Chapter 16: Health-Related Disorders and Pediatric Psychology

Test Bank

Multiple Choice

1. Which of the following is NOT a reason that elimination and sleep disorders are considered psychological disorders in the DSM-5?

a. They reflect a fundamental delay or deviation from a typical developmental trajectory.

b. They illustrate the relationship between physical and behavioral health because medical treatment alone is often insufficient.

c. They occur within the context of the caregiver relationship and are likely best viewed as existing between parents and children.

d. They reflect genetic issues passed down from parents to children.

Ans: D

Learning Objective: LO 16.1 Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Analysis

Answer Location: Throughout the chapter

Difficulty Level: Hard a. Yes. b. No, because she is not old enough c. No, because she must be wetting the bed every night for diagnosis. d. No, because this doesn’t happen during the day.

2. Nina, age 4, has a lot of trouble sleeping through the night without wetting the bed. It seems almost every night she cries out that her bed is wet. Can she be diagnosed with enuresis?

Ans: B

Learning Objective: LO 16.1 Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Application

Answer Location: What Is Enuresis?: Description

Difficulty Level: Medium a. By definition, it can only arise in children over the age of 6. b. It is more common than primary enuresis. c. It is always comorbid with another mental disorder, while primary enuresis is not. d. It might be described as a regression.

3. Secondary enuresis is which of the following?

Ans: D

Learning Objective: LO 16.1 Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Comprehension

Answer Location: What Is Enuresis?: Description

Difficulty Level: Hard a. It is more effective than placebo. b. It is no more effective than placebo. c. Group therapies focusing on managing children’s symptoms and improving social and problem-solving skills were associated with greater improvements than those focused on facts about illnesses. d. Groups therapies that focused mostly on providing facts to families about specific illnesses were associated with greater improvements than those focused on improving social and problem-solving skills.

4. A meta-analysis of the effectiveness of group therapy for children with chronic illness (Plante, Lobato, & Engel, 2001) has indicated which of the following?

Ans: C

Learning Objective: LO 16.3. Define the field of pediatric psychology, and illustrate some of the major professional activities of pediatric psychologists. Show how pediatric psychologists help youths with chronic medical problems.

Cognitive Domain: Knowledge

Answer Location: Group and Peer-Assisted Therapy to Enhance Social Support

Difficulty Level: Medium a. It is more common in boys. b. It is more common in younger children than older children. c. Every year, 15% of those with enuresis experience spontaneous remission. d. The disorder cannot occur in adults.

5. Which of the following is NOT true concerning the prevalence of enuresis?

Ans: D

Learning Objective: LO 16.1. Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Knowledge

Answer Location: What Is Enuresis?:Epidemiology

Difficulty Level: Medium a. boys b. youths with secondary enuresis c. young children d. those with diurnal enuresis

6. Which of the following individuals with enuresis would be LEAST likely to have socioemotional problems?

Ans: C

Learning Objective: LO 16.1 Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Knowledge

Answer Location: What Is Enuresis?: Associated Problems

Difficulty Level: Medium a. ADHD and enuresis are unrelated. b. ADHD makes enuresis more likely c. Enuresis makes ADHD more likely. d. Both ADHD and enuresis are made more likely by underlying difficulty with attention and arousal.

7. Which of the following explanations best reflects the current understanding of the relationship between ADHD and enuresis?

Ans: D

Learning Objective: LO 16.1 Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Comprehension

Answer Location: What Is Enuresis?: Associated Problems

Difficulty Level: Medium a. It can provide a guide to a cure for other individuals who have also been cured of their chronic illness. b. It can reduce feelings of isolation. c. It can provide social skills and problem-solving training. d. It allows children to receive feedback on their behavior from their peers.

8. Which of the following is NOT a primary way in which group therapy can be helpful for children with chronic illness?

Ans: A

Learning Objective: LO 16.3. Define the field of pediatric psychology, and illustrate some of the major professional activities of pediatric psychologists. Show how pediatric psychologists help youths with chronic medical problems.

Cognitive Domain: Knowledge

Answer Location: Group and Peer-Assisted Therapy to Enhance Social Support

Difficulty Level: Medium a. genetics b. increased secretion of arginine vasopressin (AVP) c. difficulty responding to signals fo a full bladder while asleep d. difficulty inhibiting urination during sleep

9. Which of the following is NOT typically considered a cause of monosymptomatic primary enuresis?

Ans: B

Learning Objective: LO 16.1 Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Knowledge

Answer Location: Causes of Nocturnal Enuresis

Difficulty Level: Hard a. monosymptomatic primary enuresis b. late-onset enuresis c. polysymptomatic nocturnal enuresis d. secondary enuresis

10. If you knew someone had bladder instability, which of the following conditions would you expect the person would likely have?

