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PSYCH 239 > Chapter 8: Sleep-Wake and Eating Disorders > Flashcards

Chapter 8: Sleep-Wake and Eating Disorders Flashcards

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1
Q

Feeding and Easting Disorders

A

psychological disorders involving disturbed eating patterns and maladaptive ways of controlling body weight

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2
Q

Anorexia Nervosa

A

eating disorder, primarily affecting young women

characterized by maintenance of an abnormally low body weight, distortions of body image, and intense fears of gaining weight

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3
Q

Bulimia Nervosa

A

eating disorder characterized by a recurrent pattern of binge eating followed by inappropriate compensatory behaviors to prevent weight gain and accompanied by persistent overconcern with body weight and shape

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4
Q

Binge-Eating Disorder

A

eating disorder characterized nu repeated episodes in which binge eating occurs but is not followed by purging

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5
Q

Amenorrhea

A

absence of menstruation, a possible sign of anorexia nervosa

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6
Q

Osteoporosis

A

physical disorder caused by calcium deficiency that is characterized by extreme bitterness of the bones

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7
Q

Systems Perspective

A

view that problems reflect the systems (family, social, school, ecological, etc.) in which they are embedded

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8
Q

Sleep-Wake Disorders

A

diagnostic category represented persistent or recurrent sleep-related problems that cause significant personal distress or impaired functioning

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9
Q

Polysomnographic (PSG) Recording

A

the simultaneous measurement of multiple physiological responses during sleep or attempted sleep

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10
Q

Insomnia

A

term applying to difficulties falling asleep, remaining asleep, or achieving restorative sleep

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11
Q

Hypersomnolence Disorder

A

sleep-wake disorder involving a persistent pattern of excessive sleepiness during the day

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12
Q

Narcolepsy

A

sleep-wake disorder characterized by sudden, irresistible episodes of sleep (sleep attacks)

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13
Q

Cataplexy

A

brief, sudden loss of muscular control, typically lasting from a few seconds to as long as two minutes

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14
Q

REM Sleep

A

REM (rapid eye movement) sleep is the stage of sleep associated with dreaming that is characterized by the appearance of rapid eye movements under closed eyelids

hypocretin neurotransmitter is involved in arousal and wakefulness

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15
Q

Neuropeptide

A

an amino acid found in cerebrospinal fluid that plays a role in neuronal transmission and the modulation of brain circuits or regions

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16
Q

Breathing-Related Sleep Disorders

A

sleep disorders in which sleeping is repeatedly disrupted due to difficulties breathing normally

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17
Q

Obstructive Sleep Apnea Hypopnea

A

type of breathing-related disorder involving repeated episodes of either complete or partial obstruction of breathing during sleep

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18
Q

Apnea

A

temporary cessation of breathing

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19
Q

Circadian Rhythm Sleep-Wake Disorders

A

sleep disorders characterized by disruption of sleep caused by a mismatch in sleep schedules between the body’s internal sleep-wake cycle and demands of the environment

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20
Q

Parasomnia

A

category of sleep-wake disorders involving the occurrence of abnormal behavior or physiological events during sleep or at the tension between wakefulness and sleep

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21
Q

Nightmare Disorder

A

sleep-wake disorder characterized by recurrent awakenings from sleep because of frightening nightmare

formerly called dream anxiety disorder

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22
Q

Non-Rapid Eye Movement Sleep Arousal Disorders

A

sleep-wake disorders involving recurrent episodes of incomplete arousals during sleep that are accompanied by sleep terrors or sleepwalking

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23
Q

Anxiolytics

A

drugs, such as sedatives and anesthetics, that include partial or complete unconsciousness and are commonly used in the treatment of sleep-wake disorders

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24
Q

What are feeding and eating disorders?

A

eating disorders like bulimia nervosa & anorexia nervosa often affect people of high school or college age, especially young women

incidence tends to be significantly higher in females than males

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25
Q

What are the two main types of eating disorders?

A

anorexia nervosa and bulimia nervosa

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26
Q

What is anorexia nervosa?

A

an eating disorder primarily affecting young women, characterized by maintenance of an abnormally low body weight, distortions of body image, intense fear of gaining weight, and amenorrhea in females

for males, check for tumors

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27
Q

What is the DSM-5 criteria for anorexia nervosa?

A

restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health

intense fear of gaining weight

disturbance in the way in which one’s body weight or shape is experienced

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28
Q

What are the two subtypes of anorexia nervosa?

A

restricting type

binge eating/purging type

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29
Q

What is body mass index (BMI)?

A

severity is based largely on Body Mass Index (BMI), which is calculated from weight (in kilograms) and height (in meters)

problem: it fails to take body composition into account

BMI = kg/m^2

extreme: <15

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30
Q

What is anorexia nervosa in partial remission?

