Eating disorders 2 Flashcards
what is the affiliation hypothesis with treatments?
clinicians go for their favourite treatment, only 35% report using the strongest therapy, lots of unevidenced based treatments
the most successful interventions focus on what?
maintenance factors
safety behaviours, cognitive patterns, emotional patterns, social maintenance, family accommodation, nutrition
2 studies implemented psychoeducation about dieting and disorders at ages 11-14. what was the result in both cases?
level of pathology got worse with Baronowski’s study in the short term and pathology worse in the long term for Carters study
what are the 3 equally effective treatments for adults with anorexia?
40 sessions of individual CBT-ED, 20-30 sessions of MANTRA, 20-30 sessions of SSCM
(all similar level of effectiveness to behaviour therapy and all involve changing eating behaviour)
AN-focused family therapy was most effective for children/adolescents with anorexia. What does this therapy involve?
non blaming, family starts by taking control of the childs eating then moves to giving control back and finishes with relapse prevention. helps give the parents initial control and get the child to eat
what is the effective treatment for adults/adolescents with binge eating disorder?
16-20 sessions of group of individual CBT
what is the effective treatment for adults with bulimia?
16-20 sessions of individual CBT (guided self help CBT first)
what is the effective treatment for children/adolescents with bulimia?
family therapy for BN, CBT as a second line therapy
what treatments are advised for atypical cases?
use the therapy recommended for the most similar full syndrome e.g. atypical BN use CBT-ED
what is the key element to treatment and why?
start with FOOD
nutrition/exposure to foods has physical, cognitive, emotional benefits that helps eliminate fear and allow the person to think straighter
when is it best to use in and day patients (intensive treatment) for anorexia?
stage 1 in treatment to tarry weight gain and cognitive change prior to outpatient evidence based therapies
what are some weak treatments that are no longer recommended?
SSRIs at high doses for bulimia
novel antipsychotics for anorexia
neuromodulation
leukotomy
transcranial stimulation methods seem to reduce depression slightly but evidence yet that this works =
neuromodulation
cutting fibres in frontal lobes to provide slight relief for chronic anorexia with extreme OCD =
leucotomy
reduces impulsive behaviours in binge eating disorder and bulimia but little change in core pathology, limited evidence for anorexia = which therapy?
dialectical behaviour therapy (DBT)
a therapy that works for bulimia but slower and less effective than CBT =
interpersonal therapy
what therapy is effective for anorexia but needs replicating in other countries?
focused psychodynamic approaches (FIT)
list the psychological therapies with little evidence so far
mentalisation based therapy
acceptance and commitment therapy
mindfulness based approaches
family therapies not eating focused
how much does recovery rate drop by when therapy is not followed by the book?
from 50% to 15%
what is the recovery rate for treating non-underweight cases compared to underweight cases?
50% = non underweight, 30% underweight
what does CBT_ED focus on?
perfectionism
low self esteem
need for control
why are treatments for obesity not very successful?
we live in a toxic environment!! obesity is stubborn
what can we do about obesity?
keep trying due to huge health and quality of life costs
political and social changes (sugar tax)
lifestyle coaching
what is currently the most effective long term route to weight loss?
bariatric surgery