Ans: C

Learning Objective: LO 16.1. Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Comprehension

Answer Location: Causes of Nocturnal Enuresis

Difficulty Level: Hard a. problems with arousal b. voiding postponement c. bladder instability d. small functional bladder capacity

11. Michael loves to watch the Wizard of Oz and drink his favorite juice at the same time. On multiple occasions, however, he has ended up urinating on himself during the movie because he is so attuned to what is happening on the screen, he doesn’t recognize the urge to use the bathroom. Michael’s situation is an example of which of the following?

Ans: B

Learning Objective: LO 16.1. Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Application

Answer Location: Causes of Daytime Enuresis

Difficulty Level: Medium a. negative reinforcement b. positive reinforcement c. negative punishment d. classical conditioning

12. Urine alarms are thought to stop urination through which of the following?

Ans: D

Learning Objective: LO 16.1 Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Comprehension

Answer Location: Behavioral Treatment

Difficulty Level: Medium a. it would not have the intended effect b. stopping urination would be overlearned and treatment could be halted c. wearing the alarm would become part of the daily routine d. it would be most effective

13. If a child habituated to the urine alarm, ______.

Ans: A

Learning Objective: LO 16.1 Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Comprehension

Answer Location: Behavioral Treatment

Difficulty Level: Medium a. cognitive restructuring b. systematic desensitization c. guided imagery d. refocusing

14. When Jared experiences negative emotions, his therapist teaches him to think instead about a pleasant, peaceful situation lying in his treehouse with a light breeze. This is an example of which of the following?

Ans: C

Learning Objective: LO 16.3. Define the field of pediatric psychology, and illustrate some of the major professional activities of pediatric psychologists. Show how pediatric psychologists help youths with chronic medical problems.

Cognitive Domain: Application

Answer Location: Cognitive Therapy to Help Youths Adhere to Treatment

Difficulty Level: Medium a. urine alarm training b. retention control training c. overlearning d. cleanliness training

15. Max is participating in full spectrum home training for enuresis. At this point in treatment, Max is being asked to drink a small glass of water immediately before bed. Which part of the treatment is this?

Ans: C

Learning Objective: LO 16.1 Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Application

Answer Location: Behavioral Treatment

Difficulty Level: Medium a. It is ineffective, particularly in children. b. It is effective only as long as its use is continued; children don’t remain dry after discontinuing it. c. Because it is very inexpensive and can be effective for some children, it is widely prescribed. d. It is most commonly used on a short-term basis or in treatment-resistant cases.

16. Which of the following best describes the use and effectiveness of desmopressin to treat enuresis?

Ans: D

Learning Objective: LO 16.1. Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Knowledge

Answer Location: Treatment of Nocturnal Enuresis: Medication

Difficulty Level: Medium a. punishing children for wetting during the day b. helping children recognize feelings of a full bladder c. increasing children’s control over their pelvic floor muscles d. increasing children’s functional bladder capacity.

17. Which of the following is NOT a primary component of treatment for diurnal enuresis?

Ans: A

Learning Objective: LO 16.1 Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Knowledge

Answer Location: Treatment of Daytime Enuresis

Difficulty Level: Medium a. children with developmental delay b. young children, because medication often cannot be used safely with young children c. school-age children and adolescents d. children with profound intellectual disability to help them make sense of their condition

18. Cognitive–behavioral therapy would be most likely to be used with which of the following?

Ans: C

Learning Objective: LO 16.3. Define the field of pediatric psychology, and illustrate some of the major professional activities of pediatric psychologists. Show how pediatric psychologists help youths with chronic medical problems.

Cognitive Domain: Comprehension

Answer Location: Cognitive Therapy to Help Youths Adhere to Treatment

Difficulty Level: Easy a. reminding children repeatedly what they need to do b. awarding children points when they correctly record information, and bonus points for doing it with only a little prompting or complaining c. removing chores when children have been compliant d. penalizing children by removing points when they do not comply with the doctor’s orders

19. Pediatric psychologists often recommend that parents of children with diabetes use operant conditioning to increase children’s adherence to a treatment regimen. Which of the following is LEAST likely to be recommended as part of parent’s roles?

Ans: A

Learning Objective: LO 16.3. Define the field of pediatric psychology, and illustrate some of the major professional activities of pediatric psychologists. Show how pediatric psychologists help youths with chronic medical problems.

