Integration Flashcards
What is the main focus of Dunkley et al. (2020)?
The study reviews the association between eating disorders (EDs) and sexual dysfunction, highlighting how EDs impact sexual desire, arousal, satisfaction, and functioning.
What common sexual dysfunctions do women with EDs experience?
- Decreased sexual desire & interest
- Difficulty with arousal and lubrication
- Problems achieving orgasm
- Increased sexual anxiety
- Reduced sexual satisfaction
- Pain during intercourse
What psychological factors contribute to sexual dysfunction in EDs?
- Body dissatisfaction
- Negative self-perception
- Anxiety about physical appearance
- Fear of intimacy
What are potential early-life risk factors for developing an ED?
- Early menarche (first menstruation)
- Adverse sexual experiences in childhood
- Pubertal body changes triggering body dissatisfaction
What sexual dysfunctions are common in Anorexia Nervosa (AN)?
- Lower sexual desire
- Higher sexual anxiety
- Reduced frequency of sexual activity
- Difficulty with arousal & orgasm
How do different subtypes of AN affect sexual function?
- AN-Restricting Type: More severe sexual dysfunction
- AN-Binge/Purge Type: Fewer sexual issues than restricting type, but still problematic
How do hormonal and physiological factors contribute to sexual dysfunction in AN?
- Extreme caloric restriction and malnutrition lead to decreased libido and increased sexual anxiety
- Lower BMI is linked to greater loss of sexual desire
- Hormonal imbalances (e.g., lower estrogen and testosterone) further reduce sexual functioning
What happens to sexual function in AN recovery?
- Weight restoration leads to improved sexual function
- The greater the weight loss, the more severe the sexual dysfunction
How does sexual functioning in BN compare to AN?
- Less severe sexual dysfunction than AN
- More likely to be in a romantic relationship
- Higher sexual self-esteem & activity frequency compared to AN
What risky sexual behaviors are linked to BN?
- Earlier sexual initiation
- Higher rates of impulsive and risky sexual behavior
- Increased likelihood of engaging in self-destructive behaviors
What personality traits contribute to sexual risk-taking in BN?
- Higher impulsivity
- Stronger tendencies toward self-harm
- Poor emotional regulation
How does BED impact sexual function?
- Lower sexual activity and frequency
- Greater sexual dysfunction than women with obesity alone
- Emotional eating and body dissatisfaction predict sexual problems
How does binge frequency correlate with sexual dysfunction?
- More frequent binge episodes are associated with worse sexual functioning
- Women with obesity & BED report more sexual issues than those with obesity alone
Is BED itself or obesity the main factor in sexual dysfunction?
- Sexual problems in BED are largely due to obesity, but the eating disorder symptoms also contribute
What happens to sexual function in recovered AN patients?
- Women who fully recover from AN also see sexual function improvements
- Those who do not recover continue experiencing sexual dysfunction
Which group of men is most at risk for eating disorders?
- Homosexual men have a higher risk for developing EDs
- Limited research exists on male EDs and sexual function
What psychological fears predict poor ED recovery?
- Fear of adulthood
- Fear of becoming a sexual being
- Avoidance of intimate relationships
What role does Cognitive Behavioral Therapy (CBT) play in ED-related sexual dysfunction?
- CBT improves sexual function in AN & BN patients
- However, past sexual abuse victims do not show improvement
How do body dissatisfaction and ED symptoms affect sexuality in women without a diagnosed ED?
- Even non-clinical women with body dissatisfaction and diet obsession show sexual dysfunction
- Suggests a spectrum of ED effects, rather than a strict diagnostic cut-off
What is the HiTOP model in psychology?
- A classification system that sees mental disorders on a spectrum rather than in rigid categories
- Internalizing (anxiety, depression) and externalizing (impulsivity, risky behavior) traits play a role
How does HiTOP explain the ED-Sexuality link?
- Internalizing disorders (anxiety, perfectionism) → More sexual avoidance & dysfunction
- Externalizing disorders (impulsivity, risk-taking) → More risky sexual behaviors in BN
How does body image dissatisfaction relate to sexual dysfunction?
- Negative body image is one of the strongest predictors of sexual problems
- Common across all ED subtypes
What personality traits are linked to eating disorders and sexual dysfunction?
- Neuroticism & negative affect → Internalizing disorders (AN, BN)
- Perfectionism & need for control → Linked to AN & BN
- Impulsivity & emotional dysregulation → Linked to BN & BED
How does childhood sexual abuse relate to eating disorders & sexual dysfunction?
