Clinical features

Question 0

What are the two types of AN

Answer 0

Restricting

Binge-eating / purging

Question 1

What are the features of AN

Answer 1

Restriction of energy intake relative to requirements
Leads to low weight for age, sex, dev trajectory
Intense fear of gaining weight
Disturbance in way weight is experienced, lack of seriousness

Question 2

Why was refusal to eat removed from DSM5?

Answer 2

Derogatory
Judgemental
Some bmi levels not applicable to adolescents so now termed weight less than minimally normal

Question 3

What are features of bulimia

Answer 3

Normal weight 
Repeated episodes of binge eating
Large amount in short time
Feel out of control during binge
Compensatory behaviour

Question 4

What are features of binge eating

Answer 4

Recurrent episodes of bingeing
No compensatory behaviour
Eat more rapidly
Eat until overfull or when not hungry
Distress during binge

Question 5

What are the causes of eating disorders

Answer 5

Multiple pathways
Interaction of biological (genetics,physiology)
Psych(personality, family,cog)
Social (society modelling, pressure regarding weight and appearance)

Question 6

Is anorexia an internal or external disorder

Answer 6

Internal

Question 7

What is the best predictor of bulimia in adolescence

Answer 7

Dieting

Question 8

What are the genetic factors involved in eating disorders

Answer 8

Increase risk of relative with eating disorder
AN high concordance in mono twins
Social anxiety, perfectionism, negative affect
BN lower concordance in mono twins
Tolerance to vomiting, impulsivity

Question 9

What parts of physiology play role in aetiology

Answer 9

Hypothalamus - role in hunger and eating regulation
Serotonin and dopamine and norepinephrine
Low sero assoc w impulsivity and binge eating

Question 10

What family environment factors contribute to eating disorders

Answer 10

Modelling of eating disorder behaviour
High expressed emotion
Critical conflicted family
Don’t allow individuation

Question 11

What psych factors contribute to ED

Answer 11

High level of perfectionism

Low self esteem

Question 12

What psych treatment for bulimia is treatment of choice

Answer 12

CBT

Question 13

What is the new version of CBT used to treat bulimia

Answer 13

CBT E
Can also target the key difficulty areas of 
Perfectionism
Low self esteem
Interpersonal difficulties

Question 14

What factors can lead to bingeing

Answer 14

Emotional trigger eg anger, sorrow,
Eating ‘bad’ food
Fasting for long period

Question 15

What is ipt and how can it be used for ED

Answer 15

Interpersonal psychotherapy
Assumes reciprocal link between mood interpersonal factors and eating
Improve interpersonal functioning
Effective in long term but treatment takes longer than CBT

Question 16

What is the preferred treatment for AN

Answer 16

Outpatient and family based therapy

Parents are responsible for helping child gain weight

Question 17

What are the 3 phases of family based treatment for AN

Answer 17

1. Parents restore child’s weight
2. Transfer control back to adolescent
3. Adolescent developmental issues

Question 18

What is the mean peak age for AN

Answer 18

17 years but two peaks at 14 and 18

Question 19

What are the two peak ages of AN associated with

Answer 19

Developmental crises and increasing independence eg. Puberty, transition from school/university/ work and leaving home

Question 20

What is the mean age of onset for bulimia

Answer 20

18 years

Question 21

What are the features of males with eating disorders

Answer 21

Same patterns of disturbed body image and eating
More bingeing
Rely more on fasting and exercise to compensate
More likely to have suffered premorbid obesity,alcohol problems
Less likely to have mood disorders than females

Question 22

What are features of binge eating disorder

Answer 22

Recurrent binges with lack of control
No use of inappropriate compensatory behaviours
Binges causes distress, embarrassment, disgust and guilt
Eat more rapidly,eat when not hungry,or when full

Question 23

Which disorder has highest mortality rate of any psychological disorder

Answer 23

AN

Question 24

What damage is done by AN

Answer 24

``` Electrolyte depletion Dysfunctional nerve and muscle cells Cardiac arrhythmias, cardiac arrest Hypotension, feel faint on standing Body temp drops,abdominal pain,bloating,constipation ```

Question 25

What effect on oestrogen

Answer 25

Lowered leading to amenorrhea,arrested sexual development, regression of ovaries Lower bone density, osteoporosis, stunted growth

Question 26

What types of food do bulimic so tend to binge more on

Answer 26

Junk food

Question 27

What are important features of bingeing

Answer 27

That person is out of control | Amount of food eaten

Question 28

What physiological changes seen in bulimia

Answer 28

Enlarged salivary glands Erosion of dental enamel Tearing of oesophagus Electrolyte imbalance

Question 29

What additional psych disorders seen in bulimia

Answer 29

Anxiety and mood disorders | Substance a users

Question 30

What features do AN and bulimia share

Answer 30

A morbid fear of putting on weight | Losing control of eating

Question 31

What is the difference between AN and bulimi

Answer 31

AN are proud of their weight loss and control of their diet | Bulimia are ashamed of their eating issues and lack of control

Question 32

How does bulimia differ from binge eating purging type AN

Answer 32

AN binge on small amounts of food and purge more consistently, perhaps each time they eat

Question 33

Why does su typing of AN only refer to the last 3 months

Answer 33

Bec there are few differences between the two on severity of symptoms or personality Subtyping may not be useful in predicting future course but merely reflect a phase

Question 34

What psych disorders are associated with AN

Answer 34

Anxiety and mood Obsessive compulsive disorder. Unpleasant thoughts assoc w gainig weight and so they engage in ritualistic behaviours to rid themselves of these thoughts

Question 35

How does BEDdiffer from other eating disorders

Answer 35

Different patterns of heritability More likely in males Later age of onset Greater chance of remission and response to treatment

Question 36

What are similarities between BED and AN and bulimia

Answer 36

Concerns about shape or weight

Question 37

Why do people have BED

Answer 37

Alleviate bad mood or negative affect

Question 38

What is the strongest predictor of bulimia

Answer 38

Childhood obesity | Continuing overemphasis on being thin

Question 39

Which disorder is more chronic

Answer 39

Bulimia

Question 40

Which disorder is more resistant to treatment

Answer 40

AN