AB: Eating Disorders

Question 1

What three requirements are there for anorexia nervosa?

Answer 1

1. Restriction of behaviors that promote healthy body weight
2. Intense fear of gaining weight or behavior that interferes with gaining weight.
3. Distorted body image or sense of body shape.

Question 2

What subtypes pf anorexia nervosa are presented in the DSM?

Answer 2

the restricting type, weight loss is achieved by severely limiting food intake; in the binge eating/purging type, as illustrated in Lynne’s case, the person has also regularly engaged in binge eating and purging

Question 3

Why might dividing these subtypes not be useful?

Answer 3

Nearly two-thirds of women who initially met criteria for the restricting subtype had switched over to the binge eating/purging type 8 years later.

Question 4

What is anorexia frequently comorbid with?

Answer 4

depression, obsessive-compulsive disorder, specific phobias, panic disorder, and various personality disorders. Suicide rates are quite high for people with anorexia, with as many as 5 percent completing suicide and 20 percent attempting suicide

Question 5

What are the physical consequences of anorexia nervosa?

Answer 5

Self-starvation and use of laxatives to lose weight produce numerous undesirable consequences in people with anorexia nervosa. Blood pressure often falls, heart rate slows, kidney and gastrointestinal problems develop, bone mass declines, the skin dries out, nails become brittle, hormone levels change, and mild anemia may occur. Some people lose hair from the scalp, and they may develop lanugo—a fine, soft hair—on their bodies. As in Lynne’s case, levels of electrolytes, such as potassium and sodium, are altered. These ionized salts, present in various bodily fluids, are essential to neural transmission, and lowered levels can lead to tiredness, weakness, cardiac arrhythmias, and even sudden death.

Question 6

What are the recovery.rates for people with anorexia nervosa?

Answer 6

Fifty to seventy percent of people with anorexia eventually recover or at least significantly improve. However, recovery often takes 6 or 7 years, and relapses are common before a stable pattern of eating and weight maintenance is achieved

Question 7

Is anorexia life threatening?

Answer 7

Anorexia nervosa is a life-threatening illness; death rates are 10 times higher among peple with the disorder than among the general population and twice as high as among people with other psychological disorders. Mortality
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rates among women with anorexia range from 3 to 5 percent (Crow, Peterson, et al., 2009; Keel & Brown, 2010). Death most often results from physical complications of the illness—for example, congestive heart failure and from suicide

Question 8

What is involved in bulimia nervosa?

Answer 8

episodes of rapid consumption of a large amount of food, followed by compensatory behavior such as vomiting, fasting, or excessive exercise to prevent weight gain.

Question 9

How does the DSM define binge eating?

Answer 9

eating an excessive amount of food, that is, much more than most people would eat, within a short period of time (e.g., 2 hours). Second, it involves a feeling of losing control over eating—as if one cannot stop.

Question 10

What is the difference between anorexia and bulimia

Answer 10

weight loss: People with anorexia nervosa lose a tremendous amount of weight, whereas people with bulimia nervosa do not.

Question 11

When are binges likely to occur

Answer 11

When they’re along (morning/ night) our after a negative event

Question 12

What is the DSM criteria for Bulimia?

Answer 12

• Recurrent episodes of binge eating
• Recurrent compensatory behaviors to prevent weight gain, for example, vomiting
• Body shape and weight are extremely important for self- evaluation

the DSM-5 diagnosis of bulimia nervosa requires that the episodes of bingeing and compensatory behavior occur at least once a week for 3 month

Question 13

What constitutes the severity of bulimia?

Answer 13

Mild: 1–3 compensesatory behaviors/week
Moderate: 4–7
Severe: 8–13
Extreme: 14 or more

Question 14

How does bulimia often begin?

Answer 14

Many people with bulimia nervosa were somewhat overweight before the onset of the disorder, and the binge eating often started during an episode of dieting.

Question 15

What is bulimia comorbid with?

Answer 15

depression, personality disor- ders, anxiety disorders, substance use disorders, and conduct disorder

Question 16

What are the physical consequences of bulimia?

