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Psych 405 > Chapter 10 - Eating Disorders > Flashcards

Chapter 10 - Eating Disorders Flashcards

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1
Q

What are the most common forms of eating disorders?

A

Anorexia nervosa, bulimia nervosa, and binge eating disorder

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2
Q

What is at the heart of both anorexia and bulimia?

A

An intense fear of becoming overweight and fat & a pursuit of thinness that is relentless and sometimes deadly

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3
Q

Which groups have more of the attitudes that lead to eating disorders?

A

More common in whites and Asian Americans than African Americans

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4
Q

Which disorders can be co-morbid with eating disorders?

A

Anxiety disorders, mood disorders, impulse control disorder, substance use disorder, and others

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5
Q

What are the two types of anorexia nervosa?

A

The restricting type and the binge/purge type

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6
Q

What is the restricting type of anorexia?

A

Restricting food intake

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7
Q

What is the binge/purge type of anorexia?

A

Consuming large quantity of food and purging it

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8
Q

What is the DSM-5 criteria for anorexia nervosa?

A
  • refusal to maintain body weight at or above minimally normal weight for age and height
  • intense fear of gaining weight or becoming fat despite being underweight or persistent behaviors that interfere with weight gain
  • distortions in the perception of one’s body weight or shape, undue influence of body weight or shape on self-evaluation, or denial of seriousness of current low body weight
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9
Q

What is the lifetime prevalence of anorexia? Is it more common in women or men?

A

0.6%, being more common in women

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10
Q

What percent of individuals with anorexia die from complications?

A

As many as 6%, with 1 in 5 being by suicide (not necessary to memorize this)

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11
Q

How many people with anorexia have co-morbid disorders?

A

33-50% have a mood disorder
about 50% have an anxiety disorder

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12
Q

What is the process of anorexia?

A

A normal to overweight female is on a diet -> escalation toward anorexia may follow a stressful event -> most patients recover, but many do not

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13
Q

What is the clinical picture of anorexia?

A
  • Key goal is becoming thin
  • Driving motivation is fear
  • Preoccupation with food
  • Distorted thinking
  • Psychological problems
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14
Q

What is amenorrhea?

A

The absence of menstrual cycle

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15
Q

What is lanugo?

A

Fine, silky hair, usually on newborns, which grows on the body

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16
Q

What are the medical complications involved with anorexia?

A
  • cardiovascular, metabolic, fluid and electrolyte, hematological, dental, endocrine, gastrointestinal
  • lowered body temp, low blood pressure, body swelling, reduced mineral density, slow heart rate
  • scalp hair loss, dry skin, brittle nails, cold and blue feet and hands
  • amenorrhea and lanugo
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17
Q

What is bulimia nervosa?

A

It is characterized by frequent episodes of binge eating, lack of control over one’s eating, recurrent inappropriate behavior to prevent weight gain

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18
Q

Unlike anorexia patients, bulimic patients are typically of ____ weight

A

Normal weight

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19
Q

What is the DSM-5 criteria for bulimia nervosa?

A
  • recurrent episodes of binge eating (eating in a discrete period of time within any 2 hour period, an amount of food that is larger than most people would eat during a similar period of time under similar circumstances, a sense of lack of control over eating during an episode)
  • recurrent inappropriate compensatory behavior to prevent weight gain (self-induced vomiting, laxatives, diuretics, other meds, fasting, excessive exercise)
  • the binge eating and compensatory behavior both occur on average at least once a week for 3 months, self evaluation is unduly influenced by body shape and weight
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20
Q

What is the lifetime prevalence of bulimia?

A

1%, higher in women

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21
Q

What are the likelihoods of people with bulimia having comorbid disorders?

A

Almost 50% have a mood disorder, more than 50% have an anxiety disorder, and almost 10% have substance use disorder

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22
Q

What are the 2 types of bulimia?

A

Purging type and non-purging type (using other forms to compensate for binge eating)

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23
Q

What is body dissatisfaction?

