STUDY MODE - Practice Exam 3 Flashcards
Studies on effective treatments for Bulimia Nervosa have found that:
Select one:
A. cognitive behavioral therapy alone and treatment with an SSRI alone are about equally effective but, in most cases, combining the two treatments does not improve outcomes.
B. cognitive behavioral therapy alone and treatment with an SSRI alone are about equally effective and, in many cases, combining the two treatments improves outcomes.
C. treatment with an SSRI alone is superior to cognitive behavior therapy alone but, for some patients, combining the two treatments improves outcomes.
D. cognitive behavioral therapy alone is superior to treatment with an SSRI alone but, for some patients, combining the two treatments improves outcomes.
Of the treatments for Bulimia Nervosa, cognitive behavioral therapy (CBT) has been most extensively studied and consistently found to be an effective approach.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT The studies have found that an SSRI alone is not as effective as CBT alone. However, an SSRI may be useful when administered in conjunction with CBT when CBT alone has not been sufficiently effective. See, e.g., A. J. Zhu and B. T. Walsh, Pharmacologic treatment for eating disorders, Canadian Journal of Psychiatry, 47, 227-234, 2002.
The correct answer is: cognitive behavioral therapy alone is superior to treatment with an SSRI alone but, for some patients, combining the two treatments improves outcomes.
Following the death of her pet cat, Puff, six-year-old Jane constantly follows and clings to her mother and becomes extremely upset whenever her mother leaves the house. Jane says she can’t go to school because she has a stomachache or other physical ailment. The most likely diagnosis for Jane is:
Select one:
A. Adjustment Disorder.
B. Reactive Attachment Disorder.
C. Separation Anxiety Disorder.
D. Acute Stress Disorder.
The girl’s core symptom is anxiety related to separation.
a. Incorrect Adjustment Disorder is diagnosed when symptoms do not meet the criteria for another mental disorder, which is not the case in this situation.
b. Incorrect Reactive Attachment Disorder involves markedly disturbed and developmentally inappropriate social relatedness.
c. CORRECT The girl’s anxiety is tied to separation from an attachment figure (her mother), which is the primary characteristic of Separation Anxiety Disorder. This disorder is often triggered by a stressor such as the death of a relative or pet and is manifested as somatic symptoms and school phobia.
d. Incorrect The diagnosis of Acute Stress Disorder requires exposure to an extreme stressor and a specific pattern of symptoms - e.g., avoidance of reminders of the event, distressing memories of the event, derealization.
The correct answer is: Separation Anxiety Disorder.
_______________ is the likely DSM diagnosis for a mother when her child’s persistent vomiting stops whenever the child is removed from the mother’s care for several days.
Select one:
A. Malingering
B. Factitious Disorder
C. Ganser syndrome
D. folie a deux
Answer B is correct: The major feature of Factitious Disorder is the intentional production or feigning of physical or psychological symptoms in oneself or another person. The information provided in the question suggests that the mother is inducing her child’s symptoms. (Note that, when symptoms are produced in another person, the diagnosis is Factitious Disorder Imposed on Another.)
Answer A: Malingering involves the intentional production, faking, or gross exaggeration of physical or psychological symptoms in oneself in order to obtain an external reward.
c. Incorrect Ganser Syndrome is not a DSM diagnostic category. A person with this disorder mimics behaviors he/she believes are typical of psychosis (e.g., providing obviously wrong answers to questions).
d. Incorrect Folie a deux is also known as shared psychotic disorder and involves the development of a delusion in a person who has a close personal relationship with another person who already has a delusion.
The correct answer is: Factitious Disorder
The most commonly prescribed treatment for moderate to severe obstructive sleep apnea is:
Select one:
A. tracheostomy.
B. oral appliances.
C. adaptive servo-ventilation (ASV).
D. continuous positive airway pressure (CPAP)
Sleep apnea involves brief, repeated interruptions in breathing during sleep that last for 10 seconds or more. The most common type is obstructive sleep apnea, which is caused by a relaxation of soft tissue at the back of the throat that blocks the passage of air in the nose and throat.
a. Incorrect Tracheostomy is a type of surgery that is sometimes used to alleviate severe forms of sleep apnea when other treatments have failed.
b. Incorrect Oral appliances (e.g., dental appliances that reposition the lower jaw and tongue) are generally less effective than CPAP and are sometimes used to treat mild cases of obstructive sleep apnea.
c. Incorrect ASV is an airflow device that is used to treat central and mixed sleep apnea.
d. CORRECT CPAP involves the use of a nasal mask that produces a continuous flow of air that forces the airways open. It is the most common treatment for moderate to severe obstructive sleep apnea.
