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Worst EXAM 2 > Eating Disorders > Flashcards

Eating Disorders Flashcards

1
Q

Give 3 Examples of Self-Destructive Behaviors

A

Eating Disorders & Disordered Eating

Self-harm behaviors

Suicidal thoughts & suicide

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2
Q

What are the 5 categories of eating disorders?

A

Anorexia Nervosa

Bulimia Nervosa

Eating Disorder Not Otherwise Specified

Binge Eating Disorder

Obesity

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3
Q

2 subtypes of Anorexia Nervosa

A

Restrictive Type

Binge-eating/Purging Type

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4
Q

2 subtypes of Bulimia Nervosa

A

Purging Type

Non-Purging Type

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5
Q

Epidemiology of Anorexia Nervosa

A

0.5% of population
1:10 or 1:15 male:female
Onset during mid-adolescence
Recovery rate is highly variable
Fewer than ½ recover and ⅕ remain chronically ill
Highest mortality rate of all eating disorders

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6
Q

Epidemiology of Bulimia Nervosa

A

1-3% prevalence rate
1:15 - 1:20 male:female
Onset occurs late adolescence and early adulthood
Higher recovery rate
More than ½ recover
Residual psychological symptoms decreasing over time

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7
Q

Epidemiology of Eating Disorder Not Otherwise Specified

A

Most commonly diagnosed

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8
Q

Epidemiology of Obesity

A

1/3 of adults are considered obese
African Americans have highest rates
Only 1/3 of adults have what is considered “normal weight”

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9
Q

What are the Diagnostic Criteria for Anorexia Nervosa? (4)

A

Refusal to maintain body weight at or above a minimally normal weight for age & height

Intense fear of gaining weight or becoming fat, even though underweight

Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight

Amenorrhea in postmenarchal females

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10
Q

Characterize the Restrictive Type of Anorexia Nervosa

A

Restrictive type: during current episode, person has not regularly engaged in binge-eating or purging behavior (self-induced vomiting or misuse of laxatives)

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11
Q

Characterize the Binge-Eating/ purging Type of Anorexia Nervosa

A

Binge-eating/purging type: During current episode, person has regularly engaged in binge-eating or purging behavior (self-induced vomiting or misuse of laxatives)

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12
Q

What are the 5 Diagnostic Criteria for Bulimia Nervosa

A

Recurrent episodes of binge eating

Recurrent inappropriate compensatory behavior in order to prevent weight gain

The binge-eating and inappropriate compensatory behaviors occur, on average, at least twice a week for 3 months

Self-evaluation is unduly influenced by body shape and weight

The disturbance does not occur exclusively during episodes of AN

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13
Q

What are the 2 characteristics of binge eating in Bulimia Nervosa?

A

Eating in a discrete period of time, an amount of food that is definitely larger than most people would eat during a similar period of time and under normal circumstances

A sense of lack of control over eating during the episode (a feeling that one cannot stop or control what or how much one is eating

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14
Q

Describe Purging Type of Bulimia Nervosa

A

Purging type: Person regularly engages in self-induced vomiting or the misuse of laxatives, diuretics or enemas

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15
Q

Describe Non-Purging Type of Bulimia Nervosa

A

Person uses other inappropriate compensatory behaviors: fasting or excessive exercise, but does not regularly engage in self induced vomiting or the misuse of laxatives or enemas.

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16
Q

What are Eating Disorder Not Otherwise Specified ?

A

For disorders of eating that do not meet all criteria for any specific disorder.

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17
Q

What are the diagnostic Criteria for Eating Disorder Not Otherwise Specified ? (4)

A

All AN criteria except: has regular menses and current weight is in normal range

All criteria for BN met except binge eating and inappropriate compensatory mechanisms occur at a frequency of less than twice a week or for a duration of less than 3 months

Regular use of inappropriate compensatory behavior by an individual of normal body weight after eating small amount of food

Repeatedly chewing and spitting out, but not swallowing, large amounts of food

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18
Q

What are the diagnostic Criteria for Binge Eating Disorder (4)?