A

when people evaluate their weight and shape negatively

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24
Q

What is the progression of bulimia?

A
  • normal to slightly overweight female has been on an intense diet
  • begins in adolescence or young adulthood
  • lasts for years with periodic letups
  • weight fluctuates but often stays within a normal range
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25
Q

What are the medical complications with bulimia?

A

Renal, gastrointestinal, electrolyte, dental, laxative abuse

26
Q

What are the problems with bulimia diagnostic criteria?

A

Subjective issue of meal size, timing of binge-eating episode

27
Q

What are the similarities between bulimia and anorexia?

A
  • distorted body perception
  • fear of becoming obese
  • preoccupation with food, weight, and appearance
  • disturbed eating attitudes
  • feelings of anxiety, depression, obsessiveness, and perfectionism
  • heightened risk of suicide attempts and fatalities
28
Q

What are the differences between bulimia and anorexia?

A
  • bulimia has more concern about pleasing others
  • tend to be more sexually experienced
  • mood swings, frustration, boredom, and impulsivity more likely
  • dental problems more likely
  • amenorrhea less likely
29
Q

What is binge-eating disorder?

A

Repeated eating binges without inappropriate compensatory behavior

30
Q

What is the DSM-5 criteria for binge-eating disorder?

A
  • recurrent episodes of binge eating
  • episodes are associated with 3 or more of the following: eating more rapidly than normal, eating until uncomfortably full, eating large amounts when not feeling physically hungry, eating alone out of embarrassment, feeling disgusted with oneself
  • marked distress regarding binge eating is present
  • at least once a week for 3 months
  • not associated with compensatory behaviors
31
Q

What is the lifetime prevalence of binge eating disorder?

A

2.8%

32
Q

What are the likelihoods of comorbid disorders with binge eating disorder?

A

Almost 50% have mood disorder, more than 50% have an anxiety disorder, over 20% have substance abuse disorder

33
Q

What are the medical problems from binge eating disorder?

A

Obesity, diabetes, high blood pressure, heart disease, high cholesterol, gastrointestinal

34
Q

What perspectives do most theorists and researchers use for eating disorders?

A

A multidimensional risk perspective, where several key factors place an individual at risk

35
Q

What are the psychodynamic factors for eating disorders? (Bruch)

A
  • ego deficiencies from disturbed mother-child interactions
  • perpetual disturbances
  • ineffective parenting raises children who are confused and unaware of internal needs
36
Q

What are effective and ineffective parents?

A

Effective parents accurately attend to their children’s biological and emotional needs
Ineffective parents fail to attend to their children’s needs

37
Q

What is the percentage of individuals diagnosed with bulimia or anorexia that are male?

A

25%

38
Q

What is the median duration of an eating disorder?

A

7 years

39
Q

What is the male/female prevalence of binge eating disorder?

A

40/60

40
Q

What are the biological factors that contribute to eating disorders?

A
  • genetic predisposition
  • dysregulation of hypothalamus
  • dysfunctional brain circuits
  • set point theory
41
Q

What is the genetic predisposition to eating disorders?

A

There is a high heritability for anorexia which is linked to neuroticism and perfectionism

42
Q

What are the dysfunctional brain circuits that can contribute to eating disorders?

A
  • larger and more active insula, orbitofrontal cortex, and striatum
  • smaller prefrontal cortex
  • abnormal activity levels of serotonin, dopamine, and glutamate
43
Q

What is the set point theory?

A

The body’s predetermined weight

44
Q

What are the societal pressures that contribute to eating disorders?

A
  • Western standards of attractiveness
  • socially accepted prejudice against overweight people
  • higher risk within subcultures (models, dancers, etc.)
  • social media, TV, and internet use, dark sides of the internet & pro-ana sites
44
Q

What are the sociological and psychological factors that contribute to eating disorders?