The correct answer is: continuous positive airway pressure (CPAP).
Regular use of morphine or other opioid can quickly result in the development of tolerance and dependence. When this occurs, abrupt cessation of the drug produces a withdrawal syndrome that is characterized by:
Select one:
A. blackouts and seizures.
B. flu-like symptoms.
C. rebound anxiety and rebound insomnia.
D. delirium tremens.
Morphine withdrawal closely resembles a moderately severe case of the flu.
a. Incorrect Blackouts and seizures are not characteristic of the withdrawal syndrome associated with morphine.
b. CORRECT Common withdrawal symptoms include nausea, vomiting, diarrhea, abdominal and muscle cramps, runny nose and eyes, chills, and insomnia.
c. Incorrect Rebound anxiety and rebound insomnia are associated with withdrawal from a benzodiazepine. (“Rebound” occurs when the initial symptom - i.e., the symptom for which the drug was prescribed - returns in a more severe form when the drug is withdrawn.)
d. Incorrect Delirium tremens (confusion and visual hallucinations) are severe symptoms that may result from abrupt withdrawal from alcohol.
The correct answer is: flu-like symptoms.
Research on characteristics associated with successful smoking cessation suggests that which of the following individuals is most likely to relapse following an attempt to stop smoking cigarettes?
Select one:
A. a 51 year old married man who started smoking at age 32
B. a 25 year old single man who started smoking at age 16
C. a 34 year old married woman who started smoking at age 25
D. a 42 year old divorced woman who started smoking at age 20
Answer B is correct: Researchers have identified a number of factors that predict successful smoking cessation.
Successful quitters are more likely to be male, age 35 or older, married or living with a partner, and have started smoking at a later age. Therefore, of the individuals described in the answers to this question, a 25-year-old man who is single and started smoking at age 16 is least likely to be a successful quitter.
The correct answer is: a 25 year old single man who started smoking at age 16
For a DSM-5 diagnosis of Binge-Eating Disorder, an individual must have engaged in binge-eating, on average:
Select one:
A. once a week for at least one month.
B. once a week for at least three months.
C. twice a week for at least one month.
D. twice a week for at least three months.
Answer B is correct: For this diagnosis, the DSM-5 requires binges to have occurred, on average, once a week for a minimum of three months.
Answers A, C, and D: See explanation for answer B.
The correct answer is: once a week for at least three months.
Recent research has shown that single-session Psychological Debriefing (PD):
Select one:
A. is as effective as, or in some cases more effective than, multiple-session PD for preventing PTSD.
B. is as effective as multiple-session PD for preventing PTSD only when the session is sufficiently long to elicit a cathartic reaction.
C. is effective for preventing PTSD only when it is administered within 24 hours following exposure to the traumatic event.
D. is not effective for preventing PTSD and may actually exacerbate PTSD symptoms.
Although single-session Psychological Debriefing (PD) is utilized as a prevention for PTSD, recent empirical research has not been supportive of its use.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d. (Also note that there is some evidence that multiple-session PD may be ineffective as well.)
c. Incorrect See explanation for response d.
d. CORRECT B. T. Litz et al., for example, conclude from their review of the research that there is sufficient empirical evidence to indicate that PD should not be provided to individuals immediately after a trauma. The studies they reviewed showed that one-session PD is not effective and, in some cases, actually increases the likelihood of PTSD symptoms. (Early intervention for trauma: Current status and future directions, Clinical Psychology: Science and Practice, 9, 112-134, 2002.)
The correct answer is: is not effective for preventing PTSD and may actually exacerbate PTSD symptoms.