A
  1. Recurrent episodes of binge eating - on average 2 days/week for 6 months
  2. Binge-eating episodes are associated with three (or more) of the following:
    - Eating much more rapidly than normal
    - Eating until feeling uncomfortably full
    - Eating large amounts of food when not feeling physically hungry
    - Eating alone because of embarrassed by how much one is eating
    - Feeling disgusted with oneself, depressed or very guilty after overeating
  3. Marked distress regarding binge eating
  4. Not associated with regular use of inappropriate compensatory behaviors and does not occur exclusively during course of AN or BN
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19
Q

Characterize the binge eating episodes in the Binge Eating Disorder

A

Eating, in a discrete period of time, an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances

A sense of lack of control over eating during the episode

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20
Q

Define Overweight

A

Overweight is defined as a body mass index (BMI) in the 25 to 29 kg/m2 range

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21
Q

Define Obesity

A

Obesity is a BMI in excess of 30 kg/m2

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22
Q

What are the 3 categories of risk factors for eating disorders?

A

Biological

Sociocultural

Psychological

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23
Q

Name the 2 biological risk factors for eating disorders

A

Genetics

Neurochemicals

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24
Q

Name the 5 sociocultural risk factors for eating disorders

A

Negative parental attitudes about weight, shape and food (specifically maternal)

Homosexual males

Women in post-partum period

Exposure to the western ideal of thinness

Individuals involved in
physically-focused activities

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25
Q

Name 8 psychological risk factors for eating disorders

A

Using food to cope with negative emotions (difficulty coping with negative emotions)

Personality traits, such as perfectionism & rigid dichotomous thinking style

Individuals who diet, restrict food intake or have early digestive problems

Body dissatisfaction

Low self-esteem

Perceived pressure to be thin

Internalization of thin-ideal

Victims of sexual abuse

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26
Q

What are the General Consequences and the medical risk of eating disorders? (3)

A

Malnutrition
Critical changes in body weight
Effects on physiological and organ systems

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27
Q

what are some additional consequences for Anorexia Nervosa? (2)

A

Anemia & refeeding syndrome

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28
Q

what are some additional consequences for obesity? (4)

A

Diabetes,

Increased stress on joints/joint damage,

increased likelihood of stroke,

gallbladder disease

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29
Q

What are some psychological consequences of eating disorders?

A

Depression

Anxiety Disorders (OCD, GAD)

Social Phobia

Substance Use Disorders

Body Dysmorphic Disorder

Many of these illness transpire as a means to deal with and control negative affect and sensations

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30
Q

Name some physical warning signs of eating disorders

A

Rapid weight loss or frequent weight changes
Loss or disturbance of menstruation in girls and women and decreased libido in men
Fainting or dizziness
Feeling tired and not sleeping well
Lethargy and low energy
Signs of damage due to vomiting including swelling around the cheeks or jaw, calluses on knuckles, damage to teeth and bad breath
Feeling cold most of the time, even in warm weather
Components of the female triad

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31
Q

What are some psychological warning signs for eating disorders?

A

Preoccupation with eating, food, body shape and weight
Feeling anxious and or irritable around meal times
Feeling ‘out of control’ around food
‘Black and white’ thinking (e.g. rigid thoughts about food being ‘good’ or ‘bad’)
A distorted body image
Using food as a source of comfort (e.g. eating as a way to deal with boredom, stress or depression)
Using food as self-punishment (e.g. refusing to eat due to depression, stress or other emotional reasons)

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32
Q

What are some good questions to ask when you suspect an eating disorder with a pt?

A

What did you eat yesterday?

Do you think you are thin?

Are you satisfied with your eating habits?

Do you ever eat in secret?

Does your weight affect the way you feel about yourself?

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33
Q

Who would be the team members in a multidisciplinary treatment approach for pt with eating disorders?

A 
PT
OT
Hospitalist physician
Eating disorder specialist physician
Dietitian for nutritional therapy
Specially trained registered nurses and nursing assistants
Psychiatrist
Chaplain
Clinical social worker
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34
Q

What are some things we have to examine before starting treatment?

A

examine weight, rate of weight loss, medical stability and willingness to change

35
Q

Name 3 Treatment Options, as far as the setting they are placed in

A

Inpatient Hospitalization
Day Patient Hospitalization
Outpatient treatment

36
Q

Are there any Pharmacological Options?

A

There is no “cure” medication

Often used are:
Antidepressants & anxiety medications
Appetite Suppressants

37
Q

What are some psychological treatment options?

A

Cognitive Behavior Therapy (CBT)

Interpersonal Psychotherapy (IPT)

Family Therapy

Psychodynamic Therapy

Mindfulness-Based Therapies

38
Q

What are the 3 types of Mindfulness-Based Therapies?

A

MB-EAT: Mindfulness-based Eating Awareness Training

MBCT: Mindfulness-based cognitive Therapy

ACT: Acceptance and Commitment Therapy

39
Q

What might you do in PT as far as therapeutic exercises is concerned?

