Eating disorders Flashcards
What is the Dual Pathway Model of BED/BN?
- binge eating episodes are triggered by dietary restraint and/or negative affect
- in return, binge eating episodes leads to further negative affect and dietary restraint, thereby increasing further likelihood of binge eating episodes
What is the possible aetiology of BED?
BIOLOGICAL: suggestions of moderate heritability; hormonal disturbances
PSYCHOLOGICAL: negative affect, emotional eating associated, ?cognitive deficits
SOCIAL: poorer family fning
What are some treatment approaches for BED?
- self help approaches
- CBT
- interpersonal psychotherapy
- behavioural weight loss
- pharmacological approaches
What is the CBT approach for BED?
- develop moderate eating plan
- increase physical activity
- achieve greater acceptance of body shape and weight
- overcoming barriers for change
- not as strict as CBT in BN
How effective is IPT in BED?
- highly effective in reducing binge eating and as effective as CBT
- discuss interpersonal instead of intrapsychic problems
How is behavioural weight loss used in BED?
- emphasis on weight loss by restricting caloric intake and increasing activity
- research done by obesity researchers, not eating disorder specialists
What are the pharmacological approaches towards BED?
- antidepressant medications supported in the short term
- anti- convulsance topiramate (topamax)- reduces appetite, but there are a lot of side effects
Compare CBT and IPT in BED
- CBT is better post treatment
- at 1 year- follow up, CBT and IPT are comparable in results
Compare CBT & IPT in BN
- CBT is better than IPT post treatment
- CBT and IPT are just as good as one another at 1 - year follow- up
What is the DSM-V Criteria for BED?
CRITERION A: Recurrent episodes of bingeing; characterised by:
- eating in a discrete period (2 hours) amounts that is more than what most people would eat
- sense of LACK OF CONTROL
CRITERION B: Binge eating associated with:
- eating rapidly
- eating until uncomfortable
- eating large amounts when not hungry
- eating alone
- feeling disgusted
CRITERION C: Marked distress from binge eating
CRITERION D: Occurs once per week for 3 months
CRITERION E: Not associated with recurrent compensatory behaviours
What is the epidemiology of BED?
Prevalence:
- 50/50 for F/M
- 3-5% lifetime prevalence
What are some physical and emotional ramifications of BED?
- most prominent physical issue is OBESITY
- mood disorders, anxiety disorders, substance use and personality disorders common
What is the concern with obesity in BED?
- increases heart disease, HTN, diabetes, stroke and cancer
- obesity stigma
- risk factors for dementia
- associated with cognitive deficits, especially executive function
What did the IOWA Gambling task suggest about obese individuals?
- that there is reduced executive function as they were unable to identify the pattern of gambling
Which individuals did the worst on the IOWA Gambling task?
- Individuals with VT Lesions
- obese individuals
- AN
- Substance use
- Healthy individuals
What are the 7 different eating disorders?
- PICA
- Rumination Disorder
- Avoidant/ Restrictive Food intake disorder
- Anorexia Nervosa
- Bulimia Nervosa
- Binge eating disorders
- Other specified or eating disorder
What is the DSM-V Criteria for AN?
CRITERION A: Restriction of energy relative to requirements, leading to low BW (bmi </= 18.5; weightloss leading to maintenance of body weight less than 85% of expected; voluntary)
CRITERION B: Intense fear of gaining weight / becoming fat, or PERSISTENT behaviour to avoid weight gain, even though underweight
CRITERION C: Undue influence of BW or shape on self- evaluation, or persistent lack of recognition of the seriousness of the current low body weight.
What are the sub-types of AN?
- RESTRICTING TYPE: does not regularly engage in binge eating or purging behaviour
- BINGE-EATING/PURGING TYPE: person regularly engages in binge eating or purging behaviour
What are the effects of AN?
- ? reduced cogntive deficits
- mood intolerance
- thinned hair
- low BP, low HR, arrhythmias
- anaemia
- weakened muscles and joins
- constipation/bloating
- electrolyte imbalances
- kidney failure
- OP
- ammenhoria, bone loss
- easily bruise, dry skin, hair over body
What is the aetiology of AN?
BIOLOGICAL FACTORS: suggestion of genetic vulnerability
PSYCHOLOGICAL FACTORS: low self- esteem, low executive fn, dysfnal thinking, perfectionism, need for control
SOCIAL: family, peers, cultural
What is the cognitive model of AN? (Garner & Bemis, 1986)
- individuals fearful of gaining weight and relentless pursuit of thinness
- lose individuals to relieve distress and achieve self- control
- Maintained by DISTORTED INFORMATION PROCESSING: selective abstraction, dichotomous thinking, assessing self- worth solely in terms of shape and weight and ability to control
What is the schema model of AN?
- specific KNOWLEDGE STRUCTURE OR KNOWLEDGE of the self
- suggests that ED individuals have ATTENTIONAL BIASES TOWARDS WEIGHT, SHAPE AND FOOD STIMULI
What is the transdiagnostic theory of EDs?
There are issues overlapping in the EDS such as undue concern with body shape and weight
That there are specific maintaining processes in EDs:
- low self esteem
- interpersonal issues
- mood intolerance
- clinical perfectionism
What are the different approaches to treatment in AN?
- refeeding
- motivational interviewing
- behaviour therapy
- CBT
- cognitive remediation therapy
- IPT
- Maudsley Therapy
- Medication
