing relapse risk

Question 26

What is the definition of binge-eating disorder (BED)?

Answer 26

Recurrent episodes of binge eating involving an amount of food larger than most people would eat in similar circumstances, along with a sense of lack of control during episodes ## Footnote For diagnosis, at least three of five characteristics must be present, and episodes must occur at least once a week for three months.

Question 27

What are the five characteristic symptoms of binge-eating disorder?

Answer 27

* Eating more rapidly than usual * Eating until uncomfortably full * Eating large amounts when not feeling hungry * Feeling alone due to embarrassment about binge eating * Feeling disgusted, depressed, or very guilty about binge eating ## Footnote At least three of these symptoms are required for diagnosis.

Question 28

How is the severity of binge-eating disorder determined?

Answer 28

By the number of episodes each week ## Footnote Severity can be classified as mild, moderate, severe, or extreme.

Question 29

Is binge-eating disorder (BED) more common in men or women?

Answer 29

Women ## Footnote BED is two to three times more common in women than in men.

Question 30

What distinguishes binge-eating disorder from bulimia nervosa?

Answer 30

Those with BED do not engage in recurrent inappropriate compensatory behaviors ## Footnote BED usually has a better response to treatment compared to bulimia nervosa.

Question 31

What are the two evidence-based treatments for binge-eating disorder?

Answer 31

* Cognitive-behavior therapy-enhanced (CBT-E) * Interpersonal therapy (IPT) ## Footnote CBT-E has been found to be more effective in some studies.

Question 32

What medications have been evaluated for treating binge-eating disorder?

Answer 32

* SSRIs (fluoxetine, paroxetine, sertraline) * Topiramate * Lisdexamfetamine ## Footnote Medication alone is generally less effective than CBT.

Question 33

What is the most common treatment for nocturnal enuresis?

Answer 33

The moisture alarm (bell-and-pad) ## Footnote This device rings when a child begins to urinate while sleeping.

Question 34

What is insomnia disorder characterized by?

Answer 34

Dissatisfaction with sleep quality or quantity associated with difficulty initiating sleep, maintaining sleep, or early-morning awakening ## Footnote Must occur at least three nights a week and cause significant distress.

Question 35

What are the three types of insomnia?

Answer 35

* Sleep-onset insomnia * Sleep maintenance insomnia * Late insomnia ## Footnote Sleep maintenance insomnia is the most common single type.

Question 36

What is the nonpharmacological treatment-of-choice for insomnia disorder?

Answer 36

A multi-component cognitive-behavioral intervention ## Footnote This includes stimulus control, sleep restriction, sleep-hygiene education, relaxation training, and/or cognitive therapy.

Question 37

What characterizes narcolepsy?

Answer 37

Attacks of an irrepressible need to sleep causing sleep or naps at least three times a week for three months ## Footnote Diagnosis requires episodes of cataplexy or hypocretin deficiency.

Question 38

What are common symptoms associated with narcolepsy?

Answer 38

* Cataplexy * Hypnagogic hallucinations * Hypnopompic hallucinations * Sleep paralysis ## Footnote Cataplexy is often triggered by strong emotions.

Question 39

What medications are used to treat narcolepsy?

Answer 39

* Modafinil * Armodafinil * Amphetamines * Antidepressants (venlafaxine, fluoxetine, clomipramine) * Sodium oxybate ## Footnote Medications aim to improve alertness and reduce cataplexy.

Question 40

What are the non-rapid eye movement sleep arousal disorders?

Answer 40

* Sleepwalking * Sleep terrors ## Footnote These involve incomplete awakening from sleep during Stage 3 or 4 sleep.

Question 41

What characterizes nightmare disorder?

Answer 41

Repeated occurrences of extended, extremely dysphoric dreams usually involving threats to survival or security ## Footnote Nightmares typically occur during REM sleep in the second half of a major sleep period.