Cognitive Domain: Comprehension

Answer Location: Behavior Therapy for Children Undergoing Medical Procedures

Difficulty Level: Medium a. oppositional and defiant behavior b. constipation and overflow incontinence c. stubbornness d. never having achieved bowel control

20. Encopresis is almost always caused by which of the following?

Ans: B

Learning Objective: LO 16.1 Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Knowledge

Answer Location: What Causes Encopresis?

Difficulty Level: Easy a. laxatives b. dietary changes c. scheduled toilet sitting d. stimulant medication

21. Which of the following is NOT typically a component of treatment for encopresis?

Ans: D

Learning Objective: LO 16.1 Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Knowledge

Answer Location: What Treatments Are Effective for Children With Encopresis?

Difficulty Level: Easy a. Yes, circadian rhythm sleep–wake disorder b. No, because Kelly is not yet an adult. c. No, because it doesn’t cause her distress or impairment d. No, because we don’t know whether her family has promoted this sleep pattern.

22. Since she was a little child Kelly, age 12, has woken up feeling fully rested at 3:00 a m. She goes to sleep every evening at 7:00 p m. Would this be considered a sleep disorder?

Ans: C

Learning Objective: LO 16.2 Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment Give examples of other sleep–wake disorders that affect children and adolescents.

Cognitive Domain: Application

Answer Location: What Are Sleep–Wake Disorders?

Difficulty Level: Medium a. Does the child report dissatisfaction with sleep? b. Does the child seem excessively sleepy during the day? c. Does the child have a regular sleep–wake schedule? d. Does the child snore or have trouble breathing during sleep?

23. Which of the following is NOT one of the primary questions professionals use to screen for sleep disorders in kids?

Ans: A

Learning Objective:

LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment Give examples of other sleep–wake disorders that affect children and adolescents. Cognitive Domain: Knowledge

Answer Location: What Are Sleep–Wake Disorders?

Difficulty Level: Hard a. Yes. b. No, because she must sleep for 5 or fewer hours per night to be diagnosed with insomnia disorder c. No, because she seems to be on a regular schedule and insomnia disorder is only diagnosed when sleep is erratic. d. No, because she is not dissatisfied with the quality or quantity of her sleep.

24. Kylie, age 8, sleeps about 6 hours per night but seems perfectly rested and happy during the day. However, her parents cannot handle having a child who is fully awake at 4:00 every morning. They are sleep deprived and frustrated. Does Kylie meet the criteria for insomnia disorder?

Ans: A

Learning Objective:

LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment Give examples of other sleep wake disorders that affect children and adolescents.

Cognitive Domain: Application

Answer Location: What Is Pediatric Insomnia?: Description

Difficulty Level: Hard a. It decreases across development. b. It decreases from early childhood to late childhood and then peaks in adolescence. c. It increases over time because most of these conditions are chronic. d. It is highest among those with Tourette’s disorder

25. Which of the following is true about the prevalence of sleep disorders?

Ans: a

Learning Objective: LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment Give examples of other sleep–wake disorders that affect children and adolescents.

Cognitive Domain: Knowledge

Answer Location: What Is Pediatric Insomnia?: Epidemiology

Difficulty Level: Medium a. relaxation through tightening and loosening various muscle groups b. making a list of feared stimuli organized from least to most scary c. imaginal exposure d. avoidance of feared stimuli

26. Which of the following is NOT typically a component of systematic desensitization as it applies to pediatric psychology?

Ans: D

Learning Objective: LO 16.3. Define the field of pediatric psychology, and illustrate some of the major professional activities of pediatric psychologists. Show how pediatric psychologists help youths with chronic medical problems.

Cognitive Domain: Comprehension

Answer Location: Behavior Therapy for Children Undergoing Medical Procedures

Difficulty Level: Easy a. Lina has been negatively reinforced and is more likely to request additional stories on subsequent nights. b. Lina has been positively reinforced and is more likely to request additional stories on subsequent nights. c. Lina’s mom has been positively reinforced and is more likely to read additional stories on subsequent nights. d. Lina’s delayed bedtime, if continued, is unlikely to have any effect on her sleep quality, since the delay was relatively short.

27. It’s Lina’s bedtime. After she heads upstairs, she peeks her head out and asks her mom for “just one more story.” Her mom says, “OK, just this once. “ Lina picks a long story and ends up in bed a half-hour later than normal. Which of the following best applies to this scenario?

