Eating And Sleep-Wake Disorders Flashcards
Anorexia nervosa is characterised by what?
Person eats only minimal food or exercises vigorously to offset food intake
What is the death rate for people with anorexia nervosa?
Up to 20% die as a result of the disorder with slightly more than 5% dying within 10 years
What disorder has the highest death rate of all topics covered in the text?
Anorexia nervosa
What is the suicide rate for women with anorexia nervosa?
18 times more likely than 15-34 year old females in the general population
BMI less than 18.5 is generally considered?
Seriously undernourished
BMI of 40 or more are generally considered?
Severe or morbidly obese
The hallmark of bulimia nervosa is? page 269
- Eating large amounts of food typically more junk food than fruit and vegetables - and amount of food eaten is that the eating experience is out of control
- attempts to compensate for binge eating almost always by purging like vomiting immediately after eating, laxatives, diuretics (drugs that result in loss of fluid)
Medical consequences of chronic bulimia with purging include
- Salivary gland enlargement caused by repeated vomiting giving face a chubby appearance
- tooth enamel erosion and tear of esophagus
- chemical imbalance of bodily fluids including sodium and potassium ( called electrolyte imbalance)
- electrolyte imbalance can cause cardiac arrhythmia, seizures and renal (kidney) failure
- laxative abuse can cause severe constipation or permanent colon damage
Associated psychological disorders suffered by individuals with bulimia include
Anxiety and mood disorders
- 80.6% of individuals had an anxiety disorder at some point in their lives
- 66% of adolescents presented with a co-occurring anxiety disorder
- 20% meet criteria for mood disorder when interviewed and between 50% and 70% meet criteria at some point during course of disorder
-
Individuals with Bulimia are within what % of their normal body weight?
10%
Similarities between anorexia and bulimia are?
Both characterised by a morbid fear of gaining weight and losing control over their eating.
Differenced between anorexia and bulimia are?
People with anorexia are proud of both their diets and extraordinary control. People with bulimia are ashamed of both eating issues and lack of control
DSM-V specifies two subtypes of anorexia nervosa. In the restricting type individuals diet to limit calorie intake; in the binge eating purging type they rely on purging. What is the difference between the bing eating purging type and bulimia?
Unlike individuals with bulimia they binge on relatively small amounts of food and purge constantly ( sometimes every time they eat
Prospective data collected on 136 individuals with anorexia revealed not much difference on severity of symptoms or personality between the two subtypes thus concluding that the restrictive type and the bing eating purging type may rather reflect?
Stages or phases of anorexia
For this reason DSM criteria specify that subtyping refer only to the past 3 months
DSM criteria specify that anorexia body weight as significantly low meaning 15% below normal
Medical consequences of anorexia nervosa are?
- amenorrhea (cessation of menstruation) which often occurs in bulimia also. Because of inconsistency with cases dropped as a diagnostic criteria
- dry skin, brittle hair or nails, sensitivity to cold temperatures, lanugo (downy hair on limbs and cheeks), cardiovascular problems such as low blood pressure and heart rate
- electrolyte imbalance if vomiting part of routine resulting in cardiac and kidney problems as in bulimia
Associated psychological disorders with Anorexia
- anxiety and mood disorders like with bulimia
- depression at some point in life 71%
- a common anxiety disorder is obsessive compulsive disorder with obsessions relating to gaining weight and rituals to remove such thoughts
- like bulimia substance abuse is common and In conjunction with anorexia is a strong predictor of suicide
What classify binge eating disorder?
Experience marked distress because of binge eating but do not engage in extreme compensatory behaviours and therefore cannot be diagnosed with bulimia.
Facts about binge eating disorder include; p 273
- a greater likelihood of remission and a better response to treatment compared to other eating disorders
- individuals who meet preliminary criteria are often found in weight control programs (18 to 30%)
- crossing over to bulimia is very common
Predictive variables of eating disorders p 274 concerning young women ;
- negative affect and functioning impairment predicted all DSM-V eating disorders
- internalisation of the thin ideal, body dissatisfaction, dieting, overeating, and mental health care predicted bulimia, binge eating disorder and purging disorder
- low BMI and dieting predicted anorexia
Eating disorder prevalence rates and statistics page 274
Anorexia and particularly bulimia are the most culturally specific psychological disorders yet identified, true or false?
True
What neurotransmitter is most often associated with eating disorders?
Low levels of serotonin
Associated with impulsivity generally and binge eating specifically
What brain structure plays an important role in the regulation of eating and thus eating disorders?
