Final Exam Babyyyyy Flashcards
What are four features of anxiety disorders?
-common
-persistent
-often goes unnoticed/undiagnosed
-if untreated, it may predict future disorders
What are some cognitive, physical, and behavioural symptoms of anxiety?
Cognitive: worry abt future events, difficulty concentrating, lack of control- anxious apprehension
Physical: increase in adrenaline, heart rate, respiration - anxious arousal
Behavioural: desire to escape - avoidance behaviours
Is there some anxiety that is normal?
yes - developmentally appropriate fears (monsters, ghosts etc)
also situations where it is appropriate to feel fear
When should you be concerned/ what criteria should we consider to determine if anxiety is clinically significant?
-if its prolonged
-is it disabling/leading to avoidance
-is it overly intense/exaggerated and unreasonable
-is it overly distressing
What are 6 associated characteristics of anxiety?
-interferes with academics
-difficulty initiating and maintaining friendships
-social withdrawal, loneliness
-low self esteem
-substance use
-chronic negative feedback loop
What is a problem some youth may struggle with when they have anxiety?
Refusal to attend classes or difficulty remaining in school for an entire day
-equally common in boys and girls
-most often occurs 5-11
-2-5% of youth
-most common during transition periods (kindergarten, middle/high school, after summer break etc.)
What are 7 types of anxiety?
-Specific phobia
-Separation anxiety
-Generalized Anxiety
-Social Anxiety
-Selective Mutism
- Agoraphobia
- panic disorder
What defines Separation Anxiety Disorder?
-extreme distress when separated from home or from attachment figures
-worry about harm to caregivers or unexpected/unfortunate event causing separation
-avoidance behaviours
-physical complaints
Which gender experiences higher risk of separation anxiety?
Girls, however it is in boys as well.
What is the comorbidity of Separation Anxiety?
-another anxiety disorder
-depressive disorder
What is the age of onset for Separation Anxiety?
Can start as early as 7-8 years old - this is earliest onset and referral age of anxiety disorders
-symptoms may fluctuate throughout course
-more than 1/3 of children’s separation anxiety persists into adulthood
What is one of the most common anxiety disorders?
Separation Anxiety Disorder
What are 6 symptoms that define generalized anxiety disorder?
-Apprehensive expectation; wide range of issues; major and minor
-Episodic or continuous; uncontrollable
-physical symptoms ( ex. sore jaw from clenching)
-Chronic worry as cognitive avoudance
-intolerance for uncertainty
-associated characteristics (ex. seek lots of reassurance, perfectionist)
What gender is more likely to have generalized anxiety?
In general it is equally common in boys and girls, but theres a slightly higher prevalence in older adolescent females.
What is the comorbidity of generalized anxiety disorder?
-for younger children: separation anxiety, and conduct problems
-for older children: specific phobias, social anxiety, panic disorder, and MDD, as well as impaired social adjustment, low self-esteem, and increased risk for suicide.
What is the age of onset for Generalized anxiety disorder?
early adolescence
What defines social anxiety disorder?
-fear or anxiety of social or performance situations (+ fear of negative evaluation or causing offence)
-exposure = fear of anxiety
-avoidance behaviour or endured
-fear is out of proportion to actual danger
Which gender is most likely to experience social anxiety?
girls - 2:1
What is the age of onset for social anxiety?
11-12
-Extremely low chance of having it under the age of 10 - usually develops after puberty
Does social anxiety prevalence increase with age?
yes - social demands increase, development of self awareness
What is Specific phobia?
-fear or anxiety of specific object or situation
-exposure = fear or anxiety
-avoidance behaviour
-fear is out of proportion to actual danger
What is selective mutism?
Consistent failure to speak in social situations where it’s expected that you speak, despite speaking in other situations
-interferes with emotional, academic, and social development
-very rare, quite young onset
What are 7 anxiety treatments?
-education about anxiety
-progressive muscle relaxation exercises
-deep breathing techniques
-challenges to anxiety-provoking thoughts
-exposure to anxiety-provoking situations
-coping models
-involvement of families
What defines obsessive compulsive disorder?
-Repeated, intrusive, irrational, and anxiety causing thoughts
-ritualized behaviours (sometimes to relieve the anxiety)
-resistant to reason - kids dont understand logical reasoning as much
-severe disruptions in functioning
What gender is most likely to experience OCD?
