18 Anorexia Nervosa Flashcards
What are the crude mortality rates for:
Anorexia
Bulimia
EDNOS?
4% for AN patients; 20% with no treatment
- 9% for BN patients
- 2% for EDNOS patients.
What percentage of the population has an eating disorder? And what percentage suffer from symptoms?
1-2% has eating disorder
20% suffer from ED symptoms
What’s the gender split for AN?
90% female; 10% male
What’s the BMI cut-off for anorexia nervosa?
BMI must be less than 18.5
What is the A criterion for Anorexia Nervosa in DSM-5?
A. Restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health. Significantly low weight is defined as a weight that is less than minimally normal or, for children and adolescents, less than that minimally expected.
What becomes the criterion for AN if individual has naturally low BMI?
Weight loss.
What is the B criterion for AN in DSM-5?
B. Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.
Have most anorexics ever been overweight?
No.
What is the C criterion for Anorexia Nervosa in the DSM-5?
Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.
What makes it hard to recover once the body is in starvation mode?
Once your body is in starvation mode, you need around 3000 calories a day in order to gain weight.
What is the Restricting Type of AN?
The person does not regularly engage in binge eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas).
What is the binge-eating/purging type of AN?
During the last 3 months, the individual has engaged in recurrent episodes of binge eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas).
What are some of the physical effects of AN?
- Thin brittle hair
- Low blood pressure, heart palpitations, heart failure
- Anemia
- Weak muscles
- Bone fractures
- Kidney stones, kidney failure
- Constipation, bloating
- Amenorrhea
- Yellow skin
- Growth of fine hair all over body
What are 3 cognitive effects of AN?
- Cognitive effects comparable to those of prefrontal lesions (but recover when starvation ends)
- Depression
- Memory deficits
What 6 psychological factors predict AN?
- Low self-esteem
- Negative affect
- Dysfunctional thinking – i.e. judging self in terms of eating/weight
- Low executive function
- Perfectionism
- Need for control
How are the serotonin levels of ANs?
Abnormally high. Probably because of starvation –also the case in starved rats.
In a cognitive model of AN, in what 2 ways might the weight loss be reinforcing? (Garner and Bemis, 1986)
- Reduction in distress about being overweight
2. Feeling great about the achieved self-control.
What 4 kind of cognitive distortions might be present in ANs? (Garner and Bemis, 1986)
- Selective abstraction –focus on the negative
- Dichotomous thinking
- Magnification of events – positive results of actions are smaller than in reaiity; negative are larger than in reality
- Assessing self-worth in terms of weight and self-control
What is a weight schemata?
A specific cognitive representation of the self as a certain weight.
Schema theory hypothesises that individuals with eating disorders have an attentional bias towards what 3 things?
- Weight
- Shape
- Food stimuli
How might body dissatisfaction and body-related stimuli form a feedback loop?
Body dissatisfaction increases with body-related stimuli (e.g. word ‘flabby’, pics of thin people). More body dissatisfaction leads to more attention towards body-related stimuli.
What percentage of people with AN are actually working toward recovery?
20%
What is the number one therapy for adolescents with AN?
Maudsley Therapy
What are the three stages in Maudsley Therapy?
0 stage –refeeding
1 - parents must take control of the behaviour, take leave from work, eat every single meal with the child. Blame must be externalised, no one’s fault.
2 - adolescent takes back control of eating
3 - development of personality of adolescent
What is cognitive remediation therapy?
Mental exercises aimed at improving cognitive skills, particularly metacognition. Used in tandem with CBT.
What are the three phases of CBT for AN?
Phase 1 - therapeutic alliance and refeeding (usually inpatient)
Phase 2 - cognitive restructuring (usually outpatient)
Phase 3 - relapse prevention
Is Muscle Dysmorphia an eating disorder?
No, it’s a type of body dysmorphic disorder.