A

Bed Mobility
Abdominal strengthening
Postural training
Gait/Endurance training

40
Q

What are some outcome measures you can use in PT?

A

FIM
Walking Velocity Assessment
POMA (Tinetti)
TUG

41
Q

What are the 3 components of the Female Athlete Triad?

A

Energy Deficiency

No Menstrual Cycles

Low Bone Mass (Osteoporosis)

42
Q

What are the three opposite components of Female Athlete Triad /the healthy, ideal presentation?

A

Meeting energy needs
Normal menstrual Cycle
Strong Bones

43
Q

What are some causes of the Low Energy Availability?

A

Restricted dietary intake
Prolonged periods of exercise
Vegetarian
Limitation of types of food

44
Q

What are some risk factors that contribute to stress fractures?

A 
Low BMD
Menstrual disturbances
Late menarche 
Dietary insufficiency 
Genetic predisposition 
Biomechanical abnormalities
Training errors
Bone geometry
45
Q

What could cause Amenorrhea?

A

Low body weight and BMI*

46
Q

What is the clinical presentation of people with Eating disorders?

A

Bradycardia
Orthostatic Hypotension

Other findings
Cold/discolored hands and feet
Hypercarotenemia 
Lanugo hair 
Parotid gland enlargement
47
Q

What are some causes for eating disorders in elderly?

A

Aging physical appearance
Aging leads to feelings of being devalued & loss of sense of control
Loss of appetite due to medications

48
Q

What are the treatments that elderly with eating disorders would benefit from?

A

nutritional rehab

Also benefit from medical, psychological and pharmacological treatments

49
Q

When does the majority of bone mass form through our life?

A

Increases throughout childhood

More pronounced in pubertal years (85-90% of adult bone mass by 18)

50
Q

What age does bone mass peak and plateau at?

A

Peak at 20

Plateaus at 35

51
Q

What age does the bone mass start to decline at?

A

Decline occurs from 35 on with bone resorption exceeding bone formation

52
Q

What are the factors that influence bone health? (5 main)

A 
Genetic
          Body Composition 
Hormonal
           GH 
            Sex hormones 
Mechanical
Nutritional
Lifestyle 
            Smoking and alcohol 
            Physical Activity
53
Q

What is the relation between bone health and physical activity?

A

Necessary for the formation and maintenance of bone mass and strength

May be important in reducing the risk of OP and fracture

Period surrounding childhood and adolescent growth may represent a window of opportunity for exercise to maximize the achievement of PBM

54
Q

What type of exercise is best?

A

Dynamic loading at high strain magnitudes and high strain rates with unusual strain distribute (Tennis, volleyball, squash, track and field, gymnastics, ballet)

Sports without WB do not affect BMD

55
Q

Can exercise benefits be maintained?

A

Depends on uptake and maintenance of exercise

Continued exercise through adulthood is required to maintain effects from growing years

Establish habits young

56
Q

True/False

Genetics are the key factors in determining bone mass

A

True

While genetic factors play a key role in determining one’s bone mass potential, other hormonal and lifestyle factors will determine whether this potential is reached

57
Q

True/False

Osteoporosis can’t be prevented.

A

False

Maximizing bone mass in early years is important to reduce the risk of osteoporosis in later life

58
Q

What are some activities and behaviors recommended in the youth in order to optimize bone health?

A

High impact weight bearing exercise during the adolescent years, as well as healthy eating patterns and avoiding smoking and excessive alcohol will help maximize bone health

59
Q

True/False

Menstrual disturbances don’t contribute to bone loss.

A

False

Menstrual disturbances in female athletes contribute to bone loss and should be treated by addressing energy imbalances

60
Q

How can PTs contribute to promoting bone health in young females?

A

PT’s play role in promoting bone health in young females through participation in school activity and education programs and in their practice

61
Q

Define Self-Injurious Behavior

A

Intentional destruction of body tissue without suicidal intent and for purposes not socially sanctioned

62
Q

What are some examples of Injurious behaviors?

A

cutting, burning, biting, head banging, eye gouging, skin picking, or scratching, hair pulling

63
Q

What are the 3 major types of self injury?

A

Major Self Mutilation

Superficial or Moderate Self Harm

Stereotypical Self Injurious Behaviors

64
Q

What is Major Self Mutilation?

