Eating Disorders

Question 1

core features of AN

Answer 1

persistent restriction of food intake; intense fear of gaining weight disturbed body image

Question 2

core features of BN

Answer 2

recurrent episodes of binge eating; recurrent use of purging (vomiting most common) behs; self-eval influenced by weight/shape (youth w/ BN usually within 10% of expec. body weight)

Question 3

core features of BED

Answer 3

recurrent episodes of binge eating (diff from obesity)
- psych: tend to feel ashamed (try to conceal symptoms), binge eating often occurs in secret, usually triggered by neg affect, may also have lower self-esteem, higher lvl of dep mood

Question 4

physical characteristics of AN

Answer 4

prom. cheek bones, sunken eyes, dry skin and hair, sensitivity to cold, cardiac arrythmias

Question 5

psychological characteristics of AN

Answer 5

achievement-oriented (view weight loss as achievement), high need for approval, sensitive to criticism, value self control, weight gain seen as failure

Question 6

physical characteristics of BN

Answer 6

fatigue, headaches, swollen cheeks, eroded dental enamel and bruised knuckles (from self-induced vomiting), cramping, electrolyte imbalances, cardiac arrythmias, dehydration

Question 7

psychological characteristics of BN

Answer 7

impulsive, moody, think in absolute terms (black or white thinking)

Question 8

AN: DSM specific criteria

Answer 8

specify restricting type (dieting, fasting, or excessive exercise in past 3 months) OR binge-eating/purging type (use binge eating, purging in past 3 months)
- specify severity based on BMI

Question 9

BN: DSM specific criteria

Answer 9

recurrent episodes of binge eating + recurrent purging/other beh; both occur at least 1X/week for 3 months
- and self eval is heavily influenced by body shape/weight

Question 10

BED: DSM specific criteria

Answer 10

• recurrent episodes of binge eating, on avg, at least 1X/week for 3 months
• binge eating has 3+ features (rapid eating, eating till uncomfortably full, eating when not hungry, etc)
• marked distress assoc. w/ binge eating; no compensatory behs

Question 11

age diffs in AN, BN, BED

Answer 11

peak period of risk:
- AN: 14yrs and 18yrs
- BN: 14-19yrs
- BED: around 19yrs

Question 12

AN comorbidity

Answer 12

dep. and anx disorders most common; also OCD and SUDs
- higher suicide risk (more w/ death)

Question 13

BN comorbidity

Answer 13

dep and anx. disorders; also SUDs
- higher suicide risk (more w/ attempts)

Question 14

BED comorbidity

Answer 14

dep and anx disorders; also SUDs
- higher suicide risk

Question 15

etiology: bio

Answer 15

family/twin studies –> genetic component, higher among same sex female twins and female relatives; abnormal neurotransmitter/ hormone reg
- bio abnormalities result from ED behs, so contribute more to maintenance than onset

Question 16

etiology: individual/ psychological factors

Answer 16

assertion of control (over stressors); body dissatisfaction (very strong factor); perfectionism/OCD behs

Question 17

etiology: social fam/peers

Answer 17

family: focus on weight, dieting, achievement common, parent sub use and obesity, interactions w/ teasing, criticisms, etc

peers: focus on appearance, body weight/shape (ideals in cliques); may establish peer group norms
- peers influence on adol body dissatisfaction may be stronger than parents

Question 18

etiology: sociocultural

Answer 18

western emphasis on personal freedom, instant gratification, availability of food, cultural ideals of attractiveness & use of diet/exercise for weight loss link appearance to women’s success/ happiness
- a drive for thinness - ideals not attainable for many ppl, leads to dissatisfaction
- communication w/ peers/fam can be stronger than media

Question 19

intervention (4 pts)

Answer 19

• initially focus on restoring weight, and once figured out, LT goals used to resolve psych symptoms
• CBT most effective for BN, BED, but for AN, family approach may be best
• most treated outpatient, others need to stay in hospital. meds used but not initial choice –> w/ BN, SSRIs can be good
• team of professionals to make txtment plan. fam engagement may be needed (resolve fam probs, w/ younger children needed, have cooperation, reassure parents)

Question 20

course/outcomes of AN

Answer 20

<50% recover; 35% recovery and relapse; 20% chronic course
- mortality rate: 5-10%

Question 21

course/outcomes of BN

Answer 21

50%+ recover over several years; chronic course w/ remission and relapse common
- mortality rate: <1%

Question 22

course/outcomes of BED

Answer 22

up to 80% recover within 3-5 yrs; remission and relapse common

Question 23

sequence of risk factors pathway for BN/BED

Answer 23

pressure to be thin and thin body ideal –> body dissatisfaction (1 month)

body dissatisfaction –> dieting, neg affect (8 months);

dieting, neg afect –> ED onset (27 months)

*can spend long time in factors before dev an ED