-in childhood: males
-in adolescence: equal between males and females
What is the age of onset for OCD?
It is bimodal: onset spikes around 10-11, and also early adulthood (23)
What may be the adulthood result of children diagnosed with OCD?
If treated properly, OCD may be in remission by adulthood
-exposure therapy/other coping mechanisms
-symptoms may still come out in stressful situations
What is the comorbidity of OCD?
Anxiety, Major Depression, Tic Disorders, ADHD, Disruptive Behaviour Disorders
Is there an age where compulsions are normal?
To a certain extent yes: repeating behaviours and activities , adhering to rules, adn enacting rituals are important parts of normal development
What are some biological predispositions to anxiety?
Temperament
-Behavioural inhibition (quiet, withdrawing, and timid behaviour, reluctance to speak)
-Hyper-vigilant (state of neurological arousal in response to novel situations, including interacting with unfamiliar adults
Neurobiological - overactive stress response
Explain the temperament prediction video we watched in class
-can predict temperament based on reaction at 4 months old –> can predict outgoingness/shyness
-motor-tension, thrashing of the legs in response to stimulus predicts shyness
-lach of tenstion in response to stimulus = outgoing
*also depends on how parents react to the kids reaction –> gene environment interaction
Explain how parenting and parental modeling can positively or negatively reinforce anxiety
-parent sends subtle messages every day in repeated ways where they model reacting to specific situations
Negative: avoidance maintains anxiety, child never learns fears were unwarranted + never learns to cope
Positive: rewards : ex. stay home from school, have a good day, more likely to stay home again
What are 4 types of parental practices?
Intrusive parental control
Low psychological autonomy granting
-subtle but consistent ways parents can discourage kids from having their own options/autonomy
^Both of these are less emotionally availavle parents
Low parental expectations (ex. for childs coping)
Overprotection
^Both are over loving parents
*remember its always bidirectional between child and parent!
Attachment theory: what can cause insecure attachments?
-caregiver inaccessable or unpredictable
-less exploration
-not confident parent will provide security in time of stress
-experiences more fear
What are 2 attentional biases?
Anxious vigilance: selective attention
Threat appraisal biases: percieve threat more readily, play down safety info
What are some cognitive errors and biases of anxiety?
-overestimate likelihood of negative consequences
-underestimate ability to cope
-favour more avoidant response option
What are some characteristics of a negative information proccessing style in regards to OCD?
-inflated responsibility
-overestimation of the importance of thoughts
-the need to control thoughts
-overestimation of threat
-intolerance of uncertainty
-perfectionism
What are the three depressive disorders mentioned in the DSM-5?
- Major depressive disorder
- Persistent depressive disorder (dysthymia)
-Disruptive mood dysregulation disorder (new to DSM)
How has understanding depression in youth evolved?
psychoanalytic theory = kids aren’t capable of experiencing depression because they dont have enough superego to experience anger about the world. lol freud
storm and stress = basically just being like all adolescence is turbulence and angst, so everyone is depressed
“why isn’t Johnny crying” - maybe depression is expressed differently in kids.
masked depression = everything is depression (withdrawn / acting out = depression)
How should you respond to a youth who is saying things like “I’m a loser, no one likes me”
“I can understand why you might feel like ______”
dont say “but”, say “because” to provide validation to kid.
then meet need with reassurance / support, ect
What depressive disorder has almost identical criteria for children and adults?
Major Depressive disorder
What is the diagnostic criteria for a major depressive episode?
- 5+ symptoms.
- 2 + weeks
- change in functioning
what are the symptoms of a major depressive episode?
** depressed mood (or irritable)
** Loss of interprets or pleasure
———- 1 of these 2 MUST be present—–
- weight / appetite
- sleep
-psychomotor
-loss of energy
-worthlessness
-concentration
-thoughts of death
If untreated, how long on average does a depressive episode last?
