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Psyc 241 - Midterm 2 > Chapter 10 - Eating Disorders > Flashcards

Chapter 10 - Eating Disorders Flashcards

1
Q

Outdated views on eating disorders

A

Middle Ages - anorexic behaviours seen positively as evidence as religious asceticism

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2
Q

Anorexia nervosa - typical characteristics

A

Intense fear of weight gain, forbidden foods, restrict food, ritualistic eating behaviours, excessive exercise, disturbance in body image, social withdrawal, depression

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3
Q

Objective vs subjective binge eating

A

objective - objectively large amount of food consumed in a specific time period

subjective - loss of control while eating small or normal amounts of food

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4
Q

Bulimia nervosa - typical characteristics

A

objective binge eating episodes, compensatory behaviours

fasting, excessive exercise, vomiting - teeth damage, low potassium, CV complications

depression, social isolation, may binge eat to escape from self awareness, negative emotions before episodes

not underweight

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5
Q

Binge-eating disorder - typical characteristics

A

Regular objective binge eating episodes

no compensatory behaviours

significant distress about binge eating

obesity is common - depression if obese or not

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6
Q

Prevalence of eating disorders - ages

A

ages 11-20
2.2% boys, 4.5% girls

additional 1.1% boys, 5.1% girls have subthreshold symptoms

by mid life - 15% women have had an eating disorder -OSFED most common

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7
Q

Prevalence of eating disorders - races

A

white women no more likely

latino men - significantly more likely than white men to have a history of bulimia

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8
Q

Prevalence rate of different eating disorders

A

of surveyed women
OSFED - 7.6%
3.6% anorexia
2.2% bulimia
2% BED

overall prevalence increasing over time - either due to increased detection or increased cases

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9
Q

What % of women seek eating disorder treatment?

A

27%

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10
Q

Mortality rates for eating disorders

A

Highest mortality of all psychiatric disorders
3.6-7.6% for anorexia
1.1-2.4% bulimia
1.5-5.8% others

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11
Q

Common causes of death from eating disorders

A

Natural causes - circulatory collapse, muscle wasting (cachexia), multiple organ failure

Non-natural - suicide - 50% of deaths in bulimia

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12
Q

Prognosis of those with binge and purging behaviours

A

22-42% are able to stop with evidence based therapy

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13
Q

relapse rate of anorexia and bulimia

A

31% in first year - anorexia
50% in first year - bulimia

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14
Q

Anorexia nervosa diagnostic criteria

A

Restriction of energy intake relative to requirements leading to significantly low body weight

Intense fear of gaining weight

Disturbance in way body is experienced

Restricting type: no recurrent bingeing and purging in past 3 months

Binge-eating/purging type: recurrent episodes in past 3 months

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15
Q

Bulimia nervosa diagnostic criteria

A

Recurrent episodes of binge eating - eating in a discrete time period an abnormally large amount of food - a sense of lack of control during episode

recurrent compensatory behaviours to prevent weight gain

binge eating and compensatory behaviour occurs at least once a week for 3 months

self evaluation influenced by body shape

disturbance does not occur during episodes of anorexia

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16
Q

Binge-eating disorder diagnostic criteria

A

Recurrent episodes of binge eating - eating in a discrete time period an abnormally large amount of food - a sense of lack of control during episode

binge eating occurs at least once a week for 3 months

self evaluation influenced by body shape

disturbance does not occur during episodes of anorexia

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17
Q

Other specified/unspecified feeding or eating disorder

A

Eating disorders of clinical severity that do not meet specific criteria for anorexia, bulimia, or BED

OSFED-bulimia: low frequency/limited duration

OSFED-binge eating: low frequency/limited duration

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18
Q

OSFED-atypical anorexia

A

similar behavioural presentation to those with anorexia but are not currently significantly underweights

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19
Q

OSFED-purging disorder

A

purging without binge eating

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20
Q

Night eating syndrome

A

Repeated nocturnal eating - not binge eating - that causes significant distress and/or impairment in functioning

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21
Q

Differential diagnosis of eating disorders

A

must establish that symptoms aren’t due to a medical condition or other mental illness - weight loss due to depression, or gastrointestinal disease

more than one eating disorder is not diagnosed at once

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22
Q

Dimensional view of eating disorders

A

there can be small distinctions between eating disorders - like only weight

BED as least severe - bulimia as most severe

many individuals experience diagnostic crossover - move back and forth between diagnostic criteria - 3/4 originally diagnosed with anorexia cross over into bulimia - sub threshold bulimia to BED is common

23
Q

Eating Disorder Examination

A

structured clinical interview

good reliability and validity

numerical ratings of the frequency and severity of eating disorder symptoms

24
Q

Eating pathology symptoms inventory

A

assesses eating pathology dimensionally

measures eight core features of eating disorders - body dissatisfaction, binge eating, purging, restricting, cognitive restraint, excessive exercise, muscle building, negative attitudes towards obesity

25
Q

Information collected during diagnostic interview

A

info about past and current diet information

attitudes about weight, shape, eating

interpersonal functioning

medical background

psychological disorders

self report questionnaire

26
Q

Physical complications of anorexia

A

osteoporosis, cardiovascular, gastrointestinal, neurological, endocrine problems

decreased fertility and amenorrhea

hair loss, lanugo

27
Q

Psychological complications of anorexia

A

cognitive and emotional functioning - difficulty concentrating, increase in irritability