The symptoms of Borderline Personality Disorder are:
Select one:
A. usually most severe during the early adult years.
B. usually most severe during middle age.
C. usually most severe during older adulthood.
D. stable in terms of severity over the adult years
Borderline Personality Disorder is characterized by a pervasive pattern of instability in interpersonal relationships, self-image, and affect and marked impulsivity.
a. CORRECT Longitudinal studies have confirmed that the symptoms of BPD are ordinarily most severe during the early adulthood years. See, e.g., J. Paris, Implications of long-term outcome research for the management of patients with Borderline Personality Disorder, Harvard Review of Psychiatry, 10(6), 315-323, 2002.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: usually most severe during the early adult years.
Which of the following is not categorized as an Anxiety Disorder in the DSM-5?
Select one:
A. Obsessive-Compulsive Disorder
B. Separation Anxiety Disorder
C. Panic Disorder
D. Agoraphobia
Answer A is correct: Obsessive-Compulsive Disorder is included in the DSM-5 with Obsessive-Compulsive and Related Disorders, which also includes Body Dysmorphic Disorder, Hoarding Disorder, Trichotillomania, and Excoriation Disorder.
Answers B, C, and D: The following diagnoses are categorized as Anxiety Disorders in the DSM-5: Separation Anxiety Disorder, Selective Mutism, Specific Phobia, Social Anxiety Disorder, Panic Disorder, Agoraphobia, and Generalized Anxiety Disorder.
The correct answer is: Obsessive-Compulsive Disorder
A 31-year old male client presents with delusions and auditory hallucinations. His wife says that his symptoms developed soon after the sudden death of his mother nearly three weeks ago. The tentative diagnosis is:
Select one:
A. Schizophrenia.
B. Schizophreniform Disorder.
C. Brief Psychotic Disorder.
D. Schizoaffective Disorder.
Answer C is correct: The diagnosis of Brief Psychotic Disorder requires the presence of one or more of four characteristic symptoms with at least one symptom being delusions, hallucinations, or disorganized speech and with symptoms being present for at least one day but less than one month. Symptoms often develop after exposure to an overwhelming stressor but this is not required for the diagnosis.
Answer A: A diagnosis of Schizophrenia requires the presence of at least two active-phase symptoms for at least one month with at least one symptom being delusions, hallucinations, or disorganized speech plus continuous signs of the disorder for at least six months.
Answer B: Schizophreniform Disorder has symptoms that are similar to those of Schizophrenia but with a duration between one and six months.
Answer D: Schizoaffective Disorder is the appropriate diagnosis when the individual has a history of concurrent symptoms of Schizophrenia and a manic or major depressive episode with at least two weeks without prominent mood symptoms.
The correct answer is: Brief Psychotic Disorder.
A delusion of the erotomanic type is illustrated by which of the following?
Select one:
A. A woman is convinced that her pastor at church is madly in love with her even though he has told her that he’s not.
B. A woman believes that every man she comes into contact with wants to have sexual relations with her.
C. A man is preoccupied with sexual fantasies about a co-worker who has shown no interest in him.
D. A man is concerned about reaching orgasm far too quickly even though his wife repeatedly reassures him that he doesn’t have this problem.
A delusion of the erotomanic type involves a false belief that another person, usually of higher status, is in love with the individual.
a. CORRECT Of the situations described, this one comes closest to an erotomanic delusion.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: A woman is convinced that her pastor at church is madly in love with her even though he has told her that he’s not.
The wife of an alcoholic is told she is “co-dependent.” This means that she:
Select one:
A. also has a drinking problem.
B. overtly or covertly supports her husband’s drinking.
C. is happy only when her husband is not drinking.
D. exaggerates the impact and severity of her husband’s problem.
The term co-dependent was originally applied to people who are emotionally involved with alcoholics, but is now more widely used to refer to people who support any addiction of another person.
a. Incorrect See explanation for response b.
b. CORRECT Definitions of co-dependence vary from author to author, but this description comes closest to most currently accepted definitions. Co-dependents overtly or covertly support, and thereby help maintain, the addiction of another person.
c. Incorrect See explanation for response b. (Note that, while there may be some truth to responses c and d in some cases, they do not describe co-dependence as accurately as response b.)
d. Incorrect See explanation for response b.
The correct answer is: overtly or covertly supports her husband’s drinking.
