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05 Psych > 14bc Personality eating disorders > Flashcards

14bc Personality eating disorders Flashcards

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0
Q

Defense mechanisms

A

unconscious mental process that the ego uses to resolve conflicts. (i want to punch him but I know I shouldnt)

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1
Q

Personality parts

A
  • 50% temperament “nature”
  • Character
  • Development- negative repeated childhood events can have negative effects
  • Psyche- self awareness and ability to learn, adapt, and change
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2
Q

Immature defense mechanisms

A

Acting out
dissociation- drastic temporary change in personality etc.
Denial
Displacement- husband yells at wife- wife yells at child
fixation
identification- modeling behavior after someone more powerful
Isolation- separating feelings from ideas or events
Projection-projecting your own unacceptable impulses 2 someone else
Rationalization
Reactio formation- think of sex join monestary
regression- toilet trained child wets bed
Repression- involuntary witholding ffelings or thoughts from consciousness
splitting- all good or all bad- no inbetween

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3
Q

Mature defenses

A

Altruism- alleviating guilt by helping others
Humor- i.e. making a joke about Step 1
Sublimation- replace impulse with more acceptable one- angry at dad- take out frustrations scoring goals in soccer
Suppression- intentionally witholding thought or idea from consciousness- choosing not to worry because there are other things to do right now.

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4
Q

Personality disorder

A
  • Ingrained.inflexible
  • Gets in the way of realtionships or functioning
  • Stays stable
  • distresses people around them
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5
Q

Personality disorders stats

A

10-18% of population
30-50% psychiatric outpatient populations
>50% inpatient
34% of Axis 1 disorder patients

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6
Q

Cluster A

A

Detached and eccentric

  • Schizoid
  • schizotypal
  • paranoid
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7
Q

Schizoid PD

A 
Emotionally detached
doesnt want relationships
SchizoiD --> Distant
*M>f
*No positive symptoms of Schizophrenia
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8
Q

SchizoTypal PD

A

Eccentric/ awkward
magical Thinking
*genetic predisposition
“I dont like your vibe man”

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9
Q

Paranoid PD

A

pervasive distrust
M>F
No hallucnations or thought disorder

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10
Q

Cluster B personality disorders

A

Dramatic and imulsive

Antisocial
Borderline
Histrionic
Narcisistic

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11
Q

Borderline PD

A
  • Frantic fear of abandonment
  • Unstable and intense relationships- Idealization or devaluation
  • mood swings (minutes to hours, not days like bipolar)
  • suicide and self mutilation common
  • F>M
  • Familial- associated with MDD and substence abuse
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12
Q

Antisocial PD

A 
Sociopath
criminal, deceitful, impulsive
Aggressive, irritable
Irresponsible
-M>F
-very genetic
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13
Q

Histrionic PD

A

Paris hilton
sexually provocative, attention seeking, emotional and excitable
F>M

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14
Q

Narcissistic PD

A

*Self-important grandiosity- lack of empathy
*Success, pwer, brilliance, beauty, love
*arrogant, entitled, envious
*require admiration, take advantage of others
rages at criticism

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15
Q

Cluster C personalities

A

Cowardly, clingy, compulsive

  • avoidant
  • Obsessive compulsive
  • Dependent
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16
Q

OCPD

A

*Fixated on details- lose scope
*Perfectionism that interferes
*Inflexible values that are unattainable
M>F
rationalize, intellectualize, reactionary, controlling
EGO SYNTONIC

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17
Q

Avoidant PD

A
  • Extreme sensitivity to rejection with withdrawl

* Shy but desire relationships

18
Q

Dependent PD

A

*subordinate needs to others
*indecisive- no self confidence
*doesnt speak up because of fear
*Cant be alone
F>M

19
Q

PD treatments

A

*Psychodynamic treatment- change defenses
*supportive if patient unstable or unable to see problems
*Behavioral if behavior self destructive
Meds for symptoms

20
Q

Anorexia nervosa

A 
MOST LETHAL PSYCH DISORDER
-intense weight loss and fear of obesity
-Disturbed body image
-medical signs and symptoms of starvation
(May require inpatient)
Dx Criteria
*less than 85% of ideal weight
*intense fear of gaining weight
*Body image distortion
*(amenorrhea)
21
Q