A

some but not all criteria met for a “sustained period”

31
Q

What is anorexia nervosa in full remission?

A

no criteria met for a “sustained period of time”

32
Q

What are the medial complications of anorexia?

A

amenorrhea: no period, low estrogen, low iron

osteoporosis: brittle bones, fractures, inadequate dietary calcium

kidney damage: dehydration (not enough fluids), laxative abuse (affect electrolyte balance)

heart arrhythmias (irregular beats)

hypotension

anemia

death: about 15% of patients, malnutrition (direct, physiological), suicide (indirect, high risk of depression)

33
Q

What is bulimia nervosa?

A

an eating disorder characterized by a recurrent pattern of binge eating followed by self-induced purging and accompanied by persistent overconcern with body weight & image

34
Q

What are the DSM-5 criteria for bulimia nervosa?

A

recurrent episodes of binge eating

recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting

the binge eating and compensatory behaviors both occur, on average, at least once a week for 3 months

self-evaluation is unduly influenced by body shape

the disturbance does not occur exclusively during episodes of anorexia nervosa

35
Q

What is the DSM-5 criteria for an episode of binge eating?

A

eating, in a discrete period of time, an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances

a sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating)

36
Q

What are the specifiers of bulimia nervosa?

A

mild: 1-3 per week

moderate: 4-7 per week

severe: 8-13 per week

extreme: 14 or more

in partial remission, in full remission

37
Q

What is binge-eating disorder?

A

involves the same binge-eating features found in bulimia nervosa but without the behavior aiming to compensate for the binging (e.g. purging)

38
Q

What are medical complications of bulimia?

A

tooth erosion, cavities, and gum problems

blockage of salivatory ducts (poor bacterial control)

pancreatitis (inter-abdominal pressure causes damage)

water retention, swelling, and abdominal bloating

acute stomach distress

fluid loss with low potassium levels (extreme weakness, near paralysis, heart arrhythmias)

irregular periods

esophagus damage (including rupture)

weakening of rectal walls

39
Q

What are behavioral complications of bulimia?

A

substance abuse (30 to 70%)

impulsive behaviors (up to 50%): promiscuity, cutting, theft

40
Q

What are the risk factors for both anorexia and bulimia?

A

participation in competitive activities that emphasize endurance, aesthetics, and weight levels put athletes at risk for developing an eating disorder

female gender

age in late teens to early 20s

having a first degree relative with any kind of eating disorder

social pressures including disorted media protrayals

emotional issues such as: low self-esteem, perfectionism, anger issues, depression, anxiety, OCD, impulsivity, need for control

41
Q

What are the causes of anorexia and bulimia?

A

sociocultural factors: food is celebrated in many cultures

psychosocial factors: media portrayals of body standards

family factors: systems perspective, how is this an indicator of the broader stresses they’re going through?

biological factors: tumors in the hypothalamus (eat too much or too little), drug abuse

42
Q

What are treatments for anorexia nervosa and bulimia nervosa?

A

hospitalization: needs to be supervised when eating

cognitive analytic therapy

family therapy: multi-level thing, don’t just treat bulimia, might be trying to go against family norms

CBT: treating the thoughts that go with the disorder

interpersonal psychotherapy: individualized systems therapy, meaning of the relationships in life

43
Q

What is pica?

A

ingestion of non-nutritive substances

teenager or adult eating something that isn’t good for them

44
Q

What is rumination disorder?

A

food is regurgitated, chewed, and either spat out or re-swallowed

45
Q

What is Prader-Willi Syndrome?

A

lower than normal IQ

no matter how much they eat they don’t get sick to their stomach

46
Q

What is Cyclic Vomiting Syndrome?

A

several times an hour over a period of hours or days

not binging and purging

don’t eat it or swallow it again, partially threw up

47
Q

What are conditions related to feeding and eating disorders in adolescents and adults?

A

anorexia athletica

muscle dysmorphia (bigorexia)

orthexia nervosa: need to eat super healthy foods

night-eating syndrome: at least half their calories are consumed at night

nocturnal sleep-related eating disorder: sleep walking + eating

gourmand syndrome: super consumed with having fancy and unusual food

48
Q

What is avoidant/restrictive food intake disorder?

A

don’t have morbid fear of gaining weight

49
Q

What are sleep-wake disorders?

A

diagnostic category representing persistent or recurrent sleep-related problems that cause significant personal distress or impaired functioning

50
Q

What are the dyssomnia sleep disorders?

A

concerned with timing or amount

insomnia disorder: don’t sleep enough

hypersomnolence disorder: sleeping much more than they should

narcolepsy: no control over the tendency to fall asleep

51
Q

What are the breathing-related sleep disorders?

A

much less to do with mental health

central sleep apnea: stop breathing

sleep-related hypoventilation: not breathing deeply enough

circadian rhythm sleep-wake disorders: natural rhythm is interrupted

52
Q

What are the parasomnia sleep disorders?