Answer 16

frequent purging can cause potassium depletion. Heavy use of laxatives induces diarrhea, which can also lead to changes in electrolytes and cause irregularities in the heartbeat. Recurrent vomiting may lead to tearing of tissue in the stomach and throat and to loss of dental enamel as stomach acids eat away at the teeth, which become ragged. The salivary glands may become swollen

Question 17

What are the recovery rates for bulimia?

Answer 17

68to75percent of them recover, although about 10 to 20 percent remain fully symptomatic

Question 18

How is binge eating disorder separate from bulimia?

Answer 18

the absence of compensatory behavi

Question 19

What is binge eating disorder comorbid with?

Answer 19

mood disorders, anxiety disorders, ADHD, conduct disorder, and substance use disorders

Question 20

What are risk factors for binge eating disorders?

Answer 20

Risk factors for developing binge eating disorder include childhood obesity, critical comments about being overweight, weight-loss attempts in childhood, low self-concept, depression, and childhood physical or sexual abuse

Question 21

What are the physical consequences of binge eating disorder?

Answer 21

increased risk of type 2 diabetes, cardiovascular problems, chronic back pain, and headaches even after controlling for the independent effects of other comorbid disorders, many physical problems are present among people with binge eating disorder that are independent from co-occurring obesity, including sleep problems, anxiety, depression, irritable bowel syndrome, and, for women, early onset of menstruation

Question 22

DSM criteria for binge eating disorder?

Answer 22

• Recurrent binge eating episodes
• Binge eating episodes include at least three of the following:
• eating more quickly than usual
• eating until over full
• eating large amounts even if not hungry
• eating alone due to embarrassment about large food quantity
• feeling bad (e.g. ,disgusted ,guilty, or depressed) after the binge
• No compensatory behavior is present

Question 23

How heritable are eating disorders?

Answer 23

Eating disorders run in families. First-degree relatives of women with anorexia nervosa are more than 10 times more likely than average to have the disorder themselves. Similar results are found for bulimia nervosa, where first-degree relatives of women with bulimia nervosa are about four times more likely than average to have the disorder. relatives of people with binge eating disorder and obesity were more likely to have binge eating disorder themselves (20 percent) than were relatives of people who were obese but did not have binge eating disorder (9 percent).

Question 24

What body process is theorised to play a role in eating disorders?

Answer 24

Endogenous opioids are substances produced by the body that can reduce pain sensations, enhance mood, and suppress appetite. Opioids are released during starvation and have been hypothesized to play a role in anorexia, bulimia, and binge eating disorder. Starvation among people with anorexia may increase the levels of endogenous opioids, resulting in a positively reinforcing positive mood state

Question 25

How is the reward system linked to anorexia?

Answer 25

both groups of women showed comparable brain activation in the ventral striatum, an area associated with reward, during the food choice task. Where the groups dif- fered was in the dorsal striatum, an area of the brain linked with habitual choices and anxiety. These findings suggest that eating habits may be important in anorexia. That is, dieting or restrictive eating may become habitual, and these habits may themselves become rewarding

Question 26

How has it been proposed that neurotransmitters play a role?

Answer 26

Animal research has shown that serotonin promotes feeling full. Therefore, the binges of people with bulimia or binge eating disorder could result from a serotonin deficit that prevents them from feeling full after they eat.
A prospective study found that people with several genes that promote strong dopamine signals in the brain were more likely to have a higher BMI 2 years later

Question 27

What is meant by the incentive-sensitisation theory?

Answer 27

The incentive-sensitization theory considers both the cravings (“wanting”) for food and the pleasure (“liking”) that comes with eating foods, particularly tasty, high-calorie foods. In this model, dopamine plays a key role in the “liking” of food and the “wanting” or craving for food.

Question 28

What cognitive behavioural factors may be associated with anorexia?

Answer 28

a period of weight loss and dieting positively reinforced by comments from others (Did you lose weight? You look great!) Some theories also include personality and sociocultural variables to explain how body-image disturbances develop. For example, perfectionism and a sense of personal inadequacy may lead a person to become especially concerned with his or her appear- ance, making dieting a potent reinforcer. Another important factor in producing
a strong drive for thinness and a disturbed body image is criticism from peers and par- ents about being overweight

Question 29

How is emotion involved In anorexia?

