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7153PSY > 8. Eating disorders > Flashcards

8. Eating disorders Flashcards

1
Q

AN

A

persistent energy intake restriction
intense fear of weight gain/becoming fat/ persistent behaviour that interferes with weight gain
disturbance in self perceived weight or shape

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2
Q

BN

A

recurrent episodes of binge eating
recurrent inappropriate compensatory behaviours to prevent weight gain
self evaluation that is unduly influenced by shape and weight

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3
Q

BED

A

recurrent episodes of binge eating that must occur on average at least once per week for 3 MO

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4
Q

body image disparagement

A

view that one’s body is loathsome or repulsive
commonly accompanied by body shape avoidance

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5
Q

debting

A

creation of an energy deficit or ‘debt” typically through exercising to accomodate subseqeuent eating

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6
Q

core transdiagnostic psychopathology of eating disorders

A

over evaluation of shape, weight and their control

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7
Q

assessment

A

clinical interview- unstructured, semi/structured (EDE)
informant perspectives (sometimes not appropriate for adults)
self report questionnaires (EDE-Q, CIA, EDI-III)
medical/health assessment and contact

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8
Q

NICE guidelines first line treatment for adults with AN

A

individual eating disorder CBT (CBT-E, CBT-ED)
MANTRA
SSCM (specialist supportive clinical management)
if one unacceptable, contraindicated or ineffective, try one of the others or ED focused psychodynamic therapy

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9
Q

NICE guidelines first line treatments for children/young people with AN

A

AN focused family therapy (FT-AN), options for single and family sessions
if unacceptable, contraindicated or ineffective, try CBT-ED or adolescent focused psychotherapy for AN (AFP-AN)

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10
Q

NICE guidelines first line treatment for adults with BN

A

guided self help

IF U/A: CBT-ED

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11
Q

NICE guidelines first line treatment for children/young people with BN

A

FT-BN options for single and family sessions throughout

IF U/A: CBT-ED

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12
Q

NICE guidelines first line treatment for adults/children/young people with BN

A

guided self help

IF U/A: CBT-ED

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13
Q

When to include other HPs

A

weight low
dietary restrictions
health complications (diabetes)
other mental health comorbidities

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14
Q

Formulation- CBT theory of restricting AN

A

overevaluation of shape and weight and their control
strict dieting- non compensatory weight control behaviour
significantly low weight- preoccupation with eating, social withdrawal, heightened fullness, heightened obsessionality

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15
Q

Formulation- CBT theory of BN

A

over evaluation of shape and weight and their control
strict dieting, non-compensatory weight control behaviour
events and associated mood change
binge eating
compensatory vomiting/laxative misuse

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16
Q

transdiagnostic theory of EDs

A

over evaluation of shape and weight and their control
strict dieting- non compensatory weight control behaviour
significantly low weight

events and associated mood change
AND/OR might lead to binge eating
compensatory vomiting/laxative misuse

17
Q

Formulation- extended transdiagnostic theory of EDs

A

refer to slide 22

18
Q

CBT-E

A

usually 20 sessions over 20 W, if bm <17.5 recommend 40 sessions
Core (ED psychopathology and mood intolerance) or broad (adds in modules on clinical perfectionism, core low self-esteem and interpersonal difficulties
versions for younger (adolescent) patients
intensive inpatient and group versions as well
principle of parsimony
heavy behavioural focus, limited use of cog strategies
de-centering from the eating problem
may involve significant other sessions
caution again combining with eclectic approaches

19
Q

contraindications to CBT-E

A

compromised physical health
suicide risk
severe clinical depression
persistent substance misuse
major life events or crises
inability to attend treatment/any planned absence of therapist

20
Q

CBT-E phase 1A

A

sessions 1-2, twice weekly
establish therapeutic relationship
assessment
goals
instilling hope, enthusiasm, ownership
formulation and formulation feedback (diagram)
preparation for treatment
initiation of self monitoring and rationale for homework
education about weight checking

21
Q

CBT-E phase 1B

A

sessions 3-8, twice weekly
in session weighing 5 mins
reviewing monitoring records and homework assignments 10 mins
collaboratively setting agenda 3 mins
working through agenda and agreeing on homework tasks 30 mins
summarising, confirming homework, setting next appt 3 mins

22
Q

CBT-E phase 1 goals

A

education of eating problems- guided reading
establish a pattern of regular eating
involve significant others if helpful

23
Q

CBT-E Phase 2

A

sessions 9-10 weekly
transitional phase

24
Q

CBT-E Phase 2 goals

A

conduct a joint review of progress
identify barriers to change
review the formulation
deciding whether to use core or broad CBT-E
Design phase 3

25
Q

CBT-E phase 2 designing stage 3- ordering your maintaining mechanisms

A

overevaluation of shape and weight
over evaluation of control over eating
dietary restraint
dietary restriction
being underweight
event or mood triggered changes in eating

26
Q

CBT-E phase 3- overevaluation of shape, weight and control

A

identifying the over evaluation and its consequences
enhancing the importance of other domains for self evaluation
addressing shape checking and avoidance
addressing feeling fat
exploring origins of the over evaluation
learning to control the eating disorder mindset
self evaluation pie chart

27
Q

CBT-E phase 3- dietary restraint/restriction

A

helping patients view their dieting as a ‘problem’
identifying and addressing dietary rules
addressing over evaluation of control

28
Q

CBT-E phase 3- events, mood and eating

A

proactive problem solving
development of functional methods of mood modulation

29
Q

CBT-E Phase 4

A

ending treatment 3-4 sessions 2-3 weeks apart
addressing concerns about ending treatment
ensuring progress is maintained
phasing out treatment procedures
minimising risk of relapse
review

30
Q

adaptations/broad CBT-E

A

core low self esteem
interpersonal problems
clinical perfectionism
CBT-E for adolescents
group CBT-E

7153PSY (11 decks)

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