A
  • pressure to be thin
  • cultural norms of attractiveness
  • use of food to cope
  • over-concern with others’ opinions
  • rigid thinking style
  • poor family dynamics
  • history of sexual abuse
45
Q

What are the risk & causal factors of eating disorders?

A
  • sociocultural influences like magazines idealize extreme thinness, often women internalize the thin ideal, cultural influences, photoshopped models
  • families of anorexics have certain characteristics (confirmed by studies, but are also seen in families of other disorders)
46
Q

What are the characteristics of families with anorexics?

A
  • limited tolerance of disharmonious effects or psychological tension
  • an emphasis on propriety (conforming to societal norms)
  • parental over-direction of child or subtle discouragement of autonomous strivings
  • poor conflict resolution skills
  • preoccupation with thinness, dieting, and having a good physical appearance
47
Q

What are the racial and ethnic differences in eating disorders?

A
  • different beauty ideals
  • African American females demonstrate healthier eating behaviors and attitudes
  • Hispanic American female attitudes are more similar to whites
  • increase in eating disorders in Asian American females
48
Q

What are the BIPOC facts about eating disorders?

A
  • they are significantly less likely than white people to have been asked by a doctor about eating disorders
  • half as likely to be diagnosed or receive treatment
  • gay boys more likely than straight
  • gender and body dissatisfaction in trans people, non-binary people restrict eating to become thinner
49
Q

What are the cognitive-behavioral factors that contribute to eating disorders?

A
  • several cognitive factors, such as improper labeling of internal sensations and needs
  • little control over life may result in excess control of body size
  • depression helps set stage for eating disorders
    (similar brain circuit abnormalities in those with eating disorders and depression, close relatives have higher rates of depression)
50
Q

What are the two goals of treating eating disorders?

A

1) correct dangerous eating patterns ASAP
2) address broader psychological and situational factors that have led to and maintain the eating problem

51
Q

What are the treatments for anorexia?

A
  • hospitalization and refeeding (most effective if patient returns to normal weight), tube and intravenous feedings if necessary
  • behavior therapy or CBT, family therapy, motivational interviewing
  • antidepressants or other meds
  • techniques to help patient accept and value their emotions
  • restoring weight and normal eating methods
  • combination of supportive nursing are, nutritional counseling, and high-calorie diet
52
Q

How are lasting changes achieved for anorexia using CBT?

A
  • identification of core pathology and problem-solving strategies
  • monitoring ties between feelings, hunger levels, and food intake
  • changing attitudes about weight and eating
  • most successful when continued for at least a year beyond recovery and supplemented by other approaches
53
Q

How are lasting changes achieved for anorexia by changing family interactions?

A
  • involvement of whole family
  • separation of feelings and needs from those of family members
54
Q

What is the treatment aftermath of anorexia?

A
  • weight is quickly restored
  • continued improvement for majority
  • psychological and health problems may persist
55
Q

What are the treatments for bulimia?

A
  • cognitive-behavioral therapy
  • behavioral techniques
  • cognitive techniques
  • other forms of psychotherapy in individual or group formats (interpersonal, psychodynamic, family therapy)
  • antidepressants
56
Q

What are the behavioral techniques to treat bulimia?

A
  • diaries
  • exposure and response prevention (ERP)
57
Q

What are the cognitive techniques to treat bulimia?

A
  • help client recognize and change maladaptive attitudes towards food, weight, eating, and shape
  • teach individuals to identify and challenge negative thoughts that precede urge to binge
58
Q

What is the treatment aftermath of bulimia?

A

most people recover, relapses can be triggered by stress

59
Q

What are the treatments for binge eating disorder?

A
  • similar to those for bulimia
  • reduction or elimination of binge-eating patterns
  • cognitive-behavioral therapy
  • other forms of psychotherapy
  • antidepressants help reduce or eliminate binge-eating patterns and change disturbed thoughts
  • short-term effectiveness, high relapse risk
  • additional weight management interventions are often needed

Psych 405 (7 decks)

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