Eating Disorders

Question 1

AN, DSM IV criteria

Answer 1

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

Question 2

AN, LP rates

Answer 2

females = 0.3-0.9%
males = 0.05%

psychiatric d/o w/ lowest base rate of all

Question 3

AN: AAO

Answer 3

mid- to late-adolescence

typically follows a period of restrictive dieting or weight loss (prodrome)

earlier AAO = worse prognosis

Question 4

AN: chronicity? re: prognosis?

Answer 4

chronic, lifelong

prognosis worse if older, delayed initial tx, and lower BMI @ outset of tx

Question 5

what % of Px’s experience full recovery? what % go on to have a long-term course?

Answer 5

46% full recovery

20% long -term

Question 6

mortality rates and common causes of death for AN

Answer 6

5-10% (doesn’t include suicide)

cardiac arrest (and other cardio complications); electrolyte imbalance

Question 7

suicide attempt by subtype of AN? of the Px’s who die from AN, what proportion die by suicide?

Answer 7

purging subtype more likely to attempt suicide (impulsivity)

1 in 5 Px’s with AN die by suicide

Question 8

besides SA, what else purging subtype more likely to do?

Answer 8

SI, engage in promiscuous sexual bx, affect regulation difficultes (again, highlights impulsivity)

Question 9

AN: egosyntonic or egodystonic?

Answer 9

egosyntonic

Question 10

As Px’s loose weight what happens to food preoccupation?

Answer 10

intensifies – positive feedback loop: low self-worth -> preoccupation with food/weight/shape -> restrict/diet -> loose weight -> reinforcing

Question 11

side effects of being underweight?

Answer 11

sleep disturbance; irritability; decreased sex drive; medical consequences; preoccupation with food; freq somatic complaints; lack of eneergy; difficulties with re-feeding

Question 12

most important thing to keep in mind with re-feeding

Answer 12

its an incredibly painful process; don’t minimize the Sx’s

Question 13

briefly characterize the AN subtypes

Answer 13

restricting - habits, rules, ritualistic bx

purging - impulsivity, higer rates of substance use, more likely to have a Hx of overweight

Question 14

do Px’s have to have been overweight at some point in the in lives to receieve the AN dx?

Answer 14

no

Question 15

BN: LP for women, and ration between M and F

Answer 15

1-3%, 10:1 (F:M)

Question 16

EDs, changes from DSM IV to DSM V

Answer 16

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

Question 17

which is the most common? AN, BN, or BED

Answer 17

BED

Question 18

AN; criteria changes in DSM 5

Answer 18

A. “refusal” is out

B. same

C. same

D. removed this criteria

Question 19

why did they remove the amenorrhea criteria?

Answer 19

studies showed no difference in clinical presentation between F’s who met criteria D and F’s who met A-C but not D

Question 20

subtypes of AN

Answer 20

restricting purging

Question 21

DSM criteria for BN

Answer 21

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.