Anorexia classifications

A

Purging/restricting

Severity
Mild BMI>17
Moderate 16-16.99
Severe 15-15.99
Extree <15
22
Q

Signs of starvation

A

Hypotension
Bradycardia
Hypothermia

  • bradycardia, syncope, EKG changes, arrhythmias and suddendeath
  • skeletal: osteopenia porosis
  • Endocrine: decreased sex hormones, cold intolerance hypothermia, decr libido and amenorrhea
  • Derm- dry skin, alopecia, lanugo
  • Heme- pancytopenia
  • GI- delayed gastric emptying constipation
  • Neuro- fatigue, weakness, brain mass volume loss and cognative deterioration
23
Q

Anorexia epidemiology

A
  • 10:1 females to males
  • Mid teens
  • 1% population, 5% subclinical
  • higher socioeconomic status
  • Multifactorial, dieting common
  • Genetic predisposition
24
Q

Eating disorder psychological factors

A
  • Temperment: perfectionism, harm avoidant, high achieving
  • Control issues: feeling helpless, or controlled
  • Maturation fears: doesnt want to be full woman
  • demands to increase independence
  • Greedy/unacceptable moral desires
25
Q

Eating disorder social factors

A 
Media
Obesity ed
Family weight concerns
Teasing about weight
dieting info
performance pressures

*interfamily conflicts:
hostile, chaotic, isolative, controlling, not nuturing, not empathetic

26
Q

AN treatment

A
  • Hospitalization- slow refeeding
  • Therapy
  • family (maudsley -parents control at start then give to patient)
  • individual - CBT and DBT
  • group therapy
  • STABALIZE AND IMPROVE RELATIONSHIPS

Prognosis:
75% good to moderate improvement, 1/4 complete recovery, 1/2 still issues but functiong, waxing and waning
Poor prognosis- persisting food obsessions, bulimia, low albumin/low weight
*7-18% mortal

27
Q

Bulimia Nervosa

A
  • Binging and compensatory
  • clinical S/Sx

Dx Criteria

  • Recurrent binging and inappropriate compensatory behavior
  • twice (once in V) per week for 3 months
  • Body image distortion and self worth dependent on body image
28
Q

BN severity

A

Mild 1-3 episodes of compensation
Moderate 4-7
Severe 8-13
Extreme 14+

29
Q

BN SSx

A
  • Swollen parotid, MCP caluses (russels sign), Dental erosions and caries
  • fluid and electrolyte imbalance
  • GERD, Carices, melanosis coli
  • CV arrhythmias and myopathies
  • ENDO: menstrual abnormalitiees
  • Neuro: neuropathy, fatigue, cognative slowing, seizure
30
Q

BN labs

A

*Vomting and diuretic:
Metabolic alkylosis: lowK, low NA,high bicarb
Hypochloremic

*Laxatives:
Hyperchloremic metabolic acidosis: Low K, high Cl, Low bicarb

Low Mg, ^serum amylase

31
Q

BN Epidemiology

A

1-3% of population
Late adolescence early adulthood
*genetic predisposition - associated with mood and impulse disorders
*more responsive to serotonin changes

32
Q

BN Psychological and social

A

Overachiever, secretive, ego-dystonic, self critical, outgoing, angry, impulsive
*associated with depression, substance abuse, PDs, emotional lability, anxiety, dissociative disorders, abuse history

*media influence, anti-obesity education, weight teasing,
family conflict:les close, control issues, neglect/rejection

33
Q

BN Tx

A

Same as AN but also fluoxetine

NOT BUPROPRION- lowers seizure threshold.

Prognosis: Great as long as no substance abuse
Untreated remains chronic

34
Q

BED

A

3-5% population

  • recurrent binging with distress
  • 1X per week>3 months (1-3 mild, 4-7 moderate, 8-13 severe, 14+ extreme)
35
Q

Avoidant/restrictive food intake disorder

A
  • Fails to meet nutritional needs
  • no body image distortion
  • Not AN or BN
36
Q

Obesity

A

BMI >30

2/3 overweight or obese, 1/3 obese

37
Q

Orlistat

A

Lipase inhibitor for obesity

5-10 lbd weight loss in 6 months

38
Q

Phentermine

A

Sympathomimetic decreases appetite

39
Q

Lorcasein HCL

A

Belviq

BMI>30 or >27 with co morbid condition

40
Q

Reasonable weight loss

A

Adults:
1-2 lbs/ week or 10% weight loss over 6 months
cut calories 500-1000 calories per day

Kids:
slow weight gain by exercising to fall back on curve
if obese: maintain for 3 months then 1lb/mo weightloss

41
Q

Exercise recommendations

A

150 mins moderate aerobic weekly

2+ days muscle strengthening

42
Q

PD Tx

A

Schizotypal, paranoid, and borderline PD benefit from 1/10 dose of antipsychotics

05 Psych (8 decks)

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