8 months
what is the recurrence pattern of depressive episodes?
if left untreated, depressive episodes will reoccur..
the more you have, the more likely you are to keep getting them
same for adults and kids
that’s why early intervention is important… teach kids coping skills = prevent future depression
is a depressive episode brought on by a stressor?
the first few, we can usually point to a stressor.
later on, its less obvious and more internally normalized.
smaller causes of depressive episodes
fun fact:
negative mens mental health reports have doubled from 2013 to 2018.
das it
another fun fact:
big gender difference in diagnosing depression among youth.
mostly women diagnosed
why? (hehe answer bellow)
for kids, the symptom of depressed mood can present as irritable, but we lose this with adults..
but there are alot of grouchy cantankerous men who probably have undiagnosed depression because of our understanding of what it looks like.
what age does the rate of depression start to increase?
starts around 12 years old… then there’s a steep climb to mid adolescence (15-16 years old).
another big jump in cases diagnosed around 15-16, then stabilizes again. (big gender difference for women)
not so fun fact:
84% of trans and non binary kids indicated having chronic mental health condition…
- prairie Provences are the worst,
- Quebec is the best
:(
another not fun fact:
2/3 of the sample of non binary kids reported self harm / suicidal ideation.
21% attempted.
way higher than population average
what are some more sad stats on non binary and trans youth?
substantially higher rates of major depression episode, considered suicide, attempted suicide, feeling under stress, fee discouraged or hopeless
why is there an increase in depression during adolescence compared to younger ages?
- gender norms / social expectations become more apparent (kids are blissfully unaware)
- identity exploration
- peer evaluation becomes more saturated
- social worth / power
why are there higher rates among cis-gender girls compared to cis-gender boys in adolescence and adulthood?
- biological differences (puberty / hormones / birth control)
- stigma about boys talking about mental health
- girls express problems by manipulating, ruminating, gaslighting - lead to depression
- boys solve problems with physical aggression
what is the main difference between Major Depression and Persistent depression (dysthymia)?
the chronicity of the depression..
- persistent depressive disorder is more chronic, stable, enduring — but less severe in terms of symptoms
what is the diagnostic criteria for persistent depressive disorder (dysthymia)?
- depressed mood (irritable) - 1 year for kids (2 years for adults [don’t evaluate irritable for adults])
- 2 other symptoms
- never without a symptom for 2 months
what is “double depression”
when you have a baseline of a persistent depressive disorder, and then get major depressive episodes ontop of it
what’s the prevalence of PDD (persistent depressive disorder [dysthymia])
1% children
5% adolescence
what is the age of onset for PDD?
10 - 11 years old
* earlier than MDD**
What is Disruptive Mood Dysregualtion Disorder (DMDD)
[p.s. she won’t make us memorize all this, just wants us to know its VERY specific]
- severe and frequent temper outbursts involving yelling, ranges or physical aggression
- overacting to common stressors
- temper outbursts 3+ times a week for 12 months (cant go symptom free for more than 3 months), 2+ settings, irritable in between..
- kids age 6-18, onset before age 10
why did they introduce DMDD into the DSM so quickly & with such specific criteria?
- trying to solve the massive increase of bipolar diagnoses in kids.
- medicating 4,5,6 year olds with bipolar meds isn’t good so they tried to conceptualize it differently
what are some reasons for the comorbidity between anxiety and depression
[what do they have in common]
- both high in negative affect
- low self esteem / isolation / irritability
- avoidance*
—- if a kid is constantly missing out on regular routine, something is wrong.
—— shame and embarrassment Kidd kids from reaching out
what makes anxiety and depression a risk for each other?
- stress of coping (the wear and tear of hopefulness and optimism)
- lack of engagement (avoiding things that could be positive reinforcers)
- sense of uncontrollability (can shift into hopelessness).
How are negative thoughts related to patterns of depression?
- learn to suppress our needs (unsupported)
thoughts: I’m fake, imposter syndrome, not authentic - learn to act out - self critical
- thoughts: I’m a bad person - Learn to make up what we lack - lack confidence
thoughts: I’m weak, I cant do things like others
what are some biological risk factors for depression?
- genetics
- neurotransmitters
- neuroendocrine system
——- when body is chronically aroused and distressed can be related to depressive and anxiety disorders
Environmental / Sociocultural risk factors for depression
- early life trauma (abuse / losing a parent)
- poverty (linked to chronic stress in caregivers –> then they cant meet the Childs needs)
- family history of loss / trauma
- intergenerational trauma (multi finality)
what are some cognitive vulnerabilities that are risk factors for depression?
