Eating Disorders Flashcards

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1
Q

Define eating disorders

A

Characterized by severe disruptions in eating behavior affect physical, psychological, and social functioning

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2
Q

Define anorexia nervosa

A
  • Intense fear of gaining weight
  • Distorted body image
  • Body weight is below normal
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3
Q

Why is amenorrhea not required for diagnosis of anorexia nervosa?

A
  • Men can get diagnosed for anorexia nervosa

- You do not need to have a period/experienced puberty to get anorexia

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4
Q

When is anorexia usually first diagnosed?

A

Adolescence or adulthood

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5
Q

What is anorexia triggered by?

A

Dieting and stress

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6
Q

How many times are women more likely to be diagnosed with anorexia than men?

A

10x

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7
Q

What mental disorders is anorexia comorbid with in women?

A

Depression, OCD, phobias, panic, and alcoholism

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8
Q

What is anorexia comorbid with in men?

A

Substance dependence, mood disorders, or schizophrenia

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9
Q

Does anorexia have the highest mortality rate among all psychological disorders?

A

Yes - suicide rates are high with death rates 10x higher than the general population

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10
Q

What are some physical changes associated with anorexia?

A
  • Blood pressure and heart rate decrease
  • Kidney issues
  • Loss of bone mass
  • Brittle nails, dry skin, hair loss
  • Lanugo (soft hair)
  • Depletion of sodium and potassium electrolytes
    (can cause tiredness, weakness, and death)
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11
Q

What are the three medical sequelae or consequences of anorexia nervosa? (Give examples for each)

A
  1. Health complications
    - irregular heartbeat
    - hypotension (low blood pressure)
    - electrolyte imbalances
    - infertility
  2. Hospitalizations
    - involuntary hospitalizations
  3. Death
    - 5-8% die from complications
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12
Q

How many people eventually recover from anorexia? and how long does this take? are relapses common?

A

35-60% but less than 50% fully recover: 6-7 years: yes

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13
Q

What is a common cognitive distortion that people in the US with anorexia have?

A

They have a hard to modify distorted view of self especially in a culture that values thinness

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14
Q

What is the comorbidity rate between anorexia and body dysmorphic disorder?

A

It is not high because body dysmorphic disorder is focused on one feature of the body

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15
Q

Define bulimia nervosa

A

Uncontrollable eating binges followed by compensatory behavior to prevent weight gain

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16
Q

What are compensatory behaviors?

A

Purging, vomiting, fasting, excessive exercise

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17
Q

What is the time period of bulimia nervosa for it to be diagnosed?

A

At least one a week for 3 months

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18
Q

What are typical food choices for binges?

A

Cakes, cookies, chips

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19
Q

What does avoiding craved food do for binge?

A

It increases the likelihood of a binge?

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20
Q

What happens to a person during a binge and after it?

A

They dissociate or loss awareness during it and then feel shameful and remorseful afterwards

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21
Q

What is the onset age of bulimia nervosa?

A

Late adolescence or early adulthood

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22
Q

What percent of women have bulimia nervosa?

A

90%

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23
Q

What causes bulimia nervosa?

A

The person is overweight and they start to diet

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24
Q

What is bulimia nervosa comorbid with?

A

Depression, panic disorders, anxiety, substance abuse

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25
Q

How do the suicide rates of bulimia nervosa compare to the general population and anorexia nervosa?

A

They are higher than the general population but are much lower than in anorexia

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26
Q

What does the BMI/weight look like in people with bulimia nervosa?

A

Normal BMI or are overweight

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27
Q

What are the three medical sequelae/consequences of bulimia nervosa?

A
  1. Health complications
    - unstable weight
    - electrolyte weight
    - dental problems
    - cardiac problems
  2. Hospitalization
  3. Death
    - arise from complications
    - mortality rate of 4%
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28
Q

What is the recovery rate of bulimia nervosa?

A

75%

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29
Q

What does the recovery rate look like in bulimia nervosa?

A

What does recovery look like though? No longer purge but still binge?

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30
Q

What percent of people remain fully symptomatic?

A

10-20%

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31
Q

When are poorer outcomes of bulimia nervosa predicted?

A

When depression and substance abuses are comorbid

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32
Q

What helps improving outcomes of bulimia nervosa?

A

Early interventions

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33
Q

What is binge eating disorder caused by?

A

Obesity and history of dieting

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34
Q

Do all obese people meet criteria for binge eating disorder? If not, what makes people qualify?

A

No (2-25% of obese people qualify) – must report binge eating episodes and a feeling of loss control over eating to qualify

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35
Q

What are risk factors of binge-eating disorder?

A

Childhood obesity, early childhood weight loss attempts, being taunted about your weight, low-self concept, depression, childhood physical or sexual abuse

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36
Q

What percent of people recover from binge-eating disorder?