Ans: B

Learning Objective: LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment Give examples of other sleep–wake disorders that affect children and adolescents. Cognitive Domain: Application

Answer Location: Bedtime Resistance or Struggles

Difficulty Level: Medium a. catastrophizing b. selective abstraction c. personalization d. dichotomous thinking

28. Amber can’t fall asleep because she keeps thinking about the moment in her English class presentation where a boy coughed and said the word “boring” and the class laughed. Even though the teacher had told her she’d done a good job and several other students gave the boy a dirty look when he said that, she cannot stop thinking about that one moment. This is an example of which of the following?

Ans: B

Learning Objective: LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment Give examples of other sleep–wake disorders that affect children and adolescents.

Cognitive Domain: Application

Answer Location: Anxiety or Impulsivity

Difficulty Level: Medium a. swaddling babies b. rocking babies all the way to sleep c. using a bedtime routine to put children to bed at a consistent time each night d. using a transitional object such as a teddy bear in the crib

29. Which simple intervention resulted in less time falling asleep, fewer and shorter night wakings, and better morning moods of children and improved mood and energy levels in mothers?

Ans: C

Learning Objective: LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment Give examples of other sleep–wake disorders that affect children and adolescents.

Cognitive Domain: Knowledge

Answer Location: Behavior Therapy for Infants and Young Children

Difficulty Level: Medium a. It is 0%. b. It is 25%. c. It is 50%. d. It is 100%.

30. A husband and wife, each with sickle cell disease, are thinking about having a baby and want to understand the risk that the baby will have the disease. Which of the following best describes this risk?

Ans: D

Learning Objective: LO 16.3. Define the field of pediatric psychology, and illustrate some of the major professional activities of pediatric psychologists. Show how pediatric psychologists help youths with chronic medical problems.

Cognitive Domain: Application

Answer Location: Sickle Cell Disease

Difficulty Level: Medium a. Matthew will likely go to sleep and the next night he will not cry at bedtime. b. In future similar situations, Matthew is likely to cry because he was reinforced for doing so. c. In future similar situations, Mina will likely have more resolve and not enter the room when Matthew cries for an extended period of time. d. Mina will likely not try planned ignoring again.

31. Mina is attempting to use planned ignoring to help her son Matthew fall asleep on his own. But after 20 minutes of crying, Mina can’t take it anymore. She goes into the room, nurses and rocks Matthew, and then leaves again. What are likely to be the effects of Mina’s actions?

Ans: B

Learning Objective: LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment Give examples of other sleep–wake disorders that affect children and adolescents.

Cognitive Domain: Application

Answer Location: Behavior Therapy for Infants and Young Children

Difficulty Level: Medium a. planned ignoring b. graduated ignoring c. bedtime fading d. chronotherapy

32. Archie is trying to train his son Gregor to fall asleep. He puts Gregor in the crib at 10:00 p m , 30 minutes later than his usual bedtime. Gregor is still not asleep after 10 minutes. So, Archie takes him out.

He tries again at 10:30 p.m He puts Gregor in the crib. By 10:45 p.m., Gregor is still not asleep, so Archie takes him out. He tries again at 11:00 p.m. He puts Gregor in the crib. Within 5 minutes, Gregor is asleep. The next night, Archie first tries putting Gregor in the crib at 10:30 p.m Sure enough, Gregor is asleep at 10:40 p.m. This technique is called which of the following?

Ans: C

Learning Objective: LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment Give examples of other sleep–wake disorders that affect children and adolescents.

Cognitive Domain: Application

Answer Location: Behavior Therapy for Infants and Young Children

Difficulty Level: Medium a. relaxation training b. stimulus control c. sleep restriction d. cognitive restructuring

33. Margot sometimes can’t get back to sleep when she wakes up in the middle of the night. She thinks about all the things she has to do and can’t stop her mind from racing. Her therapist tells her that if she’s not asleep within 30 minutes, she should get out of bed and read in a different location so that she doesn’t associate the bed with her feelings of anxiety. This is an example of which cognitive–behavioral technique?

Ans: B

Learning Objective:

LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment Give examples of other sleep–wake disorders that affect children and adolescents.

Cognitive Domain: Application

Answer Location: Cognitive–Behavior Therapy for Older Children and Adolescents

Difficulty Level: Medium a. behavior modification b. cognitive restructuring c. planned ignoring d. medication

34. Which is the most widely used treatment for pediatric insomnia?

Ans: D

Learning Objective: LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment Give examples of other sleep–wake disorders that affect children and adolescents.

