behavioral psychological

Question 1

Over-consumption of palatable food may affect brain’s reward system by 3

Answer 1

Stimulates opioid release
Decreases biologic stress response
Simulates addiction like changes in the brain

Question 2

BED criteria for diagnosis
Recurrent episodes of BE marked by:2
Associated with 3 or more:5
Associated feeling of \_\_\_\_
Frequency
Absence of

Answer 2

1. LACK of control
2. Eating LARGE amounts in discrete period
3. Eating more RAPIDLY than normal
4. Eating until uncomfortably FULL
5. Eating large amounts WHEN NOT HUNGRY
6. HIDING eating behavior because of embarassment
7. FEELING disgusted,depressed,guilty after episode

Associated marked distress
Minimum 1/week x 3 mos
No purging

Question 3

Severity of BED

Answer 3

Mild 1-3
Moderate 4-7
Severe 8-13
Extreme >14

Question 4

Meds for BED - 5

Answer 4

Lisdexamfetamine
topiramate, zonisamide
anti-depressants
phentermine

Question 5

Loss of Control ED kids <12
Similar to BED
Recurrent episodes marked by :2
Associated with >3 : 5
Frequency
Absence of

Answer 5

1. Sense of LACK of control
2. Food SEEKING in absence of hunger or after satiation WHEN FULL
3. Eating IN RESPONSE TO NEGATIVE affect
4. NEGATIVE AFFECT FOLLOWING eating (shame/guilt)
5. Feeling of NUMBNESS while eating
6. Eating MORE (or perception of) than others
7. SECRECY about episode
   episodes occur on average 2x/month for 3 months
   No compensatory behaviors

Question 6

Bulimia medical complications 4

Answer 6

Metabolic alkalosis ( from volume contraction)/OR metabolic acidosis from loss of bowel fluid/ other lyte imbalances
Arrythmia
Gastric and esophageal ruptures
Melanosis coli from laxative dependance

Question 7

Best meds for bulemia 2

Answer 7

fluoxetine

sertraline

Question 8

Anorexia diagnostic criteria 3

Answer 8

1. Restriction of energy intake leading to BMI<18.5
2. Intense fear of gaining weight
3. Distorted body image

Question 9

Anorexia severity specifiers

Answer 9

Mild/moderate/severe/extreme

BMI >17/16/15/<15

Question 10

Anorexia sequelae 9

Answer 10

Anemia
Low K, Mg
Bradycardia,hypotension
Amenorrhea
Osteoporosis
Increased ventricle:brain ratio
Abnormal LFT
Impaired renal function
Death

Question 11

Obesity hypoventilation syndrome criteria 3

Answer 11

Obesity BMI>30,
Daytime hypercapnia CO2>45
Sleep disordered breathing

Question 12

Sleep deprivation associated with changes in 4 hormones

Answer 12

Decreased leptin

Increased ghrelin, Orexin, Neuropeptide Y

Question 13

Sleep-related Eating Disorder - 3 associations

Answer 13

80% have other sleep related conditions
Precipitated by stress in 16% of cases
Associated with sedative/anti-psychotics

Question 14

Sleep-related Eating Disorder Diagnostic criteria - 1 core ( obvious) and other possible

Answer 14

Recurrent episodes of INVOLUNTARY eating/drinking during sleep period
Presence of 1 or more:
Adverse health consequences
Insomnia due to sleep disruption from eating
Morning anorexia
Eating odd foods/non-foods
Sleep-related injury/Dangerous behaviors while obtaining food

Question 15

Sleep related Eating disorder treatments 6(4 drugs)

Answer 15

-Remove offending drug (Zolpidem, anti-psychotics,TCA)
-CPAP in OSA,treat other associated disorders ie RLS
Topiramate
SSRI
pramipexole
Trazodone

Question 16

Borderline personality disorder - diagnosis requires impulsivity in 2/5 areas including

Answer 16

Spending
Sex
Substance abuse
Reckless driving
Binge eating

Question 17

Outcome of weight loss surgery in patients with eating disorders

Answer 17

BED-improves
LOC-ED/grazing - poor weight loss
Night Eating Syndrome - no effect 
Food addiction - may remit
Grazing - this worsens

Question 18

What are the 3 methods of communication used in motivational interviewing?

Answer 18

Collaborative
Goal oriented
Language of change

Question 19

4 RULEs of MI

Answer 19

RESIST the righting reflex : patient needs to fix the problem, not you.
UNDERSTAND the patient’s motivation: patient should give you arguments for change
LISTEN to your patient - listen reflectively, summarize
EMPOWER your patient : patient makes own decisions about life

Question 20

Key processes in MI

EFEP

Answer 20

Engagement- be curious, patient-centred, non-judgemental
Focusing - focus on a single topic, small changes support success to build motivation for other challenges
Evoking - evoke change talk!
Planning - explore barriers to change, facilitate change, assess confidence

Question 21

MI skills OARS*NB

Answer 21

OPEN QUESTIONS What have you tried in the past?
AFFIRMATIONS So, low carb diets have worked in the past?
REFLECTIONS You have tried to lose weight many times
SUMMARIES Indicate you’re about to summarize, then offer series of reflections, note ambivalence. Let’s try low carb and schedule your weight loss appt

Question 22

Principles of MI

Answer 22

EMPATHY
DEVELOP DISCREPANCY
ROLL WITH RESISTANCE
SUPPORT SELF-EFFICACY

Question 23

What is the importance ruler/Readiness scale? How is this question helpful?

Answer 23

How ready are you on a scale of 1/10 to make a change? Why not a higher number? Why not a lower number?

This question elicits change and avoids sustain talk

Question 24

Definition: Cognitive therapy

Answer 24

The identification and modification of dysfunctional thoughts to improve affect.

Question 25

Definition:Behavior therapy

Answer 25

Change behavior and the feelings will follow.

Question 26

Focus of DBT 4

Answer 26

Focuses on 
mindfulness
distress tolerance
interpersonal effectiveness
emotional regulation

Uses behavioral therapy to teach life skills

Question 27

FRAMES

Answer 27

Feedback about personal risk
Responsibility of the patient
Advice to change
Menu of strategies
Empathetic style
Self-efficacy

Question 28

The Dutch Eating Behavior Questionnaire assesses

Answer 28

emotional eating
external eating
restrained eating

Question 29

Describe how DBT works

Answer 29

Type of CBT that connects cognitive and behavioar therapy, such as changing negative thinking patterns and implementing positive behavioral changes, which then helps patients cope with mental stress, regulate emotions and improve relationships with others

Question 30

What is the difference between the Night Eating Questionnaire and the NE Diagnostic questionnaire?

Answer 30

the NEDQ assess all diagnostic criteria, vs the NEQ with assesses severity as well as 6 core diagnostic items

Question 31

What is the most common eating disorder in men?

Answer 31

BED