28
Q

Physical complications of bulimia and bingeing purging subtypes

A

dental problems - erosion of tooth enamel

electrolyte imbalances - hypokalemia (low potassium) - can lead to problems with cardiovascular functioning

emotional functioning also impacted

29
Q

Physical complications of BED

A

elevated risk of type 2 diabetes, cardiovascular disease, and sleep apnea

30
Q

Complication in studying the physical and psychological symptoms of eating disorders

A

Distinguishing whether a factor is a cause or consequence of the eating disorder

malnutrition may exaggerate personality characteriscitcs

elevated temperament in those with eating disorders

31
Q

Longitudinal study by Franklin et al.

A

Food restriction and weight loss has psychological and physiological consequences for participants

decrease in heart rate, increases in emotional stability, difficulty concentrating, decreased sex drive, lethargy

32
Q

Genetic and biological factors

A

heritable component - 50%

dysfunctional neurotransmitter activity - serotonin dysregulation in those with anorexia and bulimia - serotonin involved in satiety

dopaminergic system - BED - alterations to reward system

sex differences - role of puberty - bodies go away from ideal

33
Q

Socio cultural factors

A

internalization of body image ideals - body dissatisfaction

thin for women, muscular for men - differences culturally (black vs white women)

34
Q

Family factors

A

Do not play a primary role

Mothers may have concerns about child’s weight which could influence eating disorders

35
Q

Personality traits associated with anorexia

A

high levels of constraint, perseveration, rigidity, low levels of novelty seeking

obsessive compulsive disorder

high levels of perfectionism present prior to onset

36
Q

Personality traits associated with bulimia

A

high impulsivity, novelty, sensation seeking

borderline personality disorder

body dissatisfaction, thin ideal internalization, dieting

37
Q

Personality traits associated with BED

A

high levels of perfectionism, fear rejection

avoidant and obsessive compliant disorders

body dissatisfaction, thin ideal internalization, dieting

38
Q

Personality traits associated with all eating disorders

A

lower extraversion, higher perfectionism, neuroticism, negative urgency, avoidance motivation, self directness

39
Q

Schemas

A

those with eating disorders have more negative and fewer positive self schemas

40
Q

sports and activities

A

that place emphasis on appearance - gymnastics, ballet dancing

associated with increased risk for eating disorders

41
Q

Role of traumatic events

A

death, serious injury, sexual violence - negative effects on self esteem, body image, sense of control

all types of child maltreatment significantly associated with all types of eating disorders

42
Q

Integrative models

A

eating disorders are multifactorial

no one factor accounts

43
Q

risk and maintenance factors in bulimia

A

risk factors - variables that occur prior to the onset of the disorder and that predict the disorders onset - socio cultural, psychological factors

maintenance factors - leads the symptoms to persist after their onset - negative affect, body dissatisfaction

44
Q

Eating disorders in men

A

eating disorder field has used a female centric lens on eating disorders

Eating disorders less likely to be recognized in boys and men - men face barriers in seeking and obtaining treatment

Sometimes men present with different symptoms - weight and shape concerns may be about muscularity - cycles of food restriction followed by ‘bulking’ - abuse steroids

45
Q

Biological treatment of eating disorders - medication

A

medication - fluoxetine (anti depressant) for bulimia, topiramate (anti convulsant) for bulimia, psychotherapy for bulimia

antidepressants and Vyvanse for BED

medication doesn’t work with anorexia

46
Q

Biological treatment of eating disorders - neural stimulation

A

timulate the reward and control parts of the brain - Electroconvulsive therapy, deep brain stimulation, repetitive Transcranial magnetic stimulation

47
Q

psychological treatment - cognitive behavioural therapy

A

leading evidence based treatment for eating disorders

taught to adopt a pattern of regular eating, change dietary rules, work on evaluating themselves less based on weight and shape

Works best for bulimia and OSFED

More than 90% reduction in bingeing and purging one year after treatment

48
Q

Psychological treatment - Nutritional counselling

A

learn about food and nutrition

Not a standalone treatment

48
Q

Psychological treatment - Interpersonal therapy

A

focus on maladaptive personal relationships and ways of relating to others - identify problem areas and work to improve clients functioning - does not directly target eating disordered attitudes

similar results to CBT-E

49
Q

Psychological treatment - Family therapy

A

focuses on stresses within the family as a whole rather than on individuals

Family-based therapy - Maudsley approach - approach for adolescents with eating disorders - initial focus on the eating disorder symptoms, parents playing a key role in managing their behaviour

50
Q

Psychological therapy - self help

A

compared to control groups, produced modest and clinically significant improvements to overall eating disorder pathology

51
Q

Universal eating disorder prevention programs

A

more effective at deterring the worsening body image concerns

aimed at population in general

52
Q

Selective eating disorder prevention program

A

For those identified as high risk

Dissonance based interventions - create discrepancy between beliefs and behaviours - critique the thin ideal

53
Q

Indicated eating disorder prevention problems

A

For those exhibiting sub-threshold eating disorder symptoms

CBT based prevention programs

Psyc 241 - Midterm 2 (4 decks)

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