Cognitive Domain: Knowledge

Answer Location: What Treatments Are Effective for Youths With Insomnia?: Medication

Difficulty Level: Medium a. alpha-adrenergic agonists b. antidepressants c. antihistamines d. benzodiazepines

35. Which type of medication is NOT commonly used to treat children’s sleep problems?

Ans: B

Learning Objective: LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment Give examples of other sleep–wake disorders that affect children and adolescents.

Cognitive Domain: Knowledge

Answer Location: What Treatments Are Effective for Youths With Insomnia?: Medication

Difficulty Level: Medium a. because they are less attuned to dawn and sunset than those of other ages b. because their activity tends to be greater at night than during the day c. because puberty brings a delay in cortisol and melatonin secretion d. because their amygdala is finally becoming fully formed

36. Why do so many adolescents experience a phase delay in their circadian rhythm?

Ans: C

Learning Objective: LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment. Give examples of other sleep–wake disorders that affect children and adolescents.

Cognitive Domain: Comprehension

Answer Location: Circadian Rhythm Sleep–Wake Disorder

Difficulty Level: Medium a. chronotherapy b. melatonin c. light therapy d. antidepressants

37. Which of the following treatments for circadian rhythm sleep–wake disorder has the most evidence supporting its effectiveness?

Ans: A

Learning Objective: LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment Give examples of other sleep–wake disorders that affect children and adolescents.

Cognitive Domain: Knowledge

Answer Location: Circadian Rhythm Sleep–Wake Disorder

Difficulty Level: Medium a. Adolescents go to bed at approximately the same time no matter what time they have to wake up in the morning. Thus, later school start times are associated with greater amounts of sleep. b. Schools with later start times have students with better attendance records. c. Schools with later start times have students who have higher academic achievement. d. Delaying school start times provides more time for sports and other exercise throughout the day.

38. Which of the following is NOT one of the pieces of evidence that supports delaying school start times?

Ans: D

Learning Objective: LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment Give examples of other sleep–wake disorders that affect children and adolescents.

Cognitive Domain: Comprehension

Answer Location: Circadian Rhythm Sleep–Wake Disorder

Difficulty Level: Medium a. Only sleep terrors typically involve screaming. b. Only sleep terrors occur during non-REM sleep. c. Only sleep terrors have relatively brief durations; sleepwalking typically lasts an hour or more. d. Only sleep terrors are associated with no memory of the event.

39. Which of the following is a difference between sleepwalking and sleep terrors?

Ans: A

Learning Objective: LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment Give examples of other sleep–wake disorders that affect children and adolescents.

Cognitive Domain: Comprehension

Answer Location: Sleep Arousal Disorders

Difficulty Level: Easy a. Yes. b. No, because her nightmares are not frequent enough. c. No, because her nightmares involve a magical creature (a vampire). d. No, because her nightmares don’t cause significant distress or impairment.

40. Gloria has really scary nightmares about once a month. She wakes up thinking about the vampire she had seen in her dreams for several minutes the morning afterward. Can Gloria be diagnosed with nightmare disorder?

Ans: D

Learning Objective: LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment. Give examples of other sleep–wake disorders that affect children and adolescents.

Cognitive Domain: Application

Answer Location: Nightmare Disorder

Difficulty Level: Medium a. managing chronic pain b. increasing adherence to medication and exercise therapy c. reducing stress and conflict within the family d. improving social skills to minimize peer ostracism

41. Which of the following is NOT a main way in which pediatric psychologists are involved in the care of youths with juvenile rheumatoid arthritis (JRA) described in your text?

Ans: D

Learning Objective: LO 16.3. Define the field of pediatric psychology, and illustrate some of the major professional activities of pediatric psychologists. Show how pediatric psychologists help youths with chronic medical problems.

Cognitive Domain: Knowledge

Answer Location: Juvenile Rheumatoid Arthritis

Difficulty Level: Medium a. cognitive–behavioral therapy b. nightmare imagery rehearsal therapy c. social skills training d. relaxation training

42. Gideon has been experiencing recurrent nightmares where a witch traps him in a castle and then puts a spell on him that turns him to dust. His therapist has him think about this dream during the day and come up with an alternate ending that is happier. Gideon decides that in the nightmare he could instead be a secret wizard who puts a spell back on the witch and turns her to dust instead. This technique is which of the following?

Ans: B

Learning Objective: LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment Give examples of other sleep–wake disorders that affect children and adolescents.

