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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Outdated views on eating disorders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
Information collected during diagnostic interview
info about past and current diet information attitudes about weight, shape, eating interpersonal functioning medical background psychological disorders self report questionnaire
26
Physical complications of anorexia
osteoporosis, cardiovascular, gastrointestinal, neurological, endocrine problems decreased fertility and amenorrhea hair loss, lanugo
27
Psychological complications of anorexia
cognitive and emotional functioning - difficulty concentrating, increase in irritability
28
Physical complications of bulimia and bingeing purging subtypes
dental problems - erosion of tooth enamel electrolyte imbalances - hypokalemia (low potassium) - can lead to problems with cardiovascular functioning emotional functioning also impacted
29
Physical complications of BED
elevated risk of type 2 diabetes, cardiovascular disease, and sleep apnea
30
Complication in studying the physical and psychological symptoms of eating disorders
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
Longitudinal study by Franklin et al.
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
Genetic and biological factors
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
Socio cultural factors
internalization of body image ideals - body dissatisfaction thin for women, muscular for men - differences culturally (black vs white women)
34
Family factors
Do not play a primary role Mothers may have concerns about child’s weight which could influence eating disorders
35
Personality traits associated with anorexia
high levels of constraint, perseveration, rigidity, low levels of novelty seeking obsessive compulsive disorder high levels of perfectionism present prior to onset
36
Personality traits associated with bulimia
high impulsivity, novelty, sensation seeking borderline personality disorder body dissatisfaction, thin ideal internalization, dieting
37
Personality traits associated with BED
high levels of perfectionism, fear rejection avoidant and obsessive compliant disorders body dissatisfaction, thin ideal internalization, dieting
38
Personality traits associated with all eating disorders
lower extraversion, higher perfectionism, neuroticism, negative urgency, avoidance motivation, self directness
39
Schemas
those with eating disorders have more negative and fewer positive self schemas
40
sports and activities
that place emphasis on appearance - gymnastics, ballet dancing associated with increased risk for eating disorders
41
Role of traumatic events
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
Integrative models
eating disorders are multifactorial no one factor accounts
43
risk and maintenance factors in bulimia
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
Eating disorders in men
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
Biological treatment of eating disorders - medication
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
Biological treatment of eating disorders - neural stimulation
timulate the reward and control parts of the brain - Electroconvulsive therapy, deep brain stimulation, repetitive Transcranial magnetic stimulation
47
psychological treatment - cognitive behavioural therapy
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
Psychological treatment - Nutritional counselling
learn about food and nutrition Not a standalone treatment
48
Psychological treatment - Interpersonal therapy
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
Psychological treatment - Family therapy
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
Psychological therapy - self help
compared to control groups, produced modest and clinically significant improvements to overall eating disorder pathology
51
Universal eating disorder prevention programs
more effective at deterring the worsening body image concerns aimed at population in general
52
Selective eating disorder prevention program
For those identified as high risk Dissonance based interventions - create discrepancy between beliefs and behaviours - critique the thin ideal
53
Indicated eating disorder prevention problems
For those exhibiting sub-threshold eating disorder symptoms CBT based prevention programs

Psyc 241 - Midterm 2 (4 decks)

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