Eating Disorders Flashcards
AN, DSM IV criteria
A. body weight < 85% of expected for height
B. patho fear of being fat even though they’re underweight
C. denial (health risks)/distortion (shape/weight)/undue influence (self-eval)
D. amenorrhea
AN, LP rates
females = 0.3-0.9% males = 0.05%
psychiatric d/o w/ lowest base rate of all
AN: AAO
mid- to late-adolescence
typically follows a period of restrictive dieting or weight loss (prodrome)
earlier AAO = worse prognosis
AN: chronicity? re: prognosis?
chronic, lifelong
prognosis worse if older, delayed initial tx, and lower BMI @ outset of tx
what % of Px’s experience full recovery? what % go on to have a long-term course?
46% full recovery
20% long -term
mortality rates and common causes of death for AN
5-10% (doesn’t include suicide)
cardiac arrest (and other cardio complications); electrolyte imbalance
suicide attempt by subtype of AN? of the Px’s who die from AN, what proportion die by suicide?
purging subtype more likely to attempt suicide (impulsivity)
1 in 5 Px’s with AN die by suicide
besides SA, what else purging subtype more likely to do?
SI, engage in promiscuous sexual bx, affect regulation difficultes (again, highlights impulsivity)
AN: egosyntonic or egodystonic?
egosyntonic
As Px’s loose weight what happens to food preoccupation?
intensifies – positive feedback loop: low self-worth -> preoccupation with food/weight/shape -> restrict/diet -> loose weight -> reinforcing
side effects of being underweight?
sleep disturbance; irritability; decreased sex drive; medical consequences; preoccupation with food; freq somatic complaints; lack of eneergy; difficulties with re-feeding
most important thing to keep in mind with re-feeding
its an incredibly painful process; don’t minimize the Sx’s
briefly characterize the AN subtypes
restricting - habits, rules, ritualistic bx
purging - impulsivity, higer rates of substance use, more likely to have a Hx of overweight
do Px’s have to have been overweight at some point in the in lives to receieve the AN dx?
no
BN: LP for women, and ration between M and F
1-3%, 10:1 (F:M)
EDs, changes from DSM IV to DSM V
generally, not all that different;
BED is its own dx
probably moving purging d/o and NED to “further study” section;
feeding d/o’s from child d/o’s section are integrated into easting d/o – now possible for adults to receive dx
which is the most common? AN, BN, or BED
BED
AN; criteria changes in DSM 5
A. “refusal” is out
B. same
C. same
D. removed this criteria
why did they remove the amenorrhea criteria?
studies showed no difference in clinical presentation between F’s who met criteria D and F’s who met A-C but not D
subtypes of AN
restricting purging
DSM criteria for BN
All 5 of the following:
A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
(1) eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances
(2) a sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)**
B. Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise
C. The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for 3 months.
D. Self-evaluation is unduly influenced by body shape and weight.
E. The disturbance does not occur exclusively during episodes of Anorexia Nervosa.