X7
- hopelessness theory (attribution style)
—– why you think bad things happen, and the extent to which the attributions are internal (bad things happen because I’M NO GOOD) - negative automatic thoughts
- negative cognitive triad
—– negative feelings about themselves, the world, and the future. - negative cognitive schemata
—— main filter you take information through, is it self critical? - cognitive distortions
—— personalizing events, magnifying, overexadurating the meaningfulness of something - lack of control (perceived or real)
&&&& Negative core beliefs about self and others
Emotional / behavioural / interpersonal risk factors for depression
- poor emotional regulation
- behavioural perspective = loss of positive reinforcement, and reinforcement of depressive behaviour
- interpersonal:
- peer relationships (rejection, negative expectations, low social competence)
- withdrawal, low social support
family risk factors for depression
- family interactions
— detached parents, hostility, anger and conflict, poor communication
parent with depression:
— shared genetics
—- could signal to child the world / people are not predicable & they cant count of people
—- could influence Childs feelings of worth
Sociocultural / larger world risk factors for depression
- discrimination / racism
- living in context that devalues your existence
(constant messaging that being different is the same as being deviant / bad / wrong —> creates anger and self loathing)
what are 3 factors that increase suicide risk?
- hopelessness
- perceived burdensomeness
- lack of sense of belonging
what are 2 groups of people that are disproportionately at risk of depression?
lgbtq youth
indigenous youth
what are 2 protective factors for lgbtq youth?
teacher + family support of lgbtq identity pride
higher risk for suicide in indigenous youth, specially for kids who dot have a supportive adult in their family..
55% of girls self harmed in the past year
25% boys
51% of girls attempted suicide last year
17% boys
** these numbers almost cut in half if they are from supportive families*
what are 3 protective factors that help prevent youth suicide?
- mattering
- sense of control
- support for families
what are some proximal risks that can set the stage for disordered eating?
- biological temperament for high emotional reactivity / vulnerable to criticism / anxiety sensitivity
- traumatic experiences
- perfectionism
- need for control
- body obsession
what are some risks that maintain an eating disorder?
- encouragement of others
what are some predisposing cultural factors that can lead to an eating disorder?
- objectification (appearance as a basis for self worth)
- culture of dieting
- media - narrow range of what is considered attractive in media
- cultural norms - unrealistic body ideals (photoshop, plastic surgery, ect)
why are some people more vulnerable to sociocultural messages of beauty standards than others?
- parenting style
- rhetoric about beauty at home
- higher SES = more pressure to be beautiful (they can buy anything so..)
- personality factors
what are some predisposing individual characteristics that can lead to eating disorders?
(Bulimia specific)
- impulsivity
- difficulty coping with negative emotions
- high self criticism
- thin-ideal internalization
what are some predisposing individual characteristics that can lead to eating disorders?
(anorexia specific)
- obsessive, rigid, high drive for control
- prefer familiar (does not like change)
- perfectionism
- high self monitoring, social sensitivity
- need for approval
- more vulnerable to developmental events like puberty, and more susceptible to cultural messages*
What are some predisposing family factors for eating disorders?
- negative family environment
—- low support
—– High criticism
—- Low connection - Family environment that impedes healthy psychological development
— (interferes with development of self-efficacy, self regulation, and ability to cope with negative emotions)
Family systems theories & anorexia:
“psychosomatic families”
–> what are they
- overprotective and rigid / controlling
- enmeshed, conflict avoidant
- basically is like if someone in the family is sick, its a manifestation of a sickness in the family
- the control and anxiety placed on the child manifests in sickness.
- family loyalty > individuality
- does not value difference of opinion
Family system theory & anorexia
Struggle for autonomy and control
describe
links to a family style that doesn’t support autonomy development
child feels ineffective, less confident in self..
I guess those are factors that lead to anorexia.
family systems theory - anorexia
passive defiance: what is it
child defies their parents by exerting the control they have, not eating.
–> mostly occurs when its not okay to express a difference of opinion in your family
what are some sociocultural influences on eating disorders?
- internalization of a “thin-ideal”
- exposure to “appearance media”
(kindof repetitive, but so are her slides)
EXPOSURE TO APPEARANCE MEDIA can lead to BODY ESTEEM; BODY DISSATISFACTION..
what is a proximal mediator to this?
how much the kid internalizes appearance schemas..
questions like “what I look like is an important part of me”
can teach the child that what is on the media isn’t real.
if a child internalizes appearance schemas relayed to them by media on beauty, and develop body dissatisfaction… what can this lead to?
dieting, disordered eating.. ect..
basically just the cycle of how an eating disorder can happen
more proximal risks for eating disorders:
modelling process – parent transmits sociocultural values.. how?