Cognitive Domain: Application

Answer Location: Nightmare Disorder

Difficulty Level: Easy a. removal of the adenoids or tonsils b. sleep hygiene training c. a continuous positive air pressure (CPAP) device d. sedative medication

43. Which of the following is most likely to be a treatment for obstructive sleep apnea in children?

Ans: A

Learning Objective: LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment Give examples of other sleep–wake disorders that affect children and adolescents.

Cognitive Domain: Knowledge

Answer Location: Obstructive Sleep Apnea Hypopnea

Difficulty Level: Medium a. in medical facilities b. in private practice c. at universities d. at schools

44. Pediatric psychologists most commonly work ______.

Ans: A

Learning Objective: LO 16.3. Define the field of pediatric psychology, and illustrate some of the major professional activities of pediatric psychologists. Show how pediatric psychologists help youths with chronic medical problems.

Cognitive Domain: Knowledge

Answer Location: What Is Pediatric Psychology?

Difficulty Level: Medium a. in-patient consultant b. liaison c. facilitating coping with chronic conditions d. participating in specialized care

45. Arleen is a pediatric psychologist. She helps children who are about to receive surgery (usually removing tonsils, adenoids, or their appendix) to feel comfortable and addresses their fears and concerns. This illustrates her role as which of the following?

Ans: A

Learning Objective: LO 16.3. Define the field of pediatric psychology, and illustrate some of the major professional activities of pediatric psychologists. Show how pediatric psychologists help youths with chronic medical problems.

Cognitive Domain: Application

Answer Location: What Is Inpatient Consultation-Liaison?

Difficulty Level: Medium a. It can cure the disorder. b. It cannot affect the disorder, but it can benefit the social interactions with those around the child. c. It can affect the timing and severity of symptoms. d. It can affect who gets the disorder and in whom the disorder is dormant.

46. What is the benefit of reducing stress and changing behavior for those with irritable bowel syndrome (IBS)?

Ans: C

Learning Objective: LO 16.3. Define the field of pediatric psychology, and illustrate some of the major professional activities of pediatric psychologists. Show how pediatric psychologists help youths with chronic medical problems.

Cognitive Domain: Knowledge

Answer Location: Gastrointestinal Problems

Difficulty Level: Medium a. coping b. compliance c. communication d. collaboration

47. Mike, age 10, has just been diagnosed with diabetes. His medical team advises him that he needs to check his blood sugar by pricking his finger three times per day. A pediatric psychologist is brought in to help him with this goal. Which of the five Cs of the consultation-liaison role does this represent?

Ans: B

Learning Objective: LO 16.3. Define the field of pediatric psychology, and illustrate some of the major professional activities of pediatric psychologists. Show how pediatric psychologists help youths with chronic medical problems.

Cognitive Domain: Application

Answer Location: What Is Inpatient Consultation-Liaison?

Difficulty Level: Medium a. alcoholism b. allergies c. asthma d. diabetes

48. According to the text, the most common chronic illness affecting youths is which of the following?

Ans: C

Learning Objective: LO 16.3. Define the field of pediatric psychology, and illustrate some of the major professional activities of pediatric psychologists. Show how pediatric psychologists help youths with chronic medical problems.

Cognitive Domain: Knowledge

Answer Location: Asthma

Difficulty Level: Easy a. providing a desired item or experience after participating in the lung-clearing exercises b. providing a desired item or experience before participating in the lung-clearing exercises c. removing a desired item or experience if the child does not participate in the lung-clearing exercises d. providing an undesirable experience if the child does not participate in the lung-clearing exercises

49 In cystic fibrosis (CF) frequent exercises are needed to clear the lungs. Many children with CF resist this because it can be time consuming, laborious, and distressing. Which of the following techniques might the pediatric psychologist be most likely to recommend to parents?

Ans: A

Learning Objective: LO 16.3. Define the field of pediatric psychology, and illustrate some of the major professional activities of pediatric psychologists. Show how pediatric psychologists help youths with chronic medical problems.

Cognitive Domain: Application

Answer Location: Cystic Fibrosis

Difficulty Level: Medium a. frequent needle pricks necessary for blood sugar monitoring b. embarrassment about the condition c. resentment of having to restrict diet d. inability to actively play

50 Which of the following is NOT typically one of the challenges associated with adherence in diabetes?

Ans: D

Learning Objective: LO 16.3. Define the field of pediatric psychology, and illustrate some of the major professional activities of pediatric psychologists. Show how pediatric psychologists help youths with chronic medical problems.

