eating and sleep/wake disorders Flashcards
What are Feeding and Eating Disorders according to the DSM-5-TR?
A persistent disturbance of eating or eating-related behavior that results in altered consumption or absorption of food and significantly impairs physical health or psychosocial functioning.
What is Pica?
Persistent eating of non-nutritive, nonfood substances for at least one month, inappropriate for developmental level and not culturally acceptable.
What are common non-nutritive substances consumed in Pica?
- Paper
- Paint
- Coffee grounds
At what ages is Pica most commonly observed?
Most common among children and has an elevated rate among pregnant women.
What potential medical complications can arise from Pica?
- Intestinal obstruction
- Lead poisoning
- Other medical complications
What characterizes Anorexia Nervosa?
Restriction of energy intake causing significantly low body weight, intense fear of gaining weight, and disturbance in self-evaluation.
What are the specifiers used in diagnosing Anorexia Nervosa?
- Type (restricting or binge-eating/purging)
- Course (in partial or full remission)
- Severity (based on current BMI)
What psychological conditions often co-occur with Anorexia Nervosa?
- Depression
- Anxiety disorders (especially obsessive-compulsive disorder)
What are the initial treatment goals for Anorexia Nervosa?
- Restore a healthy weight
- Address physical complications
What role does cognitive behavior therapy (CBT) play in treating Anorexia Nervosa?
It helps establish regular eating patterns, eliminate body-checking, and replace problematic thinking.
What is Family-Based Treatment (FBT) for Anorexia Nervosa?
An outpatient intervention for adolescents focusing on parental control of nutritional rehabilitation and gradual return of control to the adolescent.
What are common medical complications of Anorexia Nervosa?
Malnutrition and extreme weight loss affecting nearly all major organ systems, potentially leading to death.
What defines Bulimia Nervosa?
Recurrent episodes of binge eating with a sense of lack of control, inappropriate compensatory behaviors, and excessive self-evaluation influenced by body shape and weight.
What are the criteria for diagnosing Bulimia Nervosa?
Binge eating and compensatory behavior must occur at least once a week for three months.
What medical complications can arise from Bulimia Nervosa?
- Dental erosion
- Gastroesophageal reflux
- Electrolyte imbalance causing heart arrhythmias
What treatments are commonly used for Bulimia Nervosa?
- Nutritional rehabilitation
- Cognitive behavior therapy (CBT)
- Enhanced cognitive-behavior therapy (CBT-E)
- Interpersonal therapy (IPT)
- Family-based treatment (FBT)
What is Enhanced Cognitive Behavior Therapy (CBT-E)?
A transdiagnostic intervention that addresses the core psychopathology shared among eating disorders, focusing on maintaining individual symptoms.
What is the focus of the first phase in Family-Based Treatment (FBT) for Bulimia Nervosa?
Disrupting bingeing, purging, and establishing healthy eating.
What does telepsychology aim to achieve in treating Bulimia Nervosa?
To produce positive results comparable to face-to-face interventions.
True or False: Individuals with Bulimia Nervosa are generally less motivated to change their behaviors than those with Anorexia Nervosa.
False
What type of motivation has been shown to predict better treatment outcomes for individuals with eating disorders?
Autonomous (intrinsic) motivation.
Fill in the blank: Anorexia Nervosa often co-occurs with _______.
[depression or anxiety disorders]
What are the long-term recovery rates for patients with Anorexia Nervosa compared to Bulimia Nervosa at the 22-year follow-up?
- 62.8% of patients with Anorexia
- 68.2% of patients with Bulimia
What evidence exists regarding the effectiveness of SSRIs in treating Bulimia Nervosa?
Effective for alleviating comorbid depression and reducing binge eating and purging.
What are some of the phases in Enhanced Cognitive Behavior Therapy (CBT-E)?
- Engaging the patient in treatment
- Reviewing progress
- Addressing overevaluation of shape and weight
- Maintaining progress and reducing relapse risk
What is the definition of binge-eating disorder (BED)?
Recurrent episodes of binge eating involving an amount of food larger than most people would eat in similar circumstances, along with a sense of lack of control during episodes
For diagnosis, at least three of five characteristics must be present, and episodes must occur at least once a week for three months.
What are the five characteristic symptoms of binge-eating disorder?
- Eating more rapidly than usual
- Eating until uncomfortably full
- Eating large amounts when not feeling hungry
- Feeling alone due to embarrassment about binge eating
- Feeling disgusted, depressed, or very guilty about binge eating
At least three of these symptoms are required for diagnosis.
How is the severity of binge-eating disorder determined?
By the number of episodes each week
Severity can be classified as mild, moderate, severe, or extreme.
Is binge-eating disorder (BED) more common in men or women?
Women
BED is two to three times more common in women than in men.
What distinguishes binge-eating disorder from bulimia nervosa?
Those with BED do not engage in recurrent inappropriate compensatory behaviors
BED usually has a better response to treatment compared to bulimia nervosa.
What are the two evidence-based treatments for binge-eating disorder?
- Cognitive-behavior therapy-enhanced (CBT-E)
- Interpersonal therapy (IPT)
CBT-E has been found to be more effective in some studies.
What medications have been evaluated for treating binge-eating disorder?
- SSRIs (fluoxetine, paroxetine, sertraline)
- Topiramate
- Lisdexamfetamine
Medication alone is generally less effective than CBT.
What is the most common treatment for nocturnal enuresis?
The moisture alarm (bell-and-pad)
This device rings when a child begins to urinate while sleeping.
What is insomnia disorder characterized by?
Dissatisfaction with sleep quality or quantity associated with difficulty initiating sleep, maintaining sleep, or early-morning awakening
Must occur at least three nights a week and cause significant distress.
What are the three types of insomnia?
- Sleep-onset insomnia
- Sleep maintenance insomnia
- Late insomnia
Sleep maintenance insomnia is the most common single type.
What is the nonpharmacological treatment-of-choice for insomnia disorder?
A multi-component cognitive-behavioral intervention
This includes stimulus control, sleep restriction, sleep-hygiene education, relaxation training, and/or cognitive therapy.
What characterizes narcolepsy?
Attacks of an irrepressible need to sleep causing sleep or naps at least three times a week for three months
Diagnosis requires episodes of cataplexy or hypocretin deficiency.
What are common symptoms associated with narcolepsy?
- Cataplexy
- Hypnagogic hallucinations
- Hypnopompic hallucinations
- Sleep paralysis
Cataplexy is often triggered by strong emotions.
What medications are used to treat narcolepsy?
- Modafinil
- Armodafinil
- Amphetamines
- Antidepressants (venlafaxine, fluoxetine, clomipramine)
- Sodium oxybate
Medications aim to improve alertness and reduce cataplexy.
What are the non-rapid eye movement sleep arousal disorders?
- Sleepwalking
- Sleep terrors
These involve incomplete awakening from sleep during Stage 3 or 4 sleep.
What characterizes nightmare disorder?
Repeated occurrences of extended, extremely dysphoric dreams usually involving threats to survival or security
Nightmares typically occur during REM sleep in the second half of a major sleep period.
