Eating Disorders Flashcards
Anorexia Nervosa is characterised by…
Excessive fear of gaining weight
The DSM5 says someone with AN must be at least ….% of the typical body weight for their size
<85%
Amenorrhea is
an abnormal absence of menstruation.
People with AN have a body image that is
disturbed /distorted
May involve three behaviours:
purging
restricted food intake
excessive exercise
Binge eating is
Eating an unusual amount of food in a discrete period. High caloric intake.
Bulimia nervosa:
In terms of affect and control, binge eating is followed by
negative affect
a sense of lack of control
Bulimia nervosa:
Binge eating –> negative affect –> ?
Compensatory behaviour e.g. purging, abusing laxatives, excessive exercise
To meet criteria for BN, one must binge … time/s a week for … months
one time a week for three months
A binge eating disorder is characterised by
binge eating with little or no compensatory behaviour
In terms of size, those with a binge eating disorder are often
overweight
To meet criteria for a binge eating disorder one must binge … a week for … months
one time a week for three months
Prevalence of total eating disorders are
2-3%
Anorexia prevalence is
0.5% lifetime prevalence (over an entire lifetime only .5% will meet criteria.
Bulimia prevalence is
1-3% lifetime (over an entire lifetime only 1-3% will meet criteria).
Sex distribution: …% of people with AN are females
95%
There have been suggestions that a male equivalent for eating disorders are
body builders, long distance runners, who show a lot of similarities to eating disorders e.g. abusing drugs like steroids, self-esteem and self-worth tied up in their weight.
Eating disorders in general is a female’s disorder, with overall … - … times more females than males with an eating disorder
6-8 times more
Average age of onset for:
- AN
- BN
- BED
- AN = 16 years. Hardly any ONSET cases after mid 20’s
- BN = 18 years
- BED = similar to BN
Is a BED chronic or episodic?
Episodic and short-lived.
Anorexia chronic or episodic?
Lasts several years. Still somewhat a temporary disorder
…% of women no longer have an eating disorder after a decade or so, but often still show …….
75%, still show some symptoms.
Eating disorders have a high comorbidity with three disorders:
1) mood disorders e.g. …..
2) anxiety disorders e.g. …… and ….
3) personality disorders (two types- IMP)
1) mood disorders e.g. depression
2) anxiety disorders e.g. OCD and social phobia (negative evaluation)
3) Personality disorders e.g. restrictive types like AN and obsessive compulsive personality disorder e.g.2. borderline personality disorder - more for those who lose control purging or binging
…% of those with AN will die from direct disorder complications e.g. starvation.
3%
Menstrual cycle trends for:
AN:
BN:
AN: cessation (Amenorrhea)
BN: menstrual irregularity
What are 4 medical complications from low weight (starvation)?
1) Low body temp.
2) Low heart rate/low blood pressure
3) Osteoporosis (a medical condition in which the bones become brittle and fragile from loss of tissue, typically as a result of hormonal changes, or deficiency of calcium or vitamin D.)
4) Lanugo growth: a soft, fine white hair that covers body in an attempt to insulate due to low fat
What is a heart problem that can occur due to starvation?
Cardiac arrhythmias: Improper beating of the heart, whether irregular, too fast or too slow.
5 Medical problems from BN?
1) tooth decay or loss
2) reducing gums
3) kidney disease
4) internal bleeding
5) gastrointestinal disorders e.g. Crohn’s disease (caused from weight loss) -infection of bowel
A social factor in eating disorders is social attitudes to thinness. Has this changed over time?
yes. Being larger used to be sign of wealth and that ideal changed 50 years ago. Twiggy model embodiment of thin ideal. Shift in ideal coincides with increase in eating disorder.
Bulimia is / is not culturally bound?
is, bulimia has a strong western culture influence.
SES and eating disorders?
Eating disorders more commonly related to high SES, more affluent families (stronger drive for thinness)
How much evidence has there been than media is to be blamed for eating disorders?