Cognitive Domain: Knowledge

Answer Location: Diabetes Mellitus

Difficulty Level: Medium a. Jessica had difficulty going to sleep in New York the night she returned from her vacation in Hawaii. b. Since beginning high school, Kate has had problems waking up for her first class at 8:00 a.m. and has had difficulty falling sleep before 1:00 a.m c. Lexi stays up very late on weekends and has a hard time waking on Monday morning. d. Meredith has problems waking in the morning during the winter, because of limited exposure to sunlight.

51. Which of the following scenarios most closely describes an adolescent with circadian rhythm sleep–wake disorder?

Ans: B

Learning Objective: LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment. Give examples of other sleep–wake disorders that affect children and adolescents.

Cognitive Domain: Application

Answer Location: Circadian Rhythm Sleep–Wake Disorder

Difficulty Level: Medium

52. According to the DSM-5, enuresis should not be diagnosed until ___ , whereas encopresis should not be diagnosed until ___ a. age 3 or older; age 2 or older b. age 5 or older; age 4 or older c. age 6 or older; age 6 or older d. age 8 or older; age 6 or older

Ans: B

Learning Objective: LO 16.1 Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Knowledge

Answer Location: What Is Enuresis?:Description; What Is Encopresis?: Description

Difficulty Level: Easy a. Children with primary enuresis have never been able to stay dry through the night b. Children with primary enuresis have an underlying medical disorder that accounts for their problem. c. Children with primary enuresis have no other existing mental disorders. d. Children with primary enuresis do not also have encopresis.

53. What is the difference between primary and secondary enuresis?

Ans: A

Learning Objective: LO 16.1. Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Knowledge

Answer Location: Causes of Nocturnal Enuresis

Difficulty Level: Medium

True/False

1. Research has confirmed that many children with monosymptomatic primary enuresis (MPE) have problems with arousal from sleep.

Ans: T

Learning Objective: LO 16.1 Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Knowledge

Answer Location: Causes of Nocturnal Enuresis

Difficulty Level: Medium

2. Those with polysymptomatic nocturnal enuresis are more likely to wake after wetting in the night than those with monosymptomatic primary enuresis.

Ans: T

Learning Objective: LO 16.1 Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Knowledge

Answer Location: Causes of Nocturnal Enuresis

Difficulty Level: Medium

3. In most cases, children’s bedwetting is attributable to medical causes.

Ans: F

Learning Objective: LO 16.1 Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Knowledge

Answer Location: Treatment of Nocturnal Enuresis

Difficulty Level: Medium

4. Encopresis is a common indicator of sexual victimization.

Ans: F

Learning Objective: LO 16.1. Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Knowledge

Answer Location: What Causes Encopresis?

Difficulty Level: Medium

5. Behavioral interventions for encopresis provide no additional benefit compared to laxatives alone.

Ans: F

Learning Objective: LO 16.1 Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Knowledge

Answer Location: What Treatments Are Effective for Children With Encopresis?

Difficulty Level: Medium

6. Clinical trials have repeatedly found medication to be more effective than cognitive–behavioral treatments for pediatric insomnia.

Ans: F

Learning Objective: LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment. Give examples of other sleep–wake disorders that affect children and adolescents.

Cognitive Domain: Knowledge

Answer Location: What Treatments Are Effective for Youths With Insomnia?: Medication

Difficulty Level: Medium

7. Camps for children with asthma, cancer, diabetes, and gastrointestinal problems have not reliably been shown to have positive results.

Ans: F

Learning Objective: LO 16.3. Define the field of pediatric psychology, and illustrate some of the major professional activities of pediatric psychologists. Show how pediatric psychologists help youths with chronic medical problems.

Cognitive Domain: Knowledge

Answer Location: Group and Peer-Assisted Therapy to Enhance Social Support

Difficulty Level: Hard

8. Children with a broad range of illnesses seem to benefit equally from individual, family, and group interventions for children with chronic illnesses.

Ans: T

Learning Objective: LO 16.3. Define the field of pediatric psychology, and illustrate some of the major professional activities of pediatric psychologists. Show how pediatric psychologists help youths with chronic medical problems.

Cognitive Domain: Knowledge

Answer Location: Effectiveness of Pediatric Interventions

Difficulty Level: Hard

9. Almost all pediatric psychologists work in the school setting. Ans: F

Learning Objective: LO 16.3. Define the field of pediatric psychology, and illustrate some of the major professional activities of pediatric psychologists. Show how pediatric psychologists help youths with chronic medical problems.

