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eating and sleep/wake disorders Flashcards

1
Q

What are Feeding and Eating Disorders according to the DSM-5-TR?

A

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.

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2
Q

What is Pica?

A

Persistent eating of non-nutritive, nonfood substances for at least one month, inappropriate for developmental level and not culturally acceptable.

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3
Q

What are common non-nutritive substances consumed in Pica?

A
  • Paper
  • Paint
  • Coffee grounds
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4
Q

At what ages is Pica most commonly observed?

A

Most common among children and has an elevated rate among pregnant women.

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5
Q

What potential medical complications can arise from Pica?

A
  • Intestinal obstruction
  • Lead poisoning
  • Other medical complications
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6
Q

What characterizes Anorexia Nervosa?

A

Restriction of energy intake causing significantly low body weight, intense fear of gaining weight, and disturbance in self-evaluation.

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7
Q

What are the specifiers used in diagnosing Anorexia Nervosa?

A
  • Type (restricting or binge-eating/purging)
  • Course (in partial or full remission)
  • Severity (based on current BMI)
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8
Q

What psychological conditions often co-occur with Anorexia Nervosa?

A
  • Depression
  • Anxiety disorders (especially obsessive-compulsive disorder)
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9
Q

What are the initial treatment goals for Anorexia Nervosa?

A
  • Restore a healthy weight
  • Address physical complications
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10
Q

What role does cognitive behavior therapy (CBT) play in treating Anorexia Nervosa?

A

It helps establish regular eating patterns, eliminate body-checking, and replace problematic thinking.

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11
Q

What is Family-Based Treatment (FBT) for Anorexia Nervosa?

A

An outpatient intervention for adolescents focusing on parental control of nutritional rehabilitation and gradual return of control to the adolescent.

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12
Q

What are common medical complications of Anorexia Nervosa?

A

Malnutrition and extreme weight loss affecting nearly all major organ systems, potentially leading to death.

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13
Q

What defines Bulimia Nervosa?

A

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.

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14
Q

What are the criteria for diagnosing Bulimia Nervosa?

A

Binge eating and compensatory behavior must occur at least once a week for three months.

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15
Q

What medical complications can arise from Bulimia Nervosa?

A
  • Dental erosion
  • Gastroesophageal reflux
  • Electrolyte imbalance causing heart arrhythmias
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16
Q

What treatments are commonly used for Bulimia Nervosa?

A
  • Nutritional rehabilitation
  • Cognitive behavior therapy (CBT)
  • Enhanced cognitive-behavior therapy (CBT-E)
  • Interpersonal therapy (IPT)
  • Family-based treatment (FBT)
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17
Q

What is Enhanced Cognitive Behavior Therapy (CBT-E)?

A

A transdiagnostic intervention that addresses the core psychopathology shared among eating disorders, focusing on maintaining individual symptoms.

18
Q

What is the focus of the first phase in Family-Based Treatment (FBT) for Bulimia Nervosa?

A

Disrupting bingeing, purging, and establishing healthy eating.

19
Q

What does telepsychology aim to achieve in treating Bulimia Nervosa?

A

To produce positive results comparable to face-to-face interventions.

20
Q

True or False: Individuals with Bulimia Nervosa are generally less motivated to change their behaviors than those with Anorexia Nervosa.

A

False

21
Q

What type of motivation has been shown to predict better treatment outcomes for individuals with eating disorders?

A

Autonomous (intrinsic) motivation.

22
Q

Fill in the blank: Anorexia Nervosa often co-occurs with _______.

A

[depression or anxiety disorders]

23
Q

What are the long-term recovery rates for patients with Anorexia Nervosa compared to Bulimia Nervosa at the 22-year follow-up?

A
  • 62.8% of patients with Anorexia
  • 68.2% of patients with Bulimia
24
Q

What evidence exists regarding the effectiveness of SSRIs in treating Bulimia Nervosa?

A

Effective for alleviating comorbid depression and reducing binge eating and purging.

25
Q

What are some of the phases in Enhanced Cognitive Behavior Therapy (CBT-E)?

A
  • Engaging the patient in treatment
  • Reviewing progress
  • Addressing overevaluation of shape and weight
  • Maintaining progress and reducing relapse risk
26
Q

What is the definition of binge-eating disorder (BED)?

A

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.

27
Q

What are the five characteristic symptoms of binge-eating disorder?

A
  • 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.

28
Q

How is the severity of binge-eating disorder determined?

A

By the number of episodes each week

Severity can be classified as mild, moderate, severe, or extreme.

29
Q

Is binge-eating disorder (BED) more common in men or women?

A

Women

BED is two to three times more common in women than in men.

30
Q

What distinguishes binge-eating disorder from bulimia nervosa?

A

Those with BED do not engage in recurrent inappropriate compensatory behaviors

BED usually has a better response to treatment compared to bulimia nervosa.

31
Q

What are the two evidence-based treatments for binge-eating disorder?

A
  • Cognitive-behavior therapy-enhanced (CBT-E)
  • Interpersonal therapy (IPT)

CBT-E has been found to be more effective in some studies.

32
Q

What medications have been evaluated for treating binge-eating disorder?

A
  • SSRIs (fluoxetine, paroxetine, sertraline)
  • Topiramate
  • Lisdexamfetamine

Medication alone is generally less effective than CBT.

33
Q

What is the most common treatment for nocturnal enuresis?

A

The moisture alarm (bell-and-pad)

This device rings when a child begins to urinate while sleeping.

34
Q

What is insomnia disorder characterized by?

A

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.

35
Q

What are the three types of insomnia?

A
  • Sleep-onset insomnia
  • Sleep maintenance insomnia
  • Late insomnia

Sleep maintenance insomnia is the most common single type.

36
Q

What is the nonpharmacological treatment-of-choice for insomnia disorder?

A

A multi-component cognitive-behavioral intervention

This includes stimulus control, sleep restriction, sleep-hygiene education, relaxation training, and/or cognitive therapy.

37
Q

What characterizes narcolepsy?

A

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.

38
Q

What are common symptoms associated with narcolepsy?

A
  • Cataplexy
  • Hypnagogic hallucinations
  • Hypnopompic hallucinations
  • Sleep paralysis

Cataplexy is often triggered by strong emotions.

39
Q

What medications are used to treat narcolepsy?

A
  • Modafinil
  • Armodafinil
  • Amphetamines
  • Antidepressants (venlafaxine, fluoxetine, clomipramine)
  • Sodium oxybate

Medications aim to improve alertness and reduce cataplexy.

40
Q

What are the non-rapid eye movement sleep arousal disorders?

A
  • Sleepwalking
  • Sleep terrors

These involve incomplete awakening from sleep during Stage 3 or 4 sleep.

41
Q

What characterizes nightmare disorder?

A

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.

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