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Eating Behaviour > Eating Disorders - Anorexia Nervosa > Flashcards

Eating Disorders - Anorexia Nervosa Flashcards

1
Q

What are the behavioural symptoms of AN?

A

A refusal to maintain a body weight normal for height and age

Usually less than 85% of what is expected

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2
Q

What are the emotional symptoms of AN?

A

Intense fear of gaining weight despite being underweight

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3
Q

What are the symptoms of AN?

A

Inability to see own thinness

Denial of the seriousness of the condition

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4
Q

What are the physiological symptoms of AN?

A

Loss of body weight and absences of periods for 3 consecutive months (amenorrhoea)

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5
Q

When is the usual onset of AN?

A

Adolescence

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6
Q

What % of cases diagnosed are female?

A

90

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7
Q

What are the 2 types of AN?

A

Restricting type

Binge/Purge type

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8
Q

Explain the restricting type?

A

They restrict their eating but do not binge or purge

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9
Q

Explain the binge/purge type?

A

They are regularly binging and purging with self induced vomiting or misuse of laxative or diuretics

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10
Q

Which type is bulimia?

A

Bing/purge type but are normally a healthy ish weight

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11
Q

What is the prevalence of AN?

A

90% females 10% males
1 in 200 adolescents
Most common in 15-17 year old girls

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12
Q

What are the associated risk factors?

A 
Hard working
High achieving
High need for approval 
Perfectionist
In a competitive environment
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13
Q

What % struggle long term?

A

25%

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14
Q

What % die within 5 years?

A

5%

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15
Q

What % recover within 10 years?

A

70%

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16
Q

What standard of attractiveness is an important contributory factor in developing AN?

A

Western standards

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17
Q

“Women portrayed as successful and happy are normally…….”

A

Very slim

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18
Q

Why do people copy celebrity thinness?

A

Attention with the celebrity status - retention - motivation with aspiring to be like them

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19
Q

Define self efficacy?

A

An individuals belief for their own capacity to execute behaviours necessary to produce specific performance attainments

The confidence in the ability to exert control over ones motivation, behaviour

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20
Q

What does the psychological explanation include?

A

Social learning with socio-cultural influences

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21
Q

What was Hoek’s aim?

A

To examine whether AN emerges in societies undergoing socio-economic transition

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22
Q

What was Hoek’s method?

A

Contacted a full range of community health and service providers with inpatient numbers for 84420
22 ppts were identified as probable incident subjects
They were interviewed and assessed by trained interviewers according to DSM IV
Research interviewer made a diagnosis but in any cases where there was uncertainties the case was discussed or re-interviewed by another researcher
Final diagnosis was a consensus diagnosis arrived by 2 members of research team

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23
Q

What was Hoek’s results?

A

11 of the 22 fulfilled the criteria
4/11 were restrictor
7/11 were purge type
11/11 were female
2/11 white - 9/11 were mixed - 0/11 were black
55% of them had been to college (10% island average)
7/11 women earned more than average for women their age
11/11 went abroad for 1 year or more to a western culture

24
Q

What were the 3 indicators established from Hoek 2005?

A

Extensive time abroad in western culture
Higher wealth
More educated
Mixed/white and no black

25
Q

What did Katzman find?

A

The women with a history of AN reported levels of perfectionism and anxiety
All viewed themselves as different from the norm
Women with AN were vulnerable to a triple threat to identity formation

26
Q

What was the triple threat to identity formation highlighted in Katzman?

A

They were mixed race - aspiring to fit into the mobile elite (white) and distancing themselves from the black population
Had the means for education and travel left them caught between modern and traditional constructs of femininity
They lived overseas and therefore struggled upon re-entry with the frustrations of what was possible within their island culture

27
Q

What were the conclusions of both Hoek and Katzman?

A

Socio-cultural factors appear to be associated with differential incidence rates
African Caribbean population of Curacao being overweight was more accepted than in white and mixed populations
The local norms enhanced resiliency to socio-cultural emphasis - protecting the black population from developing AN

28
Q

What were Becker’s aim?

A

Evaluate the impact of the recent introduction of Western TV on disordered eating among ethnic Fijians

29
Q

What was the method of Becker?

A

Prospective cross-sectional
Compared before and after western TV exposure and interviewed
Subjects answered a 26 item eating attitude test (EAT 26) including questions about binging and purging - score of 20 or more was considered significantly high
Also responded to a number of questions concerning household ownership of TV and frequency of viewing
Those with b/p tendencies were asked to respond to a semi-structured interview
In addition, narrative data was collected through open ended, semi-structures interviews from a subset of 30 ppts with a range of eating attitudes - questions probed attitudes and practices concerning diet and weight relative to culture and exposure to TV

30
Q

What were the results of Becker?

A

The % of subject with high EAT 26 scores was 12.7% in 1995 and 29.2% in 1998
% of subjects with self induced vomiting to control weight was 0% in 1995 but 11.3% in 1998
Self reported binge-eating was 7.9% 1995 and 4.6% in 1998
People who lived in houses with TV were 3 x more likely to have high EAT 26 scores
83% responded saying they felt the TV had influenced their friends and or themselves to feel differently and change their body shape
77% reported that TV had influenced their body image
Those with high EAT 26 score were more likely to report the TV’s influence on their body shape

31
Q

What were Becker’s conclusions?

A

Naturalistic experiment suggests a negative impact of TV upon eating attitudes and behaviours in media naïve populations
Western media may have profoundly negative impact upon body image and disordered eating attitudes and behaviours even in traditional cultures were it isn’t prevalent

32
Q

What are the limitations of Becker?

