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Never-Ending Road to Licensure > Feeding/Eating, Elimination, and Sleep-Wake Disorders > Flashcards

Feeding/Eating, Elimination, and Sleep-Wake Disorders Flashcards

1
Q

Pica definition

A

Eating nonfoods that have no nutrition

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2
Q

Considerations when diagnosing pica

A
  1. Developmental level
  2. Cultural practices
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3
Q

Common pica populations

A
  1. Children
  2. Pregnant women
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4
Q

Anorexia Nervosa definition

A

Restricting food that results in low body weight

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5
Q

Anorexia criteria

A
  1. Fear of weight gain
  2. Distortions in perceptions of weight/shape
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6
Q

Anorexia specifiers

A
  1. Type (restricting or binging/purging)
  2. Course (in partial/full remission)
  3. Severity (based on BMI)
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7
Q

Common co-morbidities for anorexia, bulimia, and BED

A
  1. Depression
  2. Anxiety disorder (especially OCD for anorexia), often before eating disorder
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8
Q

Anorexia prognosis

A
  1. Relapses common
  2. Difficult to treat (lack of insight)
  3. Generally better than bulimia, with mixed findings
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9
Q

Eddy et al (2017) study about recovery rates for anorexia and bulimia

A

9 years = anorexia recovery was half of bulimia recovery

22 years = similar recovery

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10
Q

Initial treatment goals for anorexia

A
  1. Healthy weight
  2. Address physical complications
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11
Q

Secondary treatment goals for anorexia

A
  1. Motivation for treatment
  2. Psychoeducation
  3. Identify beliefs, attitudes, emotions
  4. Treat contributing psychological factors
  5. Family support
  6. Relapse prevention
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12
Q

Treatments for anorexia

A
  1. CBT for anorexia
  2. CBT-E for eating disorders
  3. FBT for anorexia
  4. Inconsistent support for medication
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13
Q

CBT for anorexia

A
  1. Post-hospitalization
  2. Behavioral strategies for eating patterns
  3. Reduce body-checking
  4. Replace thinking errors
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14
Q

CBT-E for eating disorders

A
  1. Individualized based on client factors
  2. Assumes core problem is over-valuing weight/shape
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15
Q

FBT for anorexia nervosa

A
  1. Outpatient for medically stable adolescents
  2. Three phases
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16
Q

Three phases of FBT for anorexia nervosa

A
  1. Parent control over weight/nutrition for adolescent
  2. Control gradually returned to adolescent
  3. Address development factors (independence, parent-child relationship)
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17
Q

Medications for anorexia

A
  1. Olanzapine for initial weight gain
  2. Fluoxetine for weight maintenance
  3. Some support for treating co-morbidities rather than anorexia
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18
Q

Bulimia Nervosa definition

A

Binge eating with compensatory behaviors to prevent weight gain

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19
Q

Bulimia criteria

A
  1. Binge and compensatory behavior 1x/week
  2. Symptoms 3+ months
20
Q

Bulimia specifiers

A
  1. Couse (in partial/full remission)
  2. Severity (based on episodes of compensatory behavior per week)
21
Q

Typical weight for anorexia, bulimia, and BED

A

Anorexia - far below average

Bulimia - average to overweight

BED - average to obese

22
Q

Bulimia treatment

A
  1. CBT-E**
  2. Nutritional rehab and CBT*
  3. IPT (longer time to produce results)
  4. FBT for bulimia nervosa
  5. Some evidence for medication
23
Q

Three phases of FBT for bulimia nervosa

A
  1. Disrupt binging and compensatory behaviors, build healthy eating patterns
  2. Collaboration between parent and adolescent due to lack of insight, control back to adolescent over time
  3. Teen returns to normal development overall
24
Q