For some adolescents and adults, it may be difficult to distinguish ADHD from OCD due to an overlap in symptoms. ADHD may be difficult to distinguish from Obsessive-Compulsive Disorder because the individual with ADHD:
Select one:
A. may be preoccupied with multiple worries that interfere with his/her ability to concentrate and complete tasks.
B. may attempt to compensate for his/her attention deficits by developing repetitive routines.
C. tends to avoid performance situations that are likely to produce high levels of anxiety.
D. exhibits oppositional behavior and low frustruation tolerance, as manifested by excessive irritability or temper outbursts.
Eliminating answers that contain symptoms that are not characteristic of ADHD or OCD would have helped you identify the correct answer to this question.
a. Incorrect Preoccupation with multiple worries is characteristic of Generalized Anxiety Disorder (not OCD). Also, for individuals with ADHD, problems with concentration are not due to excessive worrying.
b. CORRECT Some adolescents and adults with ADHD attempt to compensate for their organizational and attentional impairments by developing repetitive routines that may resemble obsessive-compulsive behaviors. See, e.g., A. L. Robin and R. A. Barkley, ADHD in adolescents, New York, Guilford Press, 1999.
c. Incorrect Children with ADHD do not usually experience performance-related anxiety.
d. Incorrect Oppositional behaviors and low frustration tolerance are associated features of ADHD but are not characteristic of OCD.
The correct answer is: may attempt to compensate for his/her attention deficits by developing repetitive routines.
A DSM-5 diagnosis of Acute Stress Disorder requires a duration of symptoms of:
Select one:
A. two days to four weeks with an onset immediately after exposure to the trauma.
B. three days to one month with an onset within four weeks after exposure to the trauma.
C. two days to two months.
D. three days to one month.
Answer D is correct: For a diagnosis of Acute Stress Disorder, the DSM-5 requires that symptoms have a duration of three days to one month. It notes that symptoms typically begin immediately after exposure to the trauma but does not require that they do so.
The correct answer is: three days to one month.
For individuals with Schizophrenia, the poorest prognosis is associated with which of the following?
Select one:
A. female gender, younger age at onset, and predominant negative symptoms
B. female gender, older age at onset, and predominant positive symptoms
C. male gender, younger age at onset, and predominant negative symptoms
D. male gender, older age at onset, and predominant positive symptoms
As noted in the Abnormal Psychology chapter of the written study materials, prognosis for Schizophrenia has been linked to a number of factors including gender, age, type of onset, predominant symptoms, the presence of a precipitating event, and family history.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT A better prognosis is associated with female gender, later age at onset, and positive symptoms (which are more responsive to drug treatment).
d. Incorrect See explanation for response c.
The correct answer is: male gender, younger age at onset, and predominant negative symptoms
Research on high expressed emotion has linked it to a ___________ for several psychiatric disorders including Schizophrenia, Bipolar Disorder, Major Depressive Disorder, and Eating Disorders.
Select one:
A. high risk for relapse
B. better response to pharmacotherapy
C. lower motivation for treatment
D. increased potential for misdiagnosis
High expressed emotion refers to the hostility, criticism, and emotional over-involvement that family members express toward a patient with a mental disorder and has been linked to negative outcomes for several psychiatric disorders.
a. CORRECT High expressed emotion was originally linked to a higher risk for relapse for patients with Schizophrenia and was subsequently linked to relapse and other negative outcomes for other psychiatric disorders as well. See, e.g., R. L. Butzlaff and J. M. Hooley, Expressed emotion and psychiatric relapse: A meta-analysis, Archives of General Psychiatry, 55, 547-552, 1998.
b. Incorrect See explanation for response a.
c. Incorrect See explanation for response a.
d. Incorrect See explanation for response a.
The correct answer is: high risk for relapse
A number of investigators have attempted to identify the factors that reduce the likelihood that a woman will seek or remain in substance abuse treatment. Of the factors that have been studied, which of the following has most often been identified as a primary barrier to substance-abuse treatment for women?
