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psykologi- madrid > feeding and eating disorders > Flashcards

feeding and eating disorders Flashcards

1
Q

what is the prevalence?

A

4-6.5%
only 10 % receive treatment

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2
Q

what is the comorbidity

A
  • obsessive-compulsive disorder (20-60%) (every eating disorder)
  • mood disorders
  • maltreat and sexual abuse
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3
Q

what kinds of evaluation is there?

A
  • eating disorder diagnostic scale- EDDS
  • eating disorder inventory- EDI-3
  • figure rating scale- FRS
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4
Q

what kinds of interventions is there?

A
  • group:
    warning about side effects:
    For instance: people learn new methods of hiding food, throwing it away…
  • family therapy
    discovering invisible rules
    “i feel like a little girl”
    “if i don’t eat, it’s my own decision”
    “food is one of the many things i can control”
    individual
  • CBT (thoughts, emotions, behaviors)
    Christopher G Fairburn
  • pharmacotherapy
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5
Q

what kind of pharmacotherapy is there?

A

some substances can help for some cases
sertraline
appeared in 1991, after fluoxetine (1987)
trade names: lusral, zoloft, besitran
action: it’s a selective serotonin reuptake inhibitor (SSRI). Prescribed also for depressive disorder, OCD, social phobia, panic disorder
common side effects: diarrhea, nausea, sexual dysfunction, troubles with sleep

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6
Q

what are some associations?

A

ADANER and NEDA (international, national eating disorder association)

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7
Q

what kind of disorders is there?

A
  • Anorexia nervosa
  • bulimia nervosa
  • binge-eating disorder- new
  • Pica
  • rumination disorder
  • avoidant/ restrictive food intake disorder
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8
Q

describe anorexia nervosa

A
  • restriction of energy intake –> significantly low body weight in the context if age, sex etc
  • significantly low: less than minimally normal/expected
  • Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.
  • Disturbance in the way in which one’s body weight or shape is experienced
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9
Q

Which 2 types of anorexia nervosa is there?

A
  • restrictive type
  • binge-eating/ purging type
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10
Q

specify the severity of AN

A
  • MILD: BMI > 17 kg/m2
  • MODARATE: BMI > 16-16.99 kg/m2
  • SEVERE: BMI 15-15.99 kg/m2
  • EXTREME: BMI < 15 kg/m2
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11
Q

name some cognitive and emotional symtoms

A
  • fear of weight gain
  • denial of having a disorder or of the danger associated with low body weight
  • Exaggeration of the importance of body shape and weight in self-assessment or excessive interest in fashion
  • misinterpretation of body sensations
  • distortion of body image (weight or shape)
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12
Q

name some behaviors of AN

A
  • Food avoidance (refusing, hiding or throwing away food)
  • Causing vomiting
  • Laxative and diuretic abuse
  • Excessive exercise
  • Frequent weighing
  • Avoidance of eating places
  • Dressing in baggy clothes
  • Lying and irascibility (can’t talk to them about food)
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13
Q

name som physical symtoms for AN

A

*Self-induced weight loss starting 15% below normal
*Muscle and immune weakness
*Amenorrhea (loss of at least 3 menstrual cycles)
*Hypothermia
*Bradycardia
*Dermatological disorders: hair loss, dry skin, itching
*Endocrine changes, low phosphate level and electrolyte disturbances

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14
Q

name some lab abnormalities for AN

A

Hematology
1. Anemia (decrease in the total amount of red blood cells).
2. Leukopenia (deficiency in the number of white blood cells or leukocytes).

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15
Q

name some consequences of AN

A
  • Death (6-15% of cases)
  • Early menopause
  • Infantile uterus
  • Small hearts
  • Osteoporosis
  • Immunosuppression
  • Alterations in hormonal cycles
  • Dental lesions as a result of acidity from vomiting
  • Gastrointestinal problems
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16
Q

name som data of those who have AN

A

⚫ 0.1% men
⚫ 0.3-1% of females
⚫ Adolescents (40%)
⚫ Some Professions (models, dancers, athletes, etc.)
⚫ Mothers after childbirth
⚫ Elderly

17
Q

what did richard morton coin? AN

A

nervous consuption

18
Q

what did Ernest-Charles Lasègue coin? AN

A

“Anorexia Hysterique”

19
Q

who was the first to coin the term anorexia nervosa

A

William Gull

20
Q

what is bulimia nervosa?