A

Successive samples were not fully comparable (not same people) however it was an excellent matching pairs design (measured on age, grade levels, schools, BMI, IQ, ethnicity, gender)
Those who reported disordered eating experienced it before?

33
Q

What are the key assumptions of the Cognitive explanation?

A

Thinking processes that occur between a stimulus and response are responsible for the resulting emotion and behaviour

34
Q

What are the 3 faulty cognitions that result in psychological abnormality?

A

Negative automatic thoughts
Cognitive biases
Disordered schemas

35
Q

According to the cognitive explanation a person with AN is someone who is preoccupied with?

A

The way they look / think they look
Often perceiving themselves as unattractive and overweight
Distorted perception of body image
Anxious thoughts about the future and not being attractive/good enough
Tendency of thinking obsessively unwanted / disturbing thoughts that take over and constantly repeat

36
Q

How are the anxieties dealt with?

A

Increased desire for control - food intake = by doing so they feel control and self-worth which reinforces restricted eating and weight loss
Hunger is perceived as a threat to control and therefore a feeling of hunger negatively reinforces restricted eating

37
Q

What was the aim of Slade and Russell?

A

To see if there was a significant difference between the way that people with AN and a control group estimate their own body width and the height and width of other objects

38
Q

What did Slade and Russell find?

A

People with AN overestimated the width of their bodies by 25-55% whilst the control group estimate body width accurately
No difference between the people with AN and control group for estimations of the height and width of other objects
Strong link between AN and distorted body image

39
Q

What did Cooper and Turner find?

A

Looked at the emotional aspects of body self-perception in AN patients using standard questionnaire the Eating Disorder Belief Questionnaire
AN reported more negative beliefs about themselves than dieters or CG
They were more likely to believe that acceptance from other was conditional on their body type and more likely to base their own self esteem on body type

40
Q

Why does the cognitive explanation have good explanatory power?

A

Can explain why only some dieters develop AN

We are all exposed to the ideals of thinness but only those with faulty belief systems are affected

41
Q

What are the practical applications for the cognitive explanation?

A

Potentially leads to useful therapies - enabling clients to tackle self-defeating statements
Cognition should be the focus of therapy
CBT in particular involved changing the way people think
However Wilson found that whilst CBT was most effective AN treatment it was still limited in effectiveness and did not help all

42
Q

What are the cause and effect issues?

A

Although we know most ED sufferers have strong cognitive biases:
It is unclear whether these biases exist before the onset and thus play a part in their development
Alternative view these cognitive biases only develop after onset in which case they cannot be causal factor

43
Q

What did Sepulveda, Botella and Leon MA find?

A

AN patients distort or feel dissatisfied than the CG (weighted mean of 0.545)
Effect size for bulimia group was 1.019

44
Q

What are the main assumptions of Biological/Neural explanations for AN?

A

Serotonin is a brain neurotransmitter that is involved in many behavioural functions
The serotonin system has been implicated in personality traits associated with ED such as:
Perfectionism
Anxiety
Depression

It is also part of the neurotransmitter system of the hypothalamus that controls feeding behaviour - it is likely to be involved in the causes of AN

45
Q

Who was the serotonin hypothesis developed by?

A

Kaye et al

46
Q

What does the disturbance of serotonin in neural activity contribute to? KSH BO

A 
Disturbance of serotonin neural activity exists before onset contributing to:
Anxious 
Obsessional 
Perfectionist traits
All of which correlate strongly with AN
47
Q

What are the 2 types of serotonin receptor in the brain? KSH BO

A

Excitatory (ON) 5HT2A

Inhibitory (OFF) 5HT1A

48
Q

What does the hypothesis state about AN sufferers? KSH BO

A

Pre-existing imbalanced levels of each type results in:
High anxiety
Altered perception of shape
Issues with impulsivity and control

49
Q

What do altered levels of 5HT activity do? KSH BO

A

Vulnerability to restricted eating as well as obsessional behaviours and extreme mood states

50
Q

What may teenagers with altered serotonin levels experience? KSH O

A

Hormonal changes
Environmental stressors that serve to exacerbate the changes in serotonin levels
Making them even more prone to AN

51
Q

What is a function of serotonin? KSH O

A

Control appetite and altered levels mean decreased appetite

Due to suppressed appetite less food is eaten

52
Q

What do people with AN discover about restricted eating? KSH O

A

RE reduces anxious mood
Reduced intake causes reduced brain serotonin functional activity as food (carbs) are converted into tryptophan = building block for serotonin
Less food = less tryptophan = less serotonin = reduces anxiety

53
Q

What do PET Scans show about AN sufferers? KSH O

A

Altered levels of 5HT2a and 1A activity areas in the brain which are involved in awareness of internal states and assigning emotional meaning to internal and external stimuli
Meaning this develops the emotional and motivational relationships that AN patients have with their body during RE

54
Q

What was the method of Kaye et al 2005?

A

PET scans to investigate 5HT2A receptor which contribute to disturbances of appetites
To avoid confounding effects of malnutrition - recovered AN patients as sufferers would have malnutrition which alters serotonin levels which would affect results

55
Q

What were the results of Kaye et al 2005?

A 
AN individuals had reduced 5HT2A activity in areas of the brain responsible for processing:
Visual stimuli
Integrating sensory information 
Visuo-spatial processing:
   Shape
   Size
   Orientation
Explaining the distortion in attitudes and perceptions towards body weight and shape

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