Answer 29

people with anorexia experience many negative emotions. Surprisingly, though, people with anorexia also experience positive emotion, even though they may not distinguish among different positive emotional states all that well (distinguishing intense pride after not eating from happiness)

Question 30

What is the cognitive theory of bulimia?

Answer 30

. They try to follow a very rigid pattern of restrictive eating, with strict rules regarding how much to eat, what kinds of food to eat, and when to eat. These strict rules are inevitably broken, and the lapse escalates into a binge. After the binge, feelings of disgust and fear of becoming fat build up, leading to compensatory actions such as vomiting. A meta-analysis of 82 EMA studies found that negative emotion preceded the onset of a binge among people with bulimia or binge eating disorder, but the effect sizes were stronger for binge eating disorder than for bulimia

Question 31

What has research shown about the cognitive bias of people with eating disorders?

Answer 31

women with eating disorders pay greater attention not only to their own bodies, food, and weight but also to other women’s bodies, food, and shapes.

Question 32

What differences are there in race?

Answer 32

There is a somewhat greater incidence of eating disturbances and body dissatisfaction among white women than black women, but differences in actual eating disorders, particularly bulimia, do not appear to be as great
In contrast to other eating disorders, anorexia nervosa was very rare among Latina women

Question 33

How is personality involved in eating disorders?

Answer 33

Starvation can affect personality and personality traits found to predict eating disorders in girls were shy, compliant and perfectionists

Question 34

What medication is often used for bulimia?

Answer 34

Antidepressants

Question 35

What is the downside to using antidepressants for bulimia?

Answer 35

many people with bulimia stop taking medications

Question 36

How is therapy for anorexia seen as a two tiered process?

Answer 36

The immediate goal is to help the person gain weight to avoid medical complications and the possibility of death. The person is often so weak and physiological functioning so disturbed that hospital treatment is medically imperative (in addition to being needed to ensure that the patient ingests some food). Operant conditioning behavior therapy programs (e.g., providing reinforcers for weight gain) have been somewhat successful in achieving weight gain in the short term. However, the second goal of treatment—long-term maintenance of weight gain—remains a challenge for the field.

Question 37

What is often involved in psychological treatment for anorexia??

Answer 37

CBT and family therapy

Also CBT-BN, CBT-E

Question 38

What is the benefit of FT

Answer 38

Higher percentage in full remission by the end of the therapy

Question 39

What is the psychological treatments for bulimia?

Answer 39

CBT, IPT and Antidepressants

Question 40

How effective is CBT in anorexia and bulimia?

Answer 40

Anorexia: not effective enough
Bulimia: shows 70 to over 90% reduction in reduction of binging and purging, If, however, we focus on the people themselves rather than on the numbers of binges and purges across people, we find that at least half of those treated with CBT improve very little

Question 41

What two preventive programmes showed promise for eating disorders?

Answer 41

Body Project, includes a dissonance reduction intervention, focused on deemphasizing sociocultural influences; the other, called Healthy Weight, targeted risk factors. Both programs included just one 3-hour session.

Question 42

When are feeding disorders usually diagnosed?

Answer 42

In childhood

Question 43

What is pica?

Answer 43

A disorder in which non nutritive substance is eaten

Question 44

What is rumination disorder?

Answer 44

A disorder involving regurgitating food and either re-chewing it or spitting it out

Question 45

What is ARFID

Answer 45

Avoidant/ Restrictive Food Intake Disorder (commonly in children)

Question 46

How is Arfid usually distinguished from anorexia?

Answer 46

Absence of fear of weight gain, usually something along the lines of they don’t like the feeling of it in their mouths

Question 47

What evidence is there that similar processes are behind the different eating disorders

Answer 47

People often jump between the different classifications (unstable classifications)

Question 48

How does the trans diagnostic model apply to different eating disorders?

Answer 48

Some may only include certain loops

Question 49

What evidence is there for the trans diagnostic model?

Answer 49

CBT focusing on the deficits in the model does well

Network analysis finds links between the variables used

Question 50

What alternative theories are there? (2)

Answer 50

More of a fear factor in it

More of an addictive disorder

Question 51

What is the average time for. someone to seek help for an eating disorder? Average duration of an eating disorder if finding the right help?

Answer 51

4 years; 7 years