Has only been some anecdotal or circumstantial evidence. But correlation is not causation. e.g. negative connotations of being overweight, thin models, pressure to be thin.
What is the theory (flow chart) behind the media ‘causing’ eating disorders?
exposure to thin ideal –> body dissatisfaction –> eating disorder
What two styles of studies have been done on media ‘causing’ eating disorders?
1) longitudinal: some support
2) experimental: found that exposure to thin models led to greater body dissatisfaction and negative affect
What is rule violation or abstinence violation?
The black and white mentality that ‘well i’ve broken my diet I may as well binge’
What do clinical psychologists find fascinating about anorexia cases?
Very interesting talking to <1% of the population that can successfully lose weight. Something different about these people to exercise so much control and restraint.
What are six general psychological factors that will increase someone’s risk of having an eating disorder?
1) body image dissatisfaction (includes perceptual/cognitive distortions e.g. perceiving self as overweight)
2) overconcern with weight and shape
3) perfectionism
4) general negative affectivity (depression/anxiety/obsession. Comforted by sense of control in food intake when everything else in life is a mess)
5) low self esteem
6) early menarche (explained in other card)
Why is early menarche a psychological risk factor?
Girls who start puberty earlier than other girls are more at risk- you put on weight in puberty naturally, those who are earlier than their cohort may increase risk of feeling more self-conscious
Personality FACTORS involved in eating disorders are:
1) perfectionism (especially in restrictive types like AN)
2) negative affectivity (neuroticism)
3) impulsivity (loss of control for binge eaters).
Effects of family factors on eating disorders is
small, mixed evidence. Some nonspecific factors may contribute such as parent criticism/overprotection/heavy focus on weight
WHAT IS the transdiagnostic model of eating disorders?
General model of all eating disorders and what binds them together.
IMPORTANT TO MEMORISE THIS MODEL!
CANT PASTE HERE. REFER TO PHONE SCREENSAVER
If Flossy has a sister (any relative) with bulimia nervosa and a cousin Mikhaela with AN, how many times more likely is she to obtain each of those disorders?
BN: 4 times more likely with relative
AN: 11 times more likely with relative
(strong heritability factor)
Genes for heritability of eating disorders overlap with genes for …. and ….
Probably result of ……. thats common.
depression and anxiety.
Probably result of neuroticism.
Twin studies suggest heritability contributes roughly to ….% of the variance
50%
Heritability of AN
Heritability of BN
AN: .50 - .75
BN: .30 - .90
Describe the three components involved in the biology of eating (comes under brain regions)
Impaired functioning of these in eating disorder:
1) Homeostatic system involved in regulation of weight and hunger.
2) Drive systems involved in motivations to eat/or restrict weight and links with memory and learning.
3) Higher-order mental processes involved in meaning of weight and conscious control over energy.
What is the homeostatic system?
Regulates body’s set point that is determined by the hypothalamus.
Damage to lateral hypothalamus leads rats to…
restrict eating
Damage to the ventromedial hypothalamus leads rats to…
overeat, often till death.
What is 5HT and how is it related to eating disorders?
They are serotonin receptors. Involved in satiety (fullness feeling), impulse control and mood. People with AN have 5HT abnormalities.
What is 5HIAA and how does it relate to eating disorders?
Its a serotonin metabolite and ppl with AN have reduced levels in cerebral spinal fluid (CSF).
Even after recovery from AN, there has been found to be increased/decreased binding potential of 5HT1a and increased/decreased binding of 5HT2a receptors
increased 5HT1a
decreased 5HT2a
(suggests complex relationship between biochemical serotonin factors)
Dopamine is involved in
the reward system/sensation seeking system (so related to binge eating or excessive exercise in eating disorders)
What are the dopamine levels like for people with eating disorders?
lower levels of dopamine metabolites found in cerebral spinal fluid.
Some evidence for increased/decreased D2 and D3 receptor binding in ventral striatum in AN
increased
There are abnormalities in what gene for people with AN?
DRD2 gene. (process is polymorphism of that gene).