A
  • recurrent episodes of binge eating: A sense of lack of control over eating during the episode.
  • recurrent inappropiate compensatory behaviors (to prevent weight gain): vomiting; misuse of laxatives, fasting; or excessive exercise.
  • binge eating + compensatory both occurs at least 1/week for 3 months
  • self-evaluations: influenced by body shape and weight
  • not only during episodes of AN
21
Q

what is the binge-eating episodes associated (3 or more)

A

– Eating much more rapidly than normal.
– Eating until feeling uncomfortably full.
– Eating large amounts of food when not
feeling physically hungry.
– Eating alone because of feeling embarrassed
by how much one is eating.
– Feeling disgusted with oneself, depressed, or
very guilty afterward.

22
Q

specify the severity of BN

A
  • Mild = 1 - 3 episodes of inappropiate
    compensatory behaviors per week.
  • Moderate = 4 - 7
  • Severe = 8 - 13
  • Extreme = > 14
23
Q

what is the prevalence with BN

A
  • 1-3%
  • 90% women
24
Q

what is the comorbidity for BN

A
  • high risk of suicide 75%
25
Q

what is binge-eating disorder?

A

*Recurrent episodes of binge eating:
– Eating, in a discrete period of time an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances.
–A sense of lack of control over eating during the episode.
* The binge-eating episodes are associated with three (or more) of the
following:
– Eating much more rapidly than normal.
– Eating until feeling uncomfortably full.
– Eating large amounts of food when not feeling physically hungry.
– Eating alone because of feeling embarrassed by how much one is eating.
– Feeling disgusted with oneself, depressed, or very guilty afterward.
*Marked distress regarding binge eating is present.
* The binge eating occurs, on average, at least once a week for 3 months.
* The binge eating is not associated with the recurrent use of inappropriate
compensatory behavior as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.

26
Q

specify the severity of BED

A
  • Mild = 1- 3 binge-eating episodes per week
  • Moderate = 4 - 7
  • Severe = 8 - 13
  • Extreme = > 14
27
Q

what is pica?

A
  • Persistent eating of nonnutritive, nonfood substances over a period of at least 1 month.
  • The eating of nonnutritive, nonfood substances is inappropiate to the developmental level of the
    individual.
  • The eating behavior is not part of a culturally
    supported or socially normative practice.
  • If the eating behavior occurs in the context of another mental disorder, it is sufficiently severe to warrant additional clinical attention.
28
Q

what are some typical substances for pica?

A
  • Paper
  • Soap
  • Cloth
  • Hair
  • String
  • Wool
  • Soil
  • Chalk
  • Paint
  • Gum
  • Clay
29
Q

which groups are vulnerable for pica?

A
  • Children
  • Mental disorders
    – Autism Spectrum Disorder
    – Psychotic Disorders
    – etc
  • Pregnant Women
30
Q

name some additional evaluation for pica

A
  • Gastrointestinal complications
  • Poisoning
  • Infection
  • Nutritional deficiency
31
Q

what is rumination disorder?

A
  • Repeated regurgitation of food over a period of at least 1 month. Regurgitated food may be rechewed, re-swallowed, or spit out.
  • The repeated regurgitation is not attributable to an associated gastrointestinal or other medical
    condition.
  • The eating disturbance does not occur exclusively during the course of anorexia nervosa, bulimia nervosa, binge-eating disorder, or avoidant/restrictive food intake disorder.
  • If the symptoms occur in the context of another
    mental disorder, they are sufficiently severe to
    warrant additional clinical attention.
32
Q

what is avoidant/ restrictive food intake disorder?

A
  • An eating or feeding disturbance (e.g., apparent lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating) as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more)
    of the following:
    – Significant weight loss (or failure to achieve expected weight gain or faltering growth in children).
    – Significant nutritional deficiency.
    – Dependence on enteral feeding or oral nutritional supplements.
    – Marked interference with psychosocial functioning.
33
Q

what is the prevalence for avoidant/ restrictive food intake disorder?

A

1-3%

34
Q

what is the comorbidity for avoidant/ restrictive food intake disorder?

A
  • Developmental disability: 80%
  • Autistic spectrum
  • Fear of vomiting (emetophobia)
35
Q

what is additional evaluation for for avoidant/ restrictive food intake disorder?

A
  • Excluded food
    – Whole food groops (fruits, etc)
    – Based on color
    – Very hot or very cold
  • Apparent lack of interest in eating or food
  • Concern about aversive consequences of eating
36
Q
A

psykologi- madrid (7 decks)

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