- encouragement to loose weight
- discussions about dieting
- preoccupation with weight
- body as a basis for self evaluation
how can peers be a proximal risk for eating disorders?
- appearance related conversations
- pressure to be thin
- peer discussion of dieting
- socialization & selection effects ( I think this just means that based on your appearance people socialize with you and pick you differently
What are some individual proximal risks?
- body dissatisfaction
- emotional dysregualtion (low distress tolerance)
- cognitive distortions
- stressful life events
How does an eating disorder develop?
4 stages
- decision to diet
- continue or intensify diet (or stop diet)
- preoccupation with food and weight, and prolonged food restriction
- E.D.
What can lead to stage 1: decision to diet?
- cultural factors
- family and peer influences
- developmental issues
- personal characteristics (body dissatisfaction, control weight, self worth based on weight, insecure)
What happens in stage 2 of an ED (decision to stop or continue and intensify diet)
response of others.
cognitive style
self worth
what happens in stage 3 of an ED: preoccupation, restriction
(biological, emotional, cognitive)
BIOLOGICAL CHANGES
—- change in hormones (increased desire to eat)
—– serotonin and norepinephrine reduced
— body energy reduced
EMOTIONAL CHANGES
— biological markers of depression
— more emotional ups and downs (lability)
—- small “failures” = stronger emotions
COGNITIVE CHANGES
— dichotomous thinking (you’re super invested in the ED now because you put alot of time into it)
— more narrow and constricted thinking
— altered perceptions of attractiveness of food
What happens in stage 4 of an ED: Severly disordered eating patterns?
- psychological desire to continue food restriction
- biological urge to eat
- inevitable to encounter a meal where you “break the rules”
— MASSIVE FAILURE
—- all or nothing thinking.. “once ive messed up either binge or purge”
What happens when a person with an ED binges?
(big card, but its mostly intuitive)
- short term relief
- distraction
- feels good (increases serotonin)
- binging negatively reinforced [reduces distressing emotions of hunger]
ALSO
- uncomfortably full
- dissatisfaction with self
- need to compensate
- guilt and fear
the biological and psychological distress of binging usually leads to purging.
(alleviates distress)
both binging and purging negatively reinforce ED..
not so fun fact :)
how can you break the cycle of an ED?
normalize persons eating
not so fun fact!
body image issues and appearance in Canada are pervasive and persistent over time
what are the three diagnostic categories of ED?
Anorexia Nervosa
Bulimia Nervosa
Binge Eating Disorder
What is the definition of Anorexia Nervosa,
why is it innacurate?
meaning: loss of appetite
not accurate because anorexia is often EGO-SYNTONIC (people may realize what they are doing)
We have a super fat phobic culture, what are some examples of this?
the oppression of overweight individuals
the idea that higher weight people need to be “fixed”
the conflation of higher weight people and poor health
feelings of discomfort and fear when in the presence of someone of a higher weight
What are the three criteria for Anorexia Nervosa?
(refusal, avoid, denial)
must meet all 3 criteria
1: Refusal: restriction of energy intake relative to bodyweight
2: Avoid: terrified of gaining weight even though they’re skinny AF.
3: Denial: in denial that they are skinny, and wanna keep getting skinnnier
What are the two presentations of anorexia?
- restricting
- binge eating / purging
what’s the problem with BMI as a measure of health?
it was never designed to assess the healthy weight of an individual.
What are the 5 criteria for Bulimia Nervosa?
1) Binge Eating
- lack of control
- can happen because of mood change, interpersonal stress, hunger from dieting
- often concealed.
2) compensatory behaviour
- vomiting, laxative,
- fasting, exercise
3) Frequent (at least once a week for 3 months)
4) Self Evaluation
- is excessively influenced by shape and body weight
5) Not anorexia
What are the 5 criteria for binge eating disorder?
1) recurrent binge eating (same as BN)
2) 3 or more additional symptoms
- eating until uncomfortably full
3) distressed by binge eating
4) Frequent (same as BN)
5) no compensatory behaviour (not AN or
BN)
* doesnt require over concern with shape and weight
** new to DSM**
What is the rate of comorbidity between people who self-injure and have an eating disorder?