Insight and treatment motivation for anorexia v. bulimia

A

Anorexia - little to no insight, little to no motivation

Bulimia - insight w/ distress and motivation

25
Q

Medications for bulimia

A
  1. SSRIs (fluoxetine) for comorbid depression and reducing binging/purging without depression
  2. Some evidence that combined SSRI and CBT is better
26
Q

Four stages of CBT-E for bulimia

A
  1. Education and monitoring
  2. Review and revise as needed
  3. Address overvaluation of weight/shape, other factors
  4. Maintainance and relapse prevention
27
Q

Telehealth v. in-person for bulimia

A

Both positive outcomes for acceptability and retention

Better abstinence and lower rates of cognitive distortions in-person

28
Q

Binge-Eating Disorder (BED) definition

A

Eating larger amounts than typical with a sense of being out of control

29
Q

BED criteria

A
  1. 3+ symptoms (rapid eating, eating until uncomfortably full, large amounts w/o hunger, alone/hiding, negative emotions)
  2. Episodes 1x/week
  3. Symptoms 3+ months
30
Q

BED specifier

A
  1. Severity (based on episodes per week)
31
Q

BED prevalence

A

2-3x more common in women than men

32
Q

BED v. bulimia

A

BED - no compensatory behaviors, better treatment response, followed by dieting

Bulimia - compensatory behaviors, poorer treatment response, preceded by dieting

33
Q

BED treatment

A
  1. CBT-E*
  2. IPT
  3. Some evidence for medication
  4. Focus on binging before or alongside weight loss
34
Q

Medications for BED

A
  1. SSRIs (fluoxetine, paroxetine, sertraline)
  2. Topiramate
  3. Lisdexamphetamine
  4. Less effective than CBT alone or combined CBT and medication
35
Q

Enuresis criteria

A
  1. Involuntary peeing in bed or clothing
  2. 2+ times/week
  3. Symptoms 3+ months OR distress/impairment
  4. Not due to substance, medical conditions
  5. 5+ years old (age or developmentally)
36
Q

Enuresis specifiers

A
  1. Subtype (nocturnal only, diurnal only, both)
37
Q

Enuresis treatment

A
  1. Moisture alarm*
  2. Desmopressin (high risk for relapse when discontinued)
38
Q

Insomnia Disorder criteria

A
  1. 1+ symptoms
  2. 3+ nights/week
  3. Symptoms 3+ months
  4. Symptoms despite sufficient opportunity to sleep
  5. Distress or impairment
39
Q

Insomnia types

A
  1. Sleep-onset
  2. Sleep maintenance
  3. Late insomnia

Combination of three types is most common

40
Q

Subjective reports of insomnia

A

Tend to overestimate time awake and underestimate time asleep

41
Q

Insomnia treatment

A
  1. Cognitive-behavioral w/ stimulus control, sleep restriction, sleep hygiene, relaxation, cognitive therapy, etc.
42
Q

Narcolepsy criteria

A
  1. Sleep or naps 3+ times/week
  2. Symptoms 3+ months
  3. Cataplexy, hypocretin deficiency, or REM latency <15 minutes
43
Q

Narcolepsy common co-occurring problems

A
  1. Hallucinations before sleeping or after waking
  2. Sleep paralysis when falling asleep or waking
44
Q

Narcolepsy treatment

A

Behavioral strategies combined with medications to improve alertness and reduce cataplexy

45
Q

Medications for narcolepsy

A
  1. Modafinil and armodafinil (newer)
  2. Antidepressant (venlafaxine, fluoxetine, clomipramine) for cataplexy
  3. Sodium oxybate (if unresponsive to others)
46
Q

Non-Rapid Eye Movement Sleep Arousal Disorders

A

Incomplete waking w/ difficulty fully waking and little memory of episodes

  1. Sleepwalking
  2. Sleep terrors
47
Q

Nightmare Disorder criteria

A

Nightmares:
1. Extended
2. Dysphoric
3. Well-remembered
4. Threats to safety

Typically occur during REM or second half of major sleep

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