A

About 60%

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37
Q

What eating disorder is the most common and lasts the longest of the three disorders?

A

Binge-eating disorder – lasts 14.4 years

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38
Q

Compare the body weight of anorexia nervosa, bulimia, and binge eating disorders

A

AN: Low
BN: Normal or overweight
BED: Usually overweight or obese

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39
Q

Compare the fear of weight gain of anorexia nervosa, bulimia, and binge eating disorders

A

AN: Yes
BN: Yes
BED: No

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40
Q

Compare the body image of anorexia nervosa, bulimia, and binge eating disorders

A

AN: Distorted
BN: Overconcerned with weight
BED: May be unhappy with weight

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41
Q

Compare the binge eating of anorexia nervosa, bulimia, and binge eating disorders

A

AN: Maybe
BN: Yes
BED: Yes

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42
Q

Compare the purging of anorexia nervosa, bulimia, and binge eating disorders

A

AN: Maybe
BN: Yes
BED: Yes

43
Q

Compare the use of non purging methods to avoid weight gain for anorexia nervosa, bulimia, and binge eating disorders

A

AN: Yes
BN: Yes
BED: No

44
Q

Describe the rates of the three eating disorders in men

A

Anorexia - 5%
Bulimia - 20%
Binge eating - 50%

45
Q

Describe the rates of the three eating disorders in women

A

Women:
Anorexia - 95%
Bulimia - 80%
Binge eating -50%

46
Q

What percent of men and women receive treatment for binge eating disorders?

A

50%

47
Q

Compare the prevalence of anorexia and bulimia

A

AN: 0.5%-2%
BN: 1-3%

48
Q

Compare the sex ratio of anorexia and bulimia

A

AN: 10-20 –> females to males
BN: 10:1 –> females to males

49
Q

Compare the personality traits of anorexia and bulimia

A

AN: Greater harm avoidance, persistence, conscientiousness, perfectionism
BN: Greater novelty seeking, negative emotionality, social insecurity, feelings of ineffectiveness, stress reactivity

50
Q

Compare the associated clinical features of anorexia and bulimia

A

AN: Compulsivity, overcontrol
BN: Affective dysregulation, impulsivity, undercontrol

51
Q

What are the two main difference between Binge eating disorder and Anorexia?

A
  1. Absence of weight loss in binge eating disorder

2. Absence of compensatory behaviors in binge eating disorders

52
Q

What are biological factors of bulimia?

A
  • Genetic factors

- Disturbances in serotonergic and noradrenergic systems

53
Q

What are psychological factors of bulimia?

A
  • Negative self evaluation, low self-esteem

- Rigid cognitive style, all or nothing thinking

54
Q

What are social factors of bulimia?

A
  • Cultural norms, emphasis on thinness as the ideal body shape
  • Certain sports equate body size with ability to succeed
55
Q

If you have bulimia how many times more likely would your sibling be diagnosed?

A

7-20 times

56
Q

What do mood disturbances do to a person with bulimia?

A

They are more prone to developing mood disorders such as depression and anxiety

57
Q

Why are women more vulnerable to eating disorders?

A

The perceptions we have of ourselves are more interpersonal

58
Q

What do family and twin studies support in eating disorders?

A

A genetic link

59
Q

What two eating disorders have a monozygotic concordance rate?

A

Anorexia and weight

60
Q

What behaviors are heritable in eating disorders?

A

Body dissatisfaction, desire for thinness, binge eating, and weight preoccupation

61
Q

What receptors function abnormally in patients with anorexia?

A

Serotonin

62
Q

What is serotonin related to in people with eating disorders?

A

Satiety

63
Q

What do people with anorexia and bulimia have low levels of?

A

Serotonin metabolites

64
Q

What causes low levels of serotonin metabolites of people with anorexia and bulimia?

A

Under active 5HT in anorexia and 5HT deficit in bulimia prevents sense of satiety

65
Q

What are effective medications for eating disorders? What is a reason for this?

A

Antidepressants that increase serotonin perhaps because major depressive disorder is comorbid with eating disorders

66
Q

What feelings is dopamine related to?

A

Pleasure and motivation

67
Q

What do patients with anorexia and people with eating disorders feel more positive and rewarded by seeing?

A

When viewing pictures of severely underweight women

68
Q

What behaviors are negatively reinforcing and why?

A

Restrictive eating a and excessive exercise are negatively reinforcing because reduce anxiety about weight gain

69
Q

What behaviors are positively reinforcing?

A

Feelings of self control brought about by weight loss

70
Q

What lead to excessive concerns a about weight?

A

Perfectionism and personal inadequacy

71
Q

What can environmental factors can lead to the diagnosis of anorexia?

A

Criticism from family and peers

72
Q

How is self-worth influenced in people with bulimia?

