eating disorders Flashcards
1
Q
prevalence of eating disorders during the COVID-19 pandemic
A
- Diagnostic incidence was 15.3% higher in 2020
compared with previous years - Steady increase throughout 2020
- The increase occurred solely in females between
10-19 years old. - Primarily anorexia nervosa
2
Q
eating disorders * In DSM-IV
A
- AN and BN formed distinct categories reflecting the increased
attention they had received from clinicians and researchers. - Eating Disorder - Not Otherwise Specified (EDNOS)
3
Q
eating disorders In DSM-5
A
- BED is distinct category
- Removed EDNOS and
replaced it with more
specific categories
4
Q
EDNOS from DSM-4 to DSM-5
A
- DSM-5 dropped the EDNOS description for new designations.
- Unspecified Feeding Or Eating Disorder
- can be used for any condition that causes clinically significant
distress or impairment but does not meet diagnostic thresholds. - can be used when there is insufficient information such as in
hospital emergency room situations. - The other broad category is “other specified feeding or eating
disorder.” - applies to atypical, mixed, or subthreshold conditions.
- includes a variety of conditions, including subthreshold BN and
subthreshold BED. - includes night eating syndrome, which is a repetitive tendency to
wake up and eat during the night and then get quite upset about it. - includes purging disorder - this is a form of bulimia that involves self
induced vomiting or laxative use at least once a week for a minimum
of six months in the absence of binge eating
5
Q
anorexia nervosa
A
- The term AN is a misnomer because most patients do
not lose their appetite or interest in food – they
become preoccupied with food. - Essential feature is that the individual refuses to
maintain a minimally normal body weight, is intensely
afraid of gaining weight, and exhibits a significant
disturbance in the perception of the shape or size of
her/his body.
6
Q
thinness and self esteem in AN
A
- The self-esteem of people with AN is closely linked to
maintaining thinness. The tendency to link self-esteem and
self-evaluation with thinness is known as over-evaluation of
appearance. - Among people with acute AN, lower body weight is
associated with increased self-esteem. - Individuals with anorexia nervosa overestimate their own
body size and choose a thin figure as their ideal
7
Q
Development of and Comorbidity in AN
A
- Typically begins in the early to middle teenage years,
often after an episode of dieting and exposure to life
stress. - The prevalence of anorexia among children and adolescents is
increasing. - Comorbidity is high.
- Men and women at risk for eating disorders are also prone to
depression, panic disorder, and social phobia (Gadalla, 2008). - Women were at substantially greater risk for mania,
agoraphobia, and substance dependence. - Substance use disorders
8
Q
AN and death rates
A
- AN death rates are
- 10x greater than general population
- 2x greater than patients with other psychological disorders
- Longitudinal investigation found mortality rate for AN is
5x higher than the rate for the general population
(Fichter & Quadflieg, 2016). - There is no other disorder that matches the mortality
risk inherent in AN
9
Q
bulimia nervosa
A
- Involves…
- episodes of rapid consumption of a large amount of food
(binge) accompanied by a lack of self-control - followed by compensatory behaviours (purging).
- Binge = eating excessive amount of food in < 2 hours
- Typically occur in secret
- May be triggered by stress
- Purge = vomiting, fasting, or excessive exercise
10
Q
characteristics of binge eating
A
- Binge episodes tend to be preceded by poorer than average
social experiences, self-concepts, and moods. - Stressors that involve negative social interactions may be
particularly potent elicitors of binges. - People with BN have high levels of interpersonal sensitivity, as
reflected in large increases in self-criticism following negative
social interactions. - Continues until the person is uncomfortably full (Grilo,
Shiffman, & Carter-Campbell, 1994). - Binge episodes are often followed by deterioration in self-
concept, mood state, and social perception
11
Q
Fat Talk: BN and Fear of Gaining Weight
A
- The focus on fear of becoming fat and negative
appraisals of the self for being fat are the focus of
research on a phenomenon known as fat talk. - Fat talk refers to the tendency for friends, particularly female
friends, to take turns disparaging their bodies to each other. - Both average weight and overweight target people were seen
as more likeable if they were depicted engaging in fat talk
(Barwick et al., 2012). - Fat talk seems to reflect a highly defensive and negative
sense of self
12
Q
Development of and comorbidity of BN
A
- Bulimia nervosa typically begins in late adolescence or
early adulthood. - Extreme body dissatisfaction was found among 7–8% of
both girls and boys in Nova Scotia. - these children were only in Grade 5
- The data suggests that children particularly at risk can be
identified at a fairly young age (Austin, Haines, & Veugelers,
2009). - Many people with BN are somewhat overweight before
the onset of the disorder and the binge eating often starts
during a dieting episode.
13
Q
Commonalities in AN and BN
A
- The diagnoses of AN and BN share several clinical features:
- Intense fear of being overweight
- Self-evaluation is unduly influenced by body/shape weight
- There are some indications that these may not be distinct
diagnoses but may be two variants of a single disorder. - Co-twins of people diagnosed with anorexia nervosa, for
example, are themselves more likely than average to have
bulimia nervosa (Walters & Kendler, 1994). - Temporal studies also identify diagnostic crossover.
- More than 18% with AN eventually develop BN, while
approximately 7% of those with BN eventually develop AN (see
Keel, Brown, Holland, & Bodell, 2012). 24
14
Q
Binge Eating Disorder
A
- BED is linked with impaired work and social functioning,
depression, low self-esteem, substance abuse, and
dissatisfaction with body shape (Spitzer et al., 1993;
Striegel-Moore et al., 1998). - Risk factors for developing BED include:
- childhood obesity,
- critical comments regarding being overweight,
- low self-concept,
- depression, and
- childhood physical or sexual abuse
15
Q
Biological Factors in EDs
A
- Genetics
- Little research on genes
- AN and BN run in families
- Overvaluation of appearance and body dissatisfaction appear
to be heritable (twin studies) - The brain: Hypothalamus
- Regulates hunger and eating.
- Lesions in animals shows that they lose weight and have no
appetite - Regulates hormones that are abnormal in people with AN
(e.g., cortisol). These abnormalities may result from
starvation and return to normal with weight gain