Hypothalamus
What drug treatments have been found to be effective in treating anorexia?
None
Some evidence that drugs may be useful for some people with bulimia, particularly during the what cycle?
Bingeing and purging cycle
The drugs generally considered the most effective for bulimia are the same antidepressant medications effective for mood and anxiety disorders, true or false?
True
Antidepressants for the treatment of bulimia are effective in the short term and long term, true or false?
False as evidence shows drugs are not effective in the long term. They need to be paired with psychological treatments for beneficial long term effects.
In terms of psychological underpinnings, what do all eating disorders seem to share? Page 285
Anxiety focused on one’s appearance and presentation to others, as well as distorted body image.
Cognitive behavioural therapy enhanced (CBT-E) is directed at causal factors relating to which eating disorders?
It is directed at the causal factors common to all eating disorders.
What is the first stage of CBT-E? Page 285
Teaching the patient the physical consequences of binge eating and purging, as well as the ineffectiveness of vomiting and laxative abuse for weight control.
When is inpatient treatment recommended for anorexia? P 287
When body weight is below approximately 75% of the average healthy body weight
Or when weight has been lost rapidly and the individual continues to refuse food
In anorexia, is initial weight gain a strong predictor of long term outcome? P 287
False.
Restoring weight , although often a different task is probably the easiest part of treatment.
However, when analysing the benefits of FBT (family based therapy) early response of gaining at least 5 pounds in the first four weeks does predict a better outcome. Page 288
In anorexia, a family focused approach (referring to FBT) can often be beneficial. Describe some reasons why. Page 288
The negative and dysfunctional communication in the family regarding food and eating must be eliminated, and meals must be made more structured and reinforcing.
Attitudes towards body shape and image distortion are discussed at length which is necessary to cease a lifetime preoccupation
BMI 30 or greater is considered?
Obese
What is the risk of mortality for people with a BMI of 30 and for people with a BMI of 40? Obesity statistics p 289
BMI of 40 is 100%
BMI of 30 increases risk by 30%
What are the two forms of maladaptive eating patterns in people who are obese p291
Binge eating and night eating syndrome
Sleep disorders are divided into what two major categories? P 296
Dyssomnias and parasomnias
What characteristics dyssomnias p296
Difficulty getting enough sleep, problems with sleeping when you want (not being able to fall asleep until 2am), and complaints about the quality of sleep
What characterises parasomnias p 296
Abnormal behavioural or psychological events during sleep such as nightmares and sleepwalking
Some people like to stay up late and sleep late and others like to get up early and are very active in the morning. The answer to which one are you is defined by your what?
Chronotype p 296
What type of evaluation allows for the clearest and most comprehensive picture of your sleep habits ? P 296
A polysomnographic (PSG) evaluation
Diagnostic criteria for insomnia p 298
Insomnia statistics - p 298 what are the prevalence rates Amy given year?
In the general population across 66 sites and 52298 participants of different economic levels and sociocultural values among 13 countries around the world found that it ranged from 2.3% to 25.5%.
What psychological disorders are associated with insomnia p298?
Total sleep time often decreases with depression, substance use disorder, anxiety disorder, and neurocognitive disorder due to Alzheimers disease. Alcohol use can be particularly troubling due to the vicious cycle ( May helps to get to sleep but causes interrupted sleep patterns)
An integrative model of sleep disorders includes several assumptions being p 299?
The first is that at some level, both biological and psychological factors are present in most cases. The second is that multiple factors are reciprocally related. This is seen in the study we’re a parent’s depression and negative thoughts about a child’s sleep negatively influenced infant night walking.
Diagnostic criteria for hypersomnolemce disorder p 302
What is sleep hygiene? P 300
The daily activities that affect how we sleep
What is a common complaint about travelling overseas and an example of sleep hygiene?
Jet lag p 300
What are some biological vulnerabilities that can lead to eventual sleeping problems p 300?
A person may be a light sleeper, have a family history of insomnia, narcolepsy or obstructed breathing. Referred to as predisposing conditions.
What Is narcolepsy p302?
In addition to daytime sleepiness, some people with narcolepsy experience cataplexy, a sudden loss of muscle tone. Cataplexy can range from slight Wes in the facial muscles to complete physical collapse lasting from several seconds to several minutes. It is usually preceded by strong emotions such as anger or happiness.
In the treatment of sleep disorders, being instructed to limit time in bed to about 4 hours per night is an example of what?
Whereas being asked not to do any schoolwork while in bed and to get out of bed if not asleep within 15 minutes is an example of?
Sleep restriction
Stimulus control