A

It is strongly influenced by weight and have low self esteem

73
Q

What does rigid restrictive eating trigger in bulimia?

A

It triggers lapses which can become binges while eating many “off-limit” foods

74
Q

How do people feel after binging?

A

Disgust with oneself and fear of gaining weight lead to compensatory behavior

75
Q

What how does purging make people feel short term compared to long term?

A

Reduces anxiety about weight gain and then negative feelings about purging lead to lower self esteem which triggers further binges

76
Q

What triggers binges?

A

Stress and negative affect

77
Q

What scale measures dieting and overeating especially for bulimia?

A

Restraint Scale

78
Q

Talk through the schematic of cognitive behavior theory of bulimia nervosa

A

Low self esteem–> dieting to feel better about oneself –> food intake is restricted too severely –> diet is broken –> binge –> compensatory behaviors to reduce fear of weight gain

79
Q

What does American society value in men compared to women?

A

Thinness in women and muscularity in men

80
Q

What has often preceded onset of an eating disorder in women?

A

Dieting

81
Q

What also predicts eating disorders in relation to sociocultural factors?

A

Body dissatisfaction and preoccupation with thinness

82
Q

What factors play a role in unrealistic expectations for body image?

A
  • Societal objectification of women
  • Unrealistic media portrayals
  • Overweight individuals are seen as lesser
83
Q

What factors are associated with decreased eating disorder symptoms?

A

Aging and changes in life roles (having a life partner or having children)

84
Q

In other cultures how is higher weight viewed?

A

It is a sign of fertility and healthiness

85
Q

As countries become more like Western cultures …

A

Eating disorders increase

86
Q

In what societies is bulimia more common?

A

Industrialized societies

87
Q

Name the seven diathesis factors in the diathesis-stress model for eating disorders

A
  1. Genetic factors
  2. 5HT dysregulation
  3. DA dysregulation
  4. Negative self evaluation
  5. All or nothing thinking
  6. Cognitive style
  7. Perfectionism
88
Q

Name the seven diathesis stress factors in the diathesis-stress model for eating disorders

A
  1. Family interactions
  2. Puberty
  3. Bullying
  4. Hospitalization
  5. Transitions, college
  6. Trauma
  7. Divorce
89
Q

What are mediating factors for eating disorder?

A

Age, opportunity, peers, environment, culture, treatment history

90
Q

What is the diathesis for vulnerability with anorexia nervosa?

A
  • Are you genetically related to someone who has anorexia?
  • Do you have dopamingergic dysregulation?
  • Are you young?
  • ## Are you being bullied?
91
Q

What personality characteristics impact eating?

A

Perfectionism, lack of interoceptive awareness, and negative affect predicted disordered eating

92
Q

If you have anorexia what does hunger feel like?

A

Nothing - you have lost perception of it

93
Q

What do people with eating disorders report higher rates of?

A

Childhood sexual and physical abuse

94
Q

Are reports of abuse specific to eating disorders?

A

No - the presence of abuse could be too general of a variable

95
Q

What are three ways anorexia nervosa can be treated?

A
  1. Hospitalization
  2. Medications
    - Serotonin-enhancing medications
  3. Psychological treatments
    - Family therapy
    - Psychodynamic psychotherapy
    - Cognitive-behavioral therapy
96
Q

What can antidepressants such as prozac and SSRIs promote?

A

Weight gain

97
Q

Where is treatment for bulimia typically offered?

A

Eating disorder clinic

98
Q

What are the immediate goals of treatment for bulimia?

A
  • Eliminate binge: purge patterns
  • Establish good eating habits
  • Eliminate the underlying cause of bulimic patterns
  • Eat as much as 6 times per day
99
Q

What are three types of treatment for people with bulimia? * go over the graph with someone

A
A. Psychological treatments 
- Cognitive behavioral therapy (CBT) 
- Interpersonal therapy (IPT) 
- Dialect behavior therapy (DBT or BT)
B. Medications + Inpatient Treatment Program 
- SSRIs 
C. Medications + Self Help Manual 
- SSRIs
100
Q

What does CBT teach for people with binge-eating disorder?

A

Teaches restrained eating through self-monitoring, self-control, and problem solving skills

101
Q

Is CBT more effective than medication?

A

Yes

102
Q

What is equally as effective as CBT?

A

IPT

103
Q

What do behavioral weight-loss programs do?

A
  • They may promote weight loss

- Do not curb binge eating

104
Q

How are eating disorders prevented today? List 3

A
  1. Psychoeducational approaches
    - Educate early about the dangers of eating disorders
  2. De-emphasize sociocultural influences
    - Dissonance reduction intervention to deeemphasize sociocultural factors
  3. Risk-factor approach
    - Healthy weight intervention to develop healthy weight and exercise programs