Abnormal Flashcards
What is the diagnosis of Anorexia Nervosa?
Anorexia Nervosa
- Refusal to maintain weight of at least 85% of expected weight*
- Intense fear of gaining weight, though the person is underweight.
- Disturbance in body image perception
- Often perfectionistic - thus their body wieght is the only thing they can control
A criteria of a BMI < 17.5 is often also used as part of a cutoff for Anorexia.
What is the CBT Theory for the onset of Anorexia Nervosa?
CBT Theory for the onset of Anorexia Nervosa?
(control is apart of the onset and maintenance of the disorder)
Need for self-control in context of low-self esteem, perfectionism, and sense of ineffectiveness
- Control over eating is focused on as an experience of success/control
- Control over eating makes them believe they can control one aspect of their lives
- Control over body shape/weight especially salient to ascetics (their appearance)
- Influences the behaviour of others around them,
- eg someone who doesn’t eat at the dinner table, this elicits a response from a parent, which can lead to control of their family
Western society values dieting to control shape and weight.
What is ‘Sense of Control’ (Slade, 1982) in reference to Anorexia Nervosa?
Sense of Control (Slade, 1982)
- People with Anorexia Nervosa have a need for control over their lives and body shape
- Thus the ability to control weight is over emphasised with this disorder
- Stressed need for control as central feature of AN
- Success in dieting reinforces sense of control
According to CBT, what are the Maintaining factors of Anorexia Nervosia?
Maintaining factors of Anorexia Nervosia?
(control is apart of the onset and maintenance of the disorder)
-
Dietary restriction enhances the sense of being in control
- Success at dietary restriction is a potent reinforcer (Amount eaten, types of foods, times of eating)
- Control over eating as expression of control and worth
-
Aspects of starvation encourage further dietary restriction
- Hunger perceived as threat to control over eating
- Impaired concentration (cognitive function) may heighten sense of chaos/uncontrollability
-
Extreme concerns about shape and weight encourage dietary restriction
- Especially prominent in Western society
What are predicting outcomes of Anorexia Nervosa?
Predictors of Outcome - Things that influence the treatment
- Predictors of Good Outcome (better outcomes)
- Short duration of symptoms
- Good parent-child relationship
- Histrionic Personality features
- Predictors of Poor Outcome (poor outcomes)
- Vomiting
- Bulimia
- Purgatory behaviour
- Premorbid developmental abnormalities
- Eating disorders in childhood
- Chronicity
- Obsessive Compulsive Personality Disorder
- See things in black and white ways
What is the diagnostic criteria of Bulimia Nervosa?
Diagnostic criteria of Bulimia Nervosa
- Recurrent episodes of binge eating
- Eating at one sitting an abnormally large amount of food
- Perception of lack of control over eating
- Recurrent inappropriate compensatory behaviour (after binge eating)
- Excessive exercise
- Self induced vomiting
- Occurring at least twice per week over three months period
- Self-evaluation (self-identify) is unduly influenced by body shape and weight
- Exclusion criteria: cant occur exclusively in context of another eating disorder (Anorexia Nervosa).
What is the Bulimia Severity Spectrum?
The Bulimia Severity Spectrum - Ranges from…
- Binge eating disorder
- Less serve
- Engage in binging episodes without any compensatory behavior
- Bulimia Nervosa without purging behavior
- A bit more severe
- A person who is having binging episodes and not purging (vomiting/laxities) (could be doing excessive exercise)
- Bulimia Nervosa with purging behavior
- Most server
- Full version of the condition
- A person experiences binging episodes and compensatory behavior includes purging (vomiting/laxatives)
What is purging?
A compensatory behavior after binging - accosiated with Bulimia Nervosa
- Vomiting
- Laxatives
- Excessive exercise
What are the similarities of Bulimia Nervosa and OCD?
Similarities of BN and OCD
- Loss of control
- Compelled to do something (purge)
- They are district separate conditions
What is the CBT Model of Bulimia Nervosa?
CBT Model of BN
- Vulnerability factors of developing bulimia
- Set of rigid belifs
- about what they eat
- Ideas that body shape is a defining characteristics of their identity
- Disordered chaotic thinking
- What happens during a purging episode
What happens during a purging episode?