A

Bloody acts with permanent damage

Amputation of limbs or other appendages

65
Q

What is superficial or moderate Self Harm?

A

Causes pain but not permanent damage

Most common: Burning, cutting

66
Q

What is the Stereotypical Self injury behavior?

A

Monotonous, predictable

Prevalent in Autism and intellectual impairments

Easily overwhelmed or under stimulated, controls stress

67
Q

Why do people perform self-injurious behaviors?

A

They feel numb or dissociated with themselves
Reconnects them with their body

Maladaptive coping strategy

Testing out waters for a later suicide attempt

68
Q

What type of therapy is recommended for people who perform Self-Harm?

A

Behavioral therapy especially applied behavioral analysis for patients with mental deficits such as autism has been shown to be effective

Psychotherapy, various behavioral therapies, support groups

69
Q

Are there pharmacological options for self-harming people?

A

For clients who cause severe self harm while in an altered mental state due to psychosis, antipsychotic drugs are prescribed and can prevent further self harm by stabilizing the underlying psychiatric disorder

70
Q

What are the two newest and more promising types of therapy for self harming people?

A

2 new promising therapies: cognitive behavioral therapy and dialectical behavioral therapy
Both of these provided by skilled psychotherapists with training

71
Q

What should we be aware of when dealing with self-harm?

A

People who do this try and hide it.

We need to be emotional, sensitive, and nonjudgmental when addressing the situation

Self harm used to be labeled as a suicide attempt but now we know it is a coping mechanism or maybe a cry for help

72
Q

True/false

Most people who attempt suicide have a psychiatric and/or a substance abuse disorder
More likely to occur if both are present

A

True

At least 90 percent of people who commit suicide have a treatable mental illness (depression and other mood disorders)

73
Q

More Stats about Suicide (4)

A

More than 30,000 Americans commit suicide; 4 times that number make an attempt

4th leading cause of death for people between 18 and 65

3rd leading cause for adolescents

More than 50% of all suicides are caused by guns

74
Q

What are some differences between genders and suicide prevalence?

A

Men
Risk increases after the age of 55

Women
Risk decreases after the age of 55

75
Q

What are some differences between genders and suicide prevalence?

A 
Men
Use more violent means: 
Guns
Hanging
Men are 4 times more likely to complete

Women
Use less violent means
Pills
Cutting

76
Q

What population has the highest rate of suicide?

A

Caucasian males who live alone over the age of 65

77
Q

What are some things we should know about health care providers and suicide?

A

More than half of all people that attempt or commit suicide have seen a healthcare provider in the previous month who has failed to recognize the signals
This can happen because of the patients inability to communicate their emotional distress
They go in for general problems like malaise or fatigue and it is really a mental problem

78
Q

What are some things we should know about active duty military and suicide?

A

Active duty military rising rapidly
High rates of TBI’s and mental disorders
PTSD, depression, substance abuse coming home

79
Q

What are some things that we should be on a look-out for during therapy?

A

Clients who verbalize feeling helpless, hopeless, and worthless or have excessive guilt are a concern

Other cues: giving away beloved items, voicing a plan, becoming suddenly brighter in effect

Many clients send out distress signals that do not get heard

80
Q

What can we as PT can do about self harm people?

A

All providers can intervene and save someone’s life
Sensitive, nonjudgmental questioning and listening are essential to allow clients to feel safe to talk about feelings
Let them know you care, are worried about them, and want to make sure they are safe is a good place to start

81
Q

Do we ever ask patients if they have a plan to commit suicide?

A

Ask if they have a suicide plan

If answer yes, must determine if they plan to carry out and make immediate referral
Don’t leave them alone until help arrives

82
Q

Is there stigma toward self-harm people?

A

Many think the individual suffering from self-destructive behaviors are to blame for their own illness and should “just get better”

83
Q

Does the stigma associated with their problem affect Self-harm people?

A

Many sufferers have reported feeling too ashamed and afraid to seek help
Resulting in avoidance of support and treatment of their illness, in fear it will be discovered

84
Q

5 Take-Home points for the PT about Eating disorders and self destructive behaviors

A

There are many faces to an eating disorder.

Treatment for eating disorders requires an interdisciplinary approach.

Prevention, recognition and treatment of the components of the triad are important considerations when working with female athletes.

Suicide and self-harm are a rising problem and it is crucial we identify high risk behaviors and act accordingly.

PTs will encounter patients who suffer from self-destructive behavior and should be prepared to initiate the recovery process.

Worst EXAM 2 (4 decks)

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