25%-40%
What are some reasons (in terms of coping mechanisms) that eating disorders and non-suicidal self injury have such high comorbidity?
1) cope with feelings.
- both are used to change, express, or suppress emotions.
- but interferes with development of healthier coping
2) communicates some underlying distress.
Not so fun fact:
other eating disorders in the DSM are:
- Atypical AN
- BN of low frequency / limited duration
- purging disorder
- night eating syndrome
Feeding and eating disorders can first occur in infancy and early childhood…
what does this look like?
- avoidant / restrictive food intake disorder
—— kid doesnt eat food, leads to significant weight loss, can lead to nutritional deficiency - PICA
—- ingestion of inedible substances such as hair, insects, paint chips, ect.
what is the prevalence of bulimia in adolescence and adulthood?
what is the age of onset?
prevalence: 1%
age of onset: mid - late adolescence
what is the prevalence of anorexia in adolescence and adulthood?
what is the age of onset?
0.3% prevalence
age of onset: 14-18
what is the prevalence of BED in adolescence and adulthood?
what is the age of onset?
Prevelence: 1.5 - 3.0 %
Age of onset: late adolesence
Gender and eating disorder?
which gender groups are most affected?
- mostly women
- men start later
- gay men are at a higher risk than heterosexual men
- higher prevalence of body dissatisfaction and ED in sexual and gender minorities
Go look at the picture for a treatment intervention spectrum circle chart
do it
What can you do to build in protection? (health promotion/healthy development)
-help kids develop selfhood (sense of who they are)
-healp them know they matter
-give them a sense of control/efficacy in what happens
-encourage positive self-evaluation - know their strengths not just weaknesses
What is universal prevention?
provide everyone with basic child care info (nutrition, health, and safety info)
What is selective prevention
-select who gets a specific prevention based on group membership (ex. children of drug abusers)
What is indicated prevention?
Kids themselves show indication of future issues
-ex. anxious kid but no clinical anxiety yet - help prevent it from getting bad
What are three goals of prevention?
-reduce exposure to risks
-reduce impact of risks
-build in protective factors
What universal interventions can you provide in schools?
-teacher training in classroom management
-interpersonal problem solving
-reading enhancement curriculum
What is the good behaviour game?
teacher makes rules with the students that they will follow as a whole class
idk just remember the video - maybe watch it again
-remember pax good behaviour game
What is WITS?
Bullying prevention program
-grades K-5
Walk away
Ignore
Talk it out
Seek help
What is the Be Safe Red Cross program?
_sexual abuse prevention
-ages 5-9
-teaches kids to recognize and avoid potentially unsafe situations
-say NO! to unsafe touching
-Go! - Get away from unsafe sitiations
-Tell! - talk to a helping person when thay need help
What is FRIENDS program?
Anxiety prevention and resilience building
What does FUN Friends stand for?
-Feelings (talk abt feelings and care about others feelings)
-Relax (do milkshake breathing, have some quiet time
-I can try! (we can all try our best)
-Encourage (step by step plans)
-Nurture (quality time together doing fun activities)
-Dont forget - be brave! (practice skills every day with friends/fam
-Stay happy
What is SEL curriculum?
Zones of regulation
-its basically just a poster with a bunch of different emotions illustrated for kids
What are some selective prevention provrams?
Mother infant programs
-low birthweight or premature babies
-home visiting nurse (helps with caregiving)
Preschool programs
-poverty targeted
-activities designed to enhance development of cognitive and social skills, prevent cognitive delays
What is Head Start?
-targeted preschool programs
-cognitive gains, increase school-readiness, decrease repeating grades (grade retention), special ed
-intense and comprehensive
What are some prevention programs around mental disorders?
-children of parents with psychiatric disorders
-parental depression
What would they do in a program geared towards parental depression?
-teach parents to use positive parenting skills
-put support mechanisms in place to increase the chance that parents will continue to use these skills during episodes of psych problems
-focus on child - learn to cope
What is an indicated prevention program for conduct disorder
FAST Track Program
-1st graders-noncompliance and aggression
-teachers, child, and parents are involved
What is the FEAR program
for anxiety
What is some preventions adults can take for eating disorders in children?
-understad role of media (body standards)
-teach about variety of body shapes
-praise young girls for features other than looking cute
-cultivate broad basis of self evaluation
-teach about healthy and unhealthy diets
