Eating Dxs (Anorexia, Bulimia, etc.) Flashcards
Anorexia Nervosa
Criteria:
A) Restriction of energy intake relative to requirements, leading to ___________ for age, sex, developmental trajectory, and physical health.
significantly low body weight
Anorexia Nervosa
Criteria:
B) Intense fear of ________, becoming fat, OR
persistent behavior that interferes with _______
gaining weight;
weight gain
Anorexia Nervosa
Criteria:
C) Disturbance in how one’s weight or ________ is experienced
OR
Undue influence of body weight or shape on __________
OR
Persistent lack of recognition of seriousness of ___________
body shape;
self-evaluation;
current low weight
Anorexia Nervosa
Subtypes:
_______ - Weight loss through dieting, fasting, and/or excessive exercise.
- No binge or purge in last 3 months.
Restrictive
Anorexia Nervosa
Subtypes:
_________ - Last 3 months with recurrent ______ and ______
Binge-eating/purging;
Binges and purges
Anorexia Nervosa
Specifiers:
Remission can be either ______ or _______.
_______ means person meets criteria B and C but not A.
Full or partial
Partial
Anorexia Nervosa
Specifiers:
Severity: Name the 4 levels of severity
Mild
Moderate
Severe
Extreme
Each has their own corresponding BMI calculation.
Note: Severity rating can increase to reflect Sxs, functional disability, or need for supervision rather than BMI.
Anorexia Nervosa
The distinguishing factor between anorexia and bulimia is _________
low weight
Anorexia Nervosa
Binge-eating/purging does not necessarily indicate ________ Dxs
bulimia
Anorexia Nervosa
When you can, counselors should always diagnose _______ before ______ because of hierarchical issues
Anorexia; bulimia
Anorexia Nervosa
The prevalence of anorexia is higher in _______ than ______
females
Anorexia Nervosa
The age of onset is ______ & ______ (bimodal)
bimodal: 14 and 18
Anorexia Nervosa
Onset is frequently associated with a __________
stressful life event
Anorexia Nervosa
Close to ___% - ____% recover but ______ are common and recovery usually takes ____-_____ years
50-70;
relapses;
6-7 years
Anorexia Nervosa
Anorexia has a very high _______. Individuals are 5x more likely to _____ from any cause and are 18x more likely from ______
Mortality;
die;
suicide;
Bulimia Nervosa
Criteria:
A) Episodes of ________
_______= in a discrete period of time (e.g. 2 hours)
- Eat a _____ amount of food than most
- Feel a __________ over eating
binge eating;
greater amount;
lack of control;
Bulimia Nervosa
Criteria:
B) Recurrent inappropriate ______________ to prevent weight gain
(provide some examples)
compensatory behaviors;
vomiting, misuse of laxatives/diuretics, fasting, excessive exercise
Bulimia Nervosa
Criteria:
C) _______ and inappropriate _______ behaviors both occur more than 1x/week for 3 months
binges;
compensatory
Bulimia Nervosa
Criteria:
D) ________ is unduly influenced by body shape and weight
Self-evaluation
Bulimia Nervosa
Criteria:
E) Does NOT occur exclusively during episodes of ______
anorexia
Bulimia Nervosa
_______ is what differentiates Bulimia from Anorexia because the other criteria are identical
Low weight
Bulimia Nervosa
Specifiers:
Partial ______
Full ______
remission
Bulimia Nervosa
Specifiers:
Severity is based on ______ of ______ behaviors.
List 4 severity specifiers: Each severity specifier is designated by amount of episodes per week.
Note: Severity may be increased to reflect other _____ and degree of _______
frequency;
compensatory;
mild; moderate; severe; extreme
Sxs;
functional disability
Bulimia Nervosa
Which sex has a greater prevalence of BN
Females
Bulimia Nervosa
Age of onset is ….
late adolescence/early adulthood
Bulimia Nervosa
___% recover but most experience a long time before seeking _____
75%; treatment
Bulimia Nervosa
Mortality is less than, equal to, or greater than anorexia?
Most studies cite mortality as lower than anorexia, but mortality is still appreciable.