A

occurs with sleep

nightmare disorder (during REM stage)

non-REM sleep arousal disorders

REM sleep behavior disorder

restless leg syndrome

substance/medication induced

53
Q

What is sleep stage one (N1)?

A

light transitional from wakefulness

high amplitude theta (slow) waves on EEG

lasts about 5-10 minutes

54
Q

What is sleep stage two (N2)?

A

EEG shows bursts of fast activity (sleep spindles)

HR and temperature drops

55
Q

What is sleep stage three (N3)?

A

moving from transitional to deeper stages

deep, increasing slow wave EEG activity (delta band)

56
Q

What is sleep stage four (N4)?

A

“delta sleep” predominance of delta band EEG activity

lasts about 30 minutes

if sleeper is prone to enuresis or sleepwalking, it will most likely start here

57
Q

What is sleep stage five (REM)?

A

REM sleep or “paradoxical sleep”, daydreaming occurs

voluntary muscles are paralyzed, brain active, respiration increases

58
Q

What is sleep architecture?

A

on average we enter REM sleep about once every 90 minutes

typically 4 to 5 cycles per night

REM stage typically lasts longer upon each successive cycle

if you get up in the night, return to the stage you were at or the stage right before

59
Q

What happens to the sleep cycles as we age?

A

as we age, slow wave (stages 3 & 4) sleep decreases and Stage 1 increases which makes us easier to wake

hence there is heighten incidence of insomnia

60
Q

What is insomnia disorder?

A

three main varieties, can have one, two, or all three

onset: just can’t fall asleep

interrupted: tossing, turning, physical discomfort, can’t navigate stages

early: get up earlier, earlier, and earlier

61
Q

What is hypersomnia (hypersomnolence disorder)?

A

sleeping beauty syndrome

sleep for 24 hours

62
Q

What is narcolepsy?

A

loss of the chemical hypocretin in the hypothalamus

cataplexy” collapsing

dysregulation of sleep stages: awake from straight to stage five, fast movement into deep sleep = muscle paralysis at dangerous times

63
Q

What are breathing-related sleep disorders?

A

apnea, snoring

airway closes partially or completely

more likely in obese or sedated individuals (e.g. sleeping pills or alcohol)

airway may remain closed up to 90 seconds

usually sleeper reflexively in sleep as it occurs many times per night

poor oxygenation

highly disruptive to sleeping partner

64
Q

What are treatments for breathing-related sleep disorders?

A

CPAP (continuous positive air pressure) machine: high rate of non-compliance

surgery (usually laser) to remove excess tissue enlargements: uncomfortable recovery and infection rate

65
Q

What is Kleine-Levin Syndrome (KLS) “Sleeping Beauty” Syndrome?

A

recurring periods of excessive amounts of sleep, behavior changes, and impaired understanding of the world

no treatment

not in a coma, still eat

episodes may continue for 10 years or more (sometimes spontaneously recovers)

66
Q

How are anxiolytics used to treat sleep-wake disorders?

A

should only be used short-term (develop tolerance, high level of addiction)

benzos, suppress CNS

many drugs can suppress REM sleep (less restorative sleep)

67
Q

What are psychological approaches to treating sleep-wake disorders?

A

cognitive-behavioral techniques lower physiological arousal and address sleep hygiene and emotional state

deep relaxation techniques

figure out a good bed time routine

68
Q

What is nightmare disorder?

A

during REM

wakes up

tend to remember (because it occurs during REM)

69
Q

What are sleep terror disorders?

A

stages 3 and 4

not remembered (because its not in REM)

awaken confused and disoriented

70
Q

What is sleepwalking?

A

rarely occurs in stage 5 because sleep paralysis sets in

don’t usually wake up

often confused and disoriented if awoken (not dangerous to wake them up)

little recollection of dream content (because it takes place in non-REM sleep)

“sexomnia” variant: engage in sex while asleep

71
Q

What are the biological approaches to the treatment of sleep disorders?

A

benzodiazepines (anxiolytics)

risk of dependence diminished REM

72
Q

What are the psychological approaches to the treatment of sleep disorders?

A

cognitive-behavioral techniques

people can develop anticipatory anxiety that may respond to identifying rational alternate thoughts

don’t go to bed thinking you’ll have a bad sleep

73
Q

What are ten steps to overcoming insomnia?

A
  1. retire to bed only when you feel sleepy
  2. limit bed activities to sleeping
  3. if after 20 minutes you are unable to fall asleep, get out of bed and relax
  4. establish a regular routine
  5. avoid naps during the daytime
  6. avoid ruminating in bed
  7. relax before sleeping
  8. establish a regular daytime exercise schedule
  9. avoid caffeinated beverages
  10. practice rational restructuring for self-defeating thoughts

PSYCH 239 (12 decks)

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