Eating disorders

Question 1

What are the advantages of behavioural programs for weight gain?

Answer 1

• Easy to design
• Control behaviours, set goals to gain weight
• Can measure progress

Question 2

What are the disadvantages of behavioural programs for weight gain?

Answer 2

• Need to hospitalise patients
• Patients don’t enjoy the treatment, feel controlled, angry
• Might not treat the cause of the anorexia
• Doesn’t instil intrinsic motivation to gain weight to become healthy

Question 3

What are the advantages of group treatment?

Answer 3

• More intense
• More therapists
• More time in therapy
• More understanding and support from other patients
• Cheaper than individual treatment

Question 4

What are the disadvantages of group treatment?

Answer 4

• Other patients reinforce their thoughts and validate ideas
• Might not work for introverted people
• Get competitive with other anorexic girls
• They feel responsible for each other
• Group makes anorexia normal

Question 5

Which DSM-5 diagnosis would be most appropriate for Holly?

Answer 5

• Bingeing and purging was her main priority -> BN
• If she is underweight, then possibly anorexia binge/purge type but she appeared to be normal weight
• Took up to 25 laxatives a day

Question 6

What are the challenges of establishing a therapeutic alliance with patients with AN?

Answer 6

Patient gets angry with the doctor, feels they are being forced and the doctor is the bad guy

Question 7

What are some of the medical, psychological and social problems associated with AN?

Answer 7

Osteoporosis
Infertility
Cardiac problems - slow heartbeat
Hairs all over body
Brain shrinks
Susceptible to infection

Depression
Helplessness

Isolation
Bullying

Question 8

When do AN patients need to be hospitalised?

Answer 8

When heartbeat is very slow and irregular, low blood pressure, electrolytes very low, severely malnourished.

Question 9

What are some treatments for AN?

Answer 9

Motivational Enhancement Therapy

• increase their motivation to change so they engage in therapy
• explore +/- of AN, consequences

CBT

• Stage 1: establish relationship, set goals
• Stage 2: target dysfunctional beliefs about food and weight e.g. perfectionism, mood
• Stage 3: prevent relapse
• Is effective, 2/3 finish 40 sessions, gained 7.5kg and maintained for 60 wks

Question 10

What did Sachdev et al. (2008) find about brains of anorexic people?

Answer 10

Less activity when looking at pictures of self but similar processing of pictures of others.

Question 11

What are the assessments for BN?

Answer 11

EDI-3: assesses behaviours and psychological dimensions e.g. body dissatisfaction, impulse regulation

EDE: semi-structured interview targeting restraint, shape concerns, eating concerns, weight concerns

Question 12

What are the best treatments for BN?

Answer 12

CBT-E

Question 13

What is the dual pathway model of BN?

Answer 13

Dietary restriction and negative affect contribute to binge episodes independently and together. The binges increase starvation and distress.

Question 14

What personal, family and societal factors protect against binge eating disorder?

Answer 14

Personal:

• high self-esteem
• positive body image
• critical appraisal of media images
• school achievement
• thin naturally

Family:

• connected
• no emphasis on weight, appearance

Society:

• acceptance
• social support

Question 15

What are the treatments for BED?

Answer 15

CBT, CBT-E (target cognitions that maintain problem), IPT (relationships, attachment), DBT to reduce self-harm -> psych treatments to prevent relapse, improve coping skills

SSRIs (increase serotonin), SNRIs show some promise for reducing impulsivity

Only 52% abstinent from bingeing after treatments