Eating disorders Flashcards
What are the two key factors to note about the diagnostic criteria for ANOREXIA NERVOSA (AN)?
- Undue influence of shape/weight on self-evaluation
2. Don’t recognise the problem they have
What are the two subtypes of ANOREXIA NERVOSA (AN)?
- Restricting type (AN-R)
2. Binge eating/purging (AN-BP)
Of ANOREXIA NERVOSA (AN) and BULIMIA NERVOSA (BN), in which condition do people experience a ‘subjective binge’?
ANOREXIA NERVOSA (AN)
What re the psychological factors associated with ANOREXIA NERVOSA - RESTRICTED type (AN-R)
- Perfectionism
- Harm avoidance (ask avoidance)
- Feeling of ineffectiveness
- Inflexible thinking
- Socially inhibited
- Overly restrained emotional response
- Some overlap with ASD
What are the clinical presentation features of signs of ANOREXIA NERVOSA - RESTRICTED type (AN-R)
- Gradually eliminating food
- Food rituals
- Preoccupation with food
- Ignoring hunger cues
- Baggy clothes to hide body
What are some physical effects of ANOREXIA NERVOSA (AN)?
- Lanugo-type hair
- Cardiac - heart stops after the fat there is used up
- Endocrine
- Gastro-intestinal
- Highest rate of death of any mental health condition
What are some cognitive changes in ANOREXIA NERVOSA (AN)?
- Mild Cognitive deficits - exec functioning
- Mostly improve with weight restoration
… can severely impact adolescent development
What are some key things about the diagnostic criteria of BULIMIA NERVOSA (BN)?
- Binge eating, large amount (ie it is not a ‘subjective binge’) - loss of control
- Does not occur exclusively during an AN episode
What is the duration threshold for eatin disorders, typically?
Once per week for 3 months
What rre the two subtypes of BULIMIA NERVOSA (BN)?
- Purging
2. Non-purging
What is something that frequently precedes BULIMIA NERVOSA (BN)?
Dieting
In what way is comorbidity different for BN and AN?
BN has substance abuse (probably associated with impulsivity)
Do people with BULIMIA NERVOSA (BN) recognise they have a problem?
Yep, unlike AN
but often don’t want to stop restricting, just binging
What are the two key diagnostic criteria for BINGE EATING DISORDER (BED)?
- NO REGULAR USE OF COMPENSATORY BEHAVIOURS
- Distress after binge eating
- Other things, like eating alone
What are some clinical features of BINGE EATING DISORDER (BED)?
Guilt/shame
Eating when not hungry
Eating for emotional control
What is OTHER SPECIFIED FEEDING OR EATING DISORDER (OSFED)?
Basically where you have clinically significant distress but doesn’t hit the criteria for AN/BN
What some subtypes things in OSFED
- ATYPICAL AN - all criteria met, but weight loss is not out of healthy range
- PURGING DISORDER (purging without the binging) - still focused on body shape/weight
- NIGHT EATING DISORDER
What is UNSPECIFIED FEEDIN AND EATING DISORDER (UFED), and when would you diagnose it?
It’s when there’s clearly something wrong clinically significant distress) but it doesn’t meet criteria for anything specific
Used when:
- clinician chooses not to specify why criteria are not met
- or presentations where there may be insufficient information to make a more specific diagnosis (e.g. in emergency room settings)
What is AVOIDANT RESTRICTIVE FOOD INTAKE DISORDER (ARFID), and what are its two key features?
A feeding disorder! (basically aversion to food)
- Failure to get enough energy due restricting food intake
- No evidence of disturbance to body image
What is PICA?
A feeding disorder in which people eat things that aren’t food
What is RUMINATION DISORDER, and what is the key things about it?
Essentially, bringing your food back up.
They key thing is - it doesn’t happen exclusively in the course of an eating disorder like AN, BN, BED or ARFID
What is DISORDERED EATING and what are some things about it?
A SUB-THRESHOLD pathology (ie not in DSM)
- Gateway behaviour to DSM grade ED
- Common in adolescence
What is ORTHOREXIA and what are some things about it?
A SUB-THRESHOLD pathology (ie not in DSM)
Basically, Karen Medbury
What is the key features of the Stice’s (2001) model of ED?
Pressure to be thin + thin-ideal internalisation
> > >
Body dissatisfaction
> > >
Dietary restrain + Negative affect
> > >
Bulimic symptoms
What are key features of Fairburn’s trans diagnostic model of ED?
- Dysfunctional scheme for self evaluation
- Core low self esteem
- Perfectionism
- Mood intolerance
What can we say about the aetiology of EATING DISORDERS (ED)?
Key risk factors:
- DIETING
- Personality factors - neuroticism, negative affect, perfectionism
- Body dissatisfaction
- Thinspo
- Perinatal factors
- Parental psychiatric factors
- Genetic factors
What are the correlates of EATING DISORDERS (ED)?
- Childhood abuse
- some family environs
- weight based criticism
hat do we know about gender and EATING DISORDERS (ED)?
- More females
But…
- 15% of gay men have ED
- 40% of men with ED are gay
What does the evidence say about the impact of family environment/parents on the likelihood of EATING DISORDERS (ED)?
Less influential than you would think
Non-shared environment is the key thing
How heritable are EATING DISORDERS (ED)?
40-60%
What do meta analyses say about serotonin transporter and EATING DISORDERS (ED)?
Yeah but nah
What did the GWAS studies say about EATING DISORDERS (ED)?
Maybe 1 sig locus of Chromosome 12, but also associated with psychiatric and metabolic factors
Maybe this means ED could be a metabolic thing?
What are the three layers in the EATING DISORDERS (ED) aetiology model developed by Garner and Garfinkel?
- Predisposing - Genetics, biological, sociocultural
- Precipitating - stressors
- Perpetuating
What is the best form of treatment for EATING DISORDERS (ED)?
Limited evidence for specific treatments, but FAMILY BASED treatment looks pretty good
Are EATING DISORDERS (ED) treatable ED?
Yep defo
When treating EATING DISORDERS (ED), what should you target first, behaviours or cognition?
Behaviours (surprisingly)
What are the two key thing to keep in mind about OTHER SPECIFIED FEEDING OR EATING DISORDERS (OFSED), particularly the ATYPICAL ANOREXIA NERVOSA subtype?
- The person may not be underweight (hard to detect)
But…
- The health consequences can be just as severe as for AN