Cognitive Domain: Knowledge

Answer Location: What Is Pediatric Psychology?

Difficulty Level: Easy

10. Almost all children have nightmares; therefore, almost all children can be diagnosed with nightmare disorder at one time or another.

Ans: F

Learning Objective: LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment Give examples of other sleep–wake disorders that affect children and adolescents.

Cognitive Domain: Comprehension

Answer Location: Nightmare Disorder

Difficulty Level: Medium

11. Sleepwalking tends to occur during REM sleep.

Ans: F

Learning Objective: LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment Give examples of other sleep–wake disorders that affect children and adolescents.

Cognitive Domain: Comprehension

Answer Location: Sleep Arousal Disorders

Difficulty Level: Medium

Essay

1. Since many cases of enuresis spontaneously resolve, is treating it really necessary?

Ans: Recovery is often slow and stressful and enuresis interferes with children’s quality of life and social activities, and places a burden on the sleep and satisfaction of whole family units. Because treatment is largely effective, minimally in reducing and sometimes in eliminating the problem, individuals may wish to pursue treatment. That being said, only about a third of children with enuresis in the United States receive treatment, and for treatment to be maximally successful, doctors, clinicians, and families must all work together. Unless they’re all willing to do so, treatment may not be worthwhile

Learning Objective: LO 16.1 Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Comprehension

Answer Location: Treatment of Nocturnal Enuresis

Difficulty Level: Medium

2. Encopresis entails passing feces at inappropriate times or places. This seems to be the opposite of constipation, so how is it thought that constipation results in encopretic behavior?

Ans: When children don’t defecate for a long period of time the rectal wall is stretched and the nerves that line the rectum become less sensitive, such that children can no longer experience strongly the sensation that they need to defecate. Then, the fecal mass becomes impacted rock hard and difficult to pass. Further, because it is so challenging, children come to associate bowel movements with pain through classical conditioning, furthering avoidance of the toilet. Fecal matter therefore builds up behind the mass, occasionally seeping out around the sides (overflow incontinence).

Learning Objective: LO 16.1 Describe the features of childhood elimination disorders, their causes, and their evidence-based treatment.

Cognitive Domain: Comprehension

Answer Location: What Causes Encopresis?

Difficulty Level: Medium

3. Why is a polysomnogram considered the “gold standard” for assessing sleep, compared to other methods?

Ans: A polysomnogram is objective and provides multiple measurements of sleep including brain activity, eye movements, muscle activation, and heart rhythm. As such, it can accurately assess sleep duration and quality and detect abnormalities in sleep architecture and breathing during sleep. This is more objective than parental or child report and more comprehensive than use of an actometer.

Learning Objective: LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment Give examples of other sleep–wake disorders that affect children and adolescents.

Cognitive Domain: Analysis

Answer Location: What Are Sleep–Wake Disorders?

Difficulty Level: Medium

4. How might parental characteristics contribute to sleep problems in their children?

Ans: Parents may pass on a genetic propensity towards various sleep disorders but more so, certain parents are less apt to respond effectively to problems their children may develop with sleep. Some may not recognize the importance of sleep and others might experience psychosocial stress, such as living in chaotic environments, working multiple jobs, or caring for many children, that make regular bedtimes challenging. “Children’s sleep disorders are associated with parental risk factors such as stress, fatigue, poor physical health, depression, and family disruption.”

Learning Objective: LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of pediatric insomnia and its evidence-based treatment Give examples of other sleep–wake disorders that affect children and adolescents.

Cognitive Domain: Comprehension

Answer Location: Sleep Arousal Disorders and What Causes Insomnia in Children?

Difficulty Level: Medium

5. Your text discusses three possible explanations for the high comorbidity between ADHD and insomnia:

(1) problematic behavioral inhibition which underlies ADHD also interferes with self-soothing, (2) stimulant medication interferes with sleep, and (3) stimulant medication wears off in the evenings making hyperactivity or impulsivity emerge. Can you think of any other possible explanations for the relationship between these conditions?

Ans: Is it possible that Insomnia can result in ADHD like symptoms and that if the insomnia is treated the ADHD symptoms will abate? For instance, sleep restricted children were found to score significantly lower on several measures of cognitive functioning, especially attention and concentration in one recent study (Ivanenko & Johnson, 2015).

Learning Objective: LO 16.2. Describe the features of pediatric insomnia, and show how young children’s sleep problems often differ from those of adolescents and adults. Identify some of the main causes of