Part of the CBT model of Bulimia - Disordered chaotic thinking
- Dieting - eating less
- Leads to hunger
- They are unable to not eat anymore, so they think they ‘lapse’ then start eating again
- They start eating, which leads to AVE
- (Abstinence violation effect - ‘once I eat one I might as well eat the whole packet’).
- Binge - eat a lot
- Increases distress about eating too much -
- Which then motivates people to do compensate behaviour (purge) which could be vomiting, laxatives, exercise - makes them feel betting
- Leads to reduced distress and reinforces the purging behaviour
What is the number 1 risk factor for BN?
- Dieting behaviour is a risk factor for BN.*
- In 15 year-old schoolgirls, those who diet were 8 times more likely to develop an eating disorder within a one-year period than those who did not restrict food intake.
- When your hungry you are more likely to engage in binge eating
What is the Cognitive Model for developing Bulimia Nervosa?
How someone developes Bulimia Nervosa,
- Negative self-evaluation
- Extreme concerns about body weight and shape
- Perfectionism and dichotomous thinking
- leads to dieting
- Perfectionism and dichotomous thinking
- Leads to binge eating
- negative affect
- Lead to purging (compensatory behaviors) vomiting/laxative use
treatment address these components the opposite way (up)
What is the Definition of Personality?
A persistent pattern of thinking and feeling and behaving that is pervasive across situations and enduring over time
Acording to Millon (1982), what is the definition of a Personality Disorder?
Millon (1981) identified three core features that differentiate disordered personality from normal-range problematic behaviours:
- Functional inflexibility
* If the person has a way of behaving, they don’t adapt to changes (their personality is fixed in all situations - Self-defeating behaviour patterns
* Will adopt behaviours against their own interests (e.g. aggression, anger), - Tenuous stability under stress and marked instability in mood, thinking and behaviour during difficult life events
* They don’t cope well with stress
What is the DSM-5 Diagnosis of Personality Disorder?
The Diagnosis of Personality Disorder
- DSM-5 defines personality disorders as enduring patterns of perceiving, relating to and thinking about the environment and oneself that are exhibited in a wide range of social and personal contexts
- These patterns must differ from the individual’s cultural group and cause significant personal distress and impairment in functioning
What are some possible indications of a Personality Disorder?
Possible Indications of a Personality Disorder
- Does the presenting problem include aspects that are not typical of the presentation of other disorders?
- Are there previous multiple inconsistent psychiatric or psychological diagnoses?
- Have them been diagnosed with different things
- Indicative of an unstable personality
- Is the person chaotic or excessively emotionally responsive?
- Does the person have problems in relationships with others?
- Makes it different from normal problems we experience, because the person has problems with nearly everyone
- Everyone else has a problem not them
- Functional inflexibility - not changing when something is not working
- Does the person not respond to effective treatments for presenting problems?
* Things that should work don’t work - How does the therapist react to being with the person?
What is a Cluster A Personality?
odd or eccentric traits and behaviours
- Paranoid Personality Disorder
- Schizoid Personality Disorder
- Schizotypal Personality Disorder
What is a Cluster B Personality?
Dramatic, emotional, erratic traits
- Anti Social Personality Disorder
- Borderline Personality Disorder
- Histrionic Personality Disorder
- Narcissistic Personality Disorder
What is a Cluster C Personality?
anxious and fearful traits
- Avoidant Personality Disorder
- Dependant Personality Disorder
- Obsessive Compulsive Personality Disorder
What is Paranoid Personality Disorder?
A patturn of distrust and suspiciousness such that others’ motives are interpreted as malvolent.
- Must think about the environment/context, are people actually out to get them (gangs)
- Not as bizarre of delusional as psychotic disorder
What is Schizoid Personality Disorder?
A patturn of detachment from social relationships and a restricted range of emotional expression
- Will not seek treatment because they don’t feel they have a problem
What is Schizotypal Personality Disorder?
Schizotypal Personality Disorder
Discomfort with close relationships, cognitive or perceptual distoritions and eccentricities of behaviour
- e.g., belief that they are clairvoyant
- Don’t feel close with other people. odd ideas about the world, they are on a special mission
- Not odd enough to be delusions or hallucinations