Bulimia Nervosa
Name the sign of bulimia that occurs on the 1st knuckles of the hands
Russell’s Sign
Binge Eating Dx
Criteria:
Associated with at least 3 of the following:
A) Eat much more ______ than normal
B) Eat until _______ full
C) Eat _____ amounts of food when not feeling physically ______
D) Eat _____ because of feeling _______ by amount one is eating
E) Feeling ______ with oneself, ______, or very ______ afterward
F) Marked ______ regarding binge eating
G) At least ____ time per week for 3 months
H) Binges are not associated with _______ ________ behavior
I) Binges do not occur exclusively during ______ or _________
A) rapidly B) uncomfortably C) large D) alone; embarrassed E) disgusted; depressed; guilty F) distress G) 1 time H) inappropriate compensatory I) anorexia or bulimia
Binge Eating Dx
No compensatory behavior = ______
Compensatory behavior = _______
Compensatory behavior + low weight = ______
Binge eating Dx;
bulimia nervosa;
anorexia nervosa
Binge Eating Dx Specifiers: Remission: Partial = \_\_\_\_\_\_ Full = \_\_\_\_\_\_\_
less than 1x/week;
no criteria met for sustained period
Binge Eating Dx
Specifiers:
Severity:
Based on frequency of episodes of binge eating.
Name the 4 levels of severity. Each correspond to number of binge-eating episodes per week.
Note: Severity may be increased to reflect other Sxs and degree of functional disability
Mild; moderate; severe; extreme
Binge Eating Dx:
More common amongst which sex? What’s the age of onset?
Women; early adulthood
Other Specified OR Unspecified Feeding or Eating Dx
These Dxs account for __%-__% of cases seeking help at specialty eating disorder centers
40-60%
Anorexia, Bulimia, and Binge Eating Dx
Name at least 3 possible health complications for each Dx…
Anorexia: Decreased bone density Bradycardia Severe Dehydration Muscle loss; weakness Brittle hair; dry skin; growth of fine hair on body (lanugo)
Bulimia: Electrolyte imbalance leads to irregular heartbeat Tooth decay (stomach acid) Irregular bowel movements (laxatives) Mallory-weiss tears (esophagus) Russell's Sign (hands)
Binge Eating Dx: Type II Diabetes Increase cholesterol and triglycerides Increased blood pressure Obesity Increase risk of heart disease and stroke
Eating Dx Etiologies
- Genetics - _____ heritability
- Serotonin _______
- Cognitive ______
a. Lack of _____ (AN)
b. Over-valuing of ______
c. Automatic ______ - Personality traits
Too much or too little _______ depending on Dx
- Rigidity/perfectionism/excessive control (AN)
- Impulsivity/too little ______ (BN; BED) - Pressures from ______ and _______
- moderate
- imbalance
- distortions
a. insight
b. thin-ideal
c. thoughts - control; control
- culture; society
What are some aspects of Maudsley treatment for eating Dxs?
- Considering the eating disorder a distinct entity from the child.
- Parents find it difficult to be tough on a child with eating Dx. The weakness and desperation of the child make it emotionally challenging. But toughness is necessary.
- Child has to experience a break between themselves and the disorder. Disambiguation frees up child’s mind to view disorder from a more objective perspective
CBT-E (Enhanced)
Transdiagonstic view of eating Dxs means…
Same pathological processes underlying all EDs
CBT-E (Enhanced)
Highly individualized Tx and patients are asked to keep a _______.
If the person is underweight - the goal is to get the person to ________
food diary;
decide to regain weight themselves
CBT-E Vs. Maudsley Tx for Adults
There was _____ statistical difference on….
- Weight _____
- Eating ______ pathology
- Quality of ______
NO statistical difference on…
- Weight gain
- Eating disordered pathology
- Quality of life
Bulimia Tx
CBT is slightly _____ than other Txs
IPT is just ______ CBT and _____ at 1 year follow-up
CBT=slightly better
IPT is just behind CBT and catches up at 1 year follow up
Bulimia Tx
Meds:
Anti-depressants ______ binge/purge frequency.
Patient still _____ & ____ ___-____ times p/week
decrease
binge and purge 4-6 times
Binge Eating Dx Tx
Comparing meds and various types of therapy, _______ Tx comes out ahead
Not one treatment comes out ahead