Select one:
A. child and childcare concerns
B. sexual harassment from male counselors
C. denial of a substance abuse problem
D. a perception that treatment is ineffective
This is a difficult question since all of the factors listed in the answers have been identified as barriers to the treatment of women for substance abuse. However, only one of the factors is consistently cited by experts as a primary or most frequently mentioned barrier.
a. CORRECT The research has confirmed that women with substance abuse problems are more likely than men to be caring for dependent children; and factors related to children are frequently cited by women as barriers to substance abuse treatment: Many women are concerned about custody issues (i.e., that their children will be taken away from them); others are concerned about childcare while they receive treatment. With regard to the latter, a recent United Nations report on substance abuse treatment concludes that a “lack of childcare is probably the most consistent factor restricting women’s treatment access identified in the literature” [United Nations Office on Drugs and Crime, Substance abuse treatment and care for women: Case studies and lessons learned, New York, United Nations, 2004, p. 18].
b. Incorrect Although sexual harassment of women has been identified as a problem at some treatment centers, it is not the factor that has “most often” been identified as a barrier to treatment.
c. Incorrect Women are more likely to express shame and guilt about their substance abuse than to deny that they have an abuse problem.
d. Incorrect Concerns about treatment effectiveness may deter some women from seeking treatment for substance abuse problems, but this factor has not been identified as a primary barrier to treatment. In fact, there is evidence that women who have received treatment describe it as being effective [e.g., L. Nelson-Zlupko et al., Women in recovery: Their perceptions of treatment effectiveness, Journal of Substance Abuse Treatment, 13(1), 51-59, 1996].
The correct answer is: child and childcare concerns
A 33-year old married woman with one biological child receives a diagnosis of Schizophrenia. Her husband has no symptoms or family history of the disorder. Which of her relatives is at greatest risk for receiving the same diagnosis?
Select one:
A. parent
B. biological sibling
C. adopted sibling
D. child
Research on the concordance rates for Schizophrenia have supported a genetic etiology of the disorder. See I. I. Gottesman, Schizophrenic genesis, New York, Philosophy Library, 1991.
a. Incorrect The concordance rate for a parent of an individual who receives a diagnosis of Schizophrenia is about 6%.
b. Incorrect The concordance rate for biological siblings is about 9%.
c. Incorrect The concordance rate for an adopted sibling would be about the same as the concordance rate for members of the general population - i.e., 1%.
d. CORRECT The concordance rate for a biological offspring of one schizophrenic parent is 13%.
The correct answer is: child
A clinician notices that her client, age 28, experiences frequent periods in which she is very irritable, sensitive, anxious, and self-deprecating; but that, between these times, the client seems to be fairly well-adjusted and even-tempered. When the clinician asks the client about these mood changes, the client says she has always become very moody during the week before her menstrual period. The client’s symptoms are most suggestive of which of the following DSM-5 disorders?
Select one:
A. Dysmenorrhea
B. Cyclothymic Disorder
C. Premenstrual Syndrome
D. Premenstrual Dysphoric Syndrome
Answer D is correct: More information would be needed to assign a diagnosis of Premenstrual Dysphoric Syndrome. However, of the diagnoses listed in the answers, this one is most consistent with the information provided in the question.
Answer A: Dysmenorrhea is a medical condition that is characterized by physical pain during menstruation.
Answer B: While the client’s symptoms are cyclical, they do not meet the diagnostic criteria for Cyclothymic Disorder, which involves alternating periods of hypomanic and depressive symptoms.
Answer C: Premenstrual Syndrome is not a DSM-5 diagnosis.
The correct answer is: Premenstrual Dysphoric Syndrome
The assessment of patients with Alzheimer’s disease is an ongoing process due to the degenerative nature of the disease and the consequent need to alter the nature of the treatment plan. During the 4th or 5th year of the disorder, an assessment is most likely to find which of the following?
Select one:
A. deficits in new learning with remote memory mildly to moderately impaired; anomia; sadness
B. severe impairments in recent and remote memory; fluent aphasia; indifference or irritability; restlessness
C. severe impairments in memory and executive functioning; motor rigidity; confusion and delusions
D. severely disturbed intellectual functioning; limb rigidity and flexion posture; apathy; seizures
As noted in the Abnormal Psychology chapter of the written study materials, the progression of Alzheimer’s disease can be described in terms of three stages.
a. Incorrect These symptoms are more common during the first two to three years (first stage).
b. CORRECT These are characteristic symptoms during the 3rd through 10th years (middle stage).
c. Incorrect These are symptoms of the third stage (8 to 12 years).
d. Incorrect These are third stage symptoms (in addition, seizures are not necessarily associated with this disorder).
