Chapter 22 Flashcards
Predisposing factors of anorexia/bulimia
Genetics Neuroendocrine Neurochemical Psychodynamic Family
Genetics
A hereditary predisposition to eating disorders has been hypothesized.
Anorexia nervosa is more common among sisters and mothers of those with the disorder than it is among the general population.
Possible chromosomal linkage sites have been suggested.
Neuroendocrine
There has been some speculation about a primary hypothalamic dysfunction in anorexia nervosa as amenorrhea is experienced by many before starvation and weight loss.
Neurochemical
Bulimia nervosa may be associated with the neurotransmitters serotonin and norepinephrine.
Anorexia nervosa may be associated with high levels of endogenous opioids.
Psychodynamic
Suggests that eating disorders result from very early and profound disturbances in mother-infant interactions, resulting in:
Delayed ego development
Unfulfilled sense of separation-individuation
Family
Historically, family influences were heavily considered as factors, but there is not sufficient evidence to support these claims.
Family members should be involved in treatment rather than blamed for the issue.
Anorexia characteristics
Underweight (Nutritional Deficits) Amenorrhea Hypotensive Lanugo Bradycardia
Bulimia characteristics
Normal weight Eroded Tooth Enamel Knuckle Scars(Russell Sign’s) Dehydration Severe Electrolyte Imbalance (Confusion/Dizziness)
Behavior modification
Issues of control are central to the etiology of these disorders.
For the program to be successful, the client must perceive that he or she is in control of the treatment.
Successes have been observed when the client:
Is allowed to contract for privileges based on weight gain
Has input into the care plan
Clearly sees what the treatment choices are
Behavior modification:
The client has control over
Eating
Amount of exercise pursued
Staff and client agree about
Goals
System of rewards
Psychopharmacology: SSRI’s
No medications are specifically indicated for eating disorders.
Antidepressants are used.
Various medications have been prescribed for associated symptoms:
Anxiety
Depression
Underweight BMI
<18.5
Normal (Healthy Weight)
18.5-24.9