The correct answer is: severe impairments in recent and remote memory; fluent aphasia; indifference or irritability; restlessness
During your first session with Mr. and Mrs. Desvelo, Mr. Desvelo says his wife has insisted that he get “some help” with his sleep problems. Mrs. Desvelo states that she’s awakened by his frightening screams at least once a week, usually a few hours after they go to sleep, and that this is having a negative effect on her mood and their relationship. Mr. Desvelo has no history of trauma or substance abuse, and he says he recently had a physical and his health is good. In response to your questions, Mrs. Desvelo tells you that her husband sometimes wakes up when he screams and seems agitated but usually goes right back to sleep and doesn’t respond to her attempts to calm him; and Mr. Desvelo says that, in the morning, he has no memory of the episode and usually can’t recall having had any dreams. Mr. Desvelo’s symptoms are most suggestive of which of the following DSM-5 diagnoses?
Select one:
A. Nightmare Disorder
B. Sleep Terror Disorder
C. Rapid Eye Movement Sleep Behavior Disorder
D. Non-Rapid Eye Movement Sleep Arousal Disorder
Answer D is correct: A person with Non-Rapid Eye Movement Sleep Arousal Disorder, sleep terror type experiences sleep terror episodes that are usually accompanied by a panicky scream. The person shows signs of autonomic arousal, usually does not fully awaken, is unresponsive to the efforts of others to comfort him/her, rarely remembers any dreams he/she may have had, and has amnesia for the episode on awakening in the morning.
Answer A: A person with Nightmare Disorder awakens easily and completely and reports having had a vivid dream involving a threat to survival or security.
Answer B: Sleep Terror Disorder is not a DSM-5 diagnosis.
Answer C: Rapid Eye Movement Sleep Behavior Disorder involves episodes of arousal during REM sleep that are usually associated with vocalizations and/or complex motor behaviors that are consistent with the person’s dream. Upon awakening, the person is alert and oriented.
The correct answer is: Non-Rapid Eye Movement Sleep Arousal Disorder
As defined in the DSM-5, the essential feature of Delirium is:
Select one:
A. impaired ability to transfer information from short- to long-term memory.
B. a disturbance in attention and awareness.
C. a disturbance in psychomotor behavior.
D. disorientation.
Answer B is correct: According to the DSM-5, the core features of Delirium are impaired awareness and a disturbance in attention (e.g., impaired ability to focus, sustain, and shift attention).
Answers A, C, and D: Although Delirium may involve impaired memory, a disturbance in psychomotor behavior, and/or disorientation, these symptoms are not essential features of the disorder.
The correct answer is: a disturbance in attention and awareness.
Naasir N. states that he often can’t keep himself from falling asleep during the day and, as a result, has injured himself several times at work and recently started taking the bus to work because he’s afraid he’ll fall asleep while driving. He says that he often experiences weakness in his legs right before he falls asleep during the day and has vivid, sometimes frightening dreams just before he wakes up. Naasir says that he likes to have a few beers in the evening and on weekends but that this seems to increase his daytime sleepiness. He reports that he has very vivid dreams at night and usually wakes up several times each night but is able to quickly fall asleep again. Based on these symptoms, the most likely diagnosis for Naasir is:
Select one:
A. sleep apnea.
B. alcohol-induced sleep disorder.
C. primary hypersomnia.
D. narcolepsy.
Naasir is exhibiting sleep attacks with cataplexy (weakness in his legs) and hypnopompic hallucinations (vivid dreamlike hallucinations on awakening).
a. Incorrect Sleep apnea is a breathing-related sleep disorder that involves an episodic cessation of breathing that may or may not be due to an upper airway obstruction.
b. Incorrect Naasir’s daytime sleep attacks and cataplexy are not characteristic of alcohol-induced sleep disorder.
c. Incorrect Naasir’s symptoms are more characteristic of narcolepsy than of primary hypersomnia, which involves more persistent daytime sleepiness (rather than discrete sleep attacks), few or no dreams during daytime naps, an absence of cataplexy, and fewer disturbances in nocturnal sleep.
d. CORRECT Naasir’s daytime sleep attacks are characteristic of narcolepsy, which can be exacerbated by alcohol and is often accompanied by frequent awakening and vivid dreams at night.
The correct answer is: narcolepsy.