- A history of sexual abuse is strongly linked to disordered eating
- Victims often report severe sexual dysfunction later in life
What are the key conclusions from Dunkley et al. (2020)?
- Strong evidence links eating disorders & sexual dysfunction.
- The connection is supported by physiological, psychological, and sociocultural factors.
- Even non-clinical women with body dissatisfaction report sexual issues.
- ED recovery improves sexual function, but past sexual abuse may prevent this.
- More research is needed on men and sexual minorities.
What is the main focus of Nagata’s review? - minorities
The study reviews eating disorders, disordered eating behaviors, and body dissatisfaction in sexual and gender minorities (LGBTQ+ individuals).
Do eating disorders only affect sexual minorities?
No, eating disorders affect all sexual orientations, but they are more prevalent among sexual minorities.
How much higher is the risk of eating disorders in sexual minorities compared to heterosexuals?
2 to 4 times higher risk of developing an eating disorder.
Is the lifetime prevalence of eating disorders higher in sexual minorities?
Yes, sexual minorities have a higher lifetime prevalence of eating disorders.
What eating disorder behaviors are more prevalent in gay & bisexual men/adolescent boys?
- Fasting
- Use of diet pills
- Purging (vomiting, laxative use)
- Pressure to be muscular
- Higher body dissatisfaction
- Increased likelihood of dieting
What psychological factors are associated with eating disorders in gay/bisexual men?
- Depression
- Experiencing stigma around sexual orientation
- Lower self-compassion
- Higher risk for comorbid disorders (e.g., depression)
What eating disorder behaviors are more prevalent in lesbian & bisexual women?
- Higher risk of eating disorders
- More use of diet pills
- More purging (vomiting/laxatives)
- More fasting
How does body dissatisfaction differ among sexual minority women? + how does it differ across etnicity
- Sexual minority women report higher body dissatisfaction than heterosexual women.
- White sexual minority women report more eating disorder symptoms than Black sexual minority women.
What is a significant predictor of eating disorders in lesbian women?
Depression is a strong predictor of eating disorder symptoms.
What does the Minority Stress Theory say about eating disorders in LGBTQ+ individuals?
- Experiences related to gender & sexual orientation create stress.
- This stress can lead to disordered eating & body dissatisfaction.
How does stigma impact eating disorder risk in gay men?
- Experienced stigma is a key factor in minority stress.
- It contributes to higher body dissatisfaction and disordered eating behaviors.
How does weight discrimination impact eating disorder risk in sexual minorities?
- Weight-based discrimination significantly increases the risk of eating disorders.
- Both men and women in sexual minorities are affected.
How much research exists on eating disorders in transgender individuals?
- Limited research is available.
- However, it suggests unique experiences of body dissatisfaction & disordered eating.
How do gender norms & ideals contribute to eating disorders in transgender individuals?
- Masculine ideals focus on muscularity.
- Feminine ideals focus on thinness.
- Mismatch between one’s body and sociocultural ideals can increase body dissatisfaction.
How does gender dysphoria treatment impact body satisfaction?
- Gender-affirming treatments (e.g., hormones, surgery) improve body satisfaction.
What body image concerns do transgender men experience?
- Desire for a masculine body
- Engagement in bodybuilding & muscle-building behaviors
What disordered eating behaviors are more common in transgender men?
- Higher rates of binge eating
- Fasting for weight control
- Purging (vomiting/laxatives)
What eating disorder behaviors are more prevalent in transgender women?
- More dietary restriction
- More binge-eating episodes
- More excessive exercise
- Higher rates of purging
Why do transgender women engage in weight loss behaviors?
- Desire to suppress secondary male characteristics
- Pressure to conform to feminine body ideals
What are the key findings from Nagata’s review? About sexual minorites and eating disorders
- Sexual minorities have 2-4x higher risk of eating disorders.
- Gay/bisexual men experience higher body dissatisfaction & disordered eating.
- Lesbian/bisexual women have higher ED prevalence than heterosexual women.
- Transgender individuals have unique ED risks due to gender dysphoria.
- Weight discrimination & minority stress contribute to ED risk.
- More research is needed on transgender ED experiences
What is the main focus of Christensen et al.’s study?
Investigating the bidirectional relationship between insomnia symptoms and eating disorder pathology, including underlying biological mechanisms.
How are eating disorders and sleep disturbances connected?
- Eating behaviors can disrupt sleep.
- Sleep problems can contribute to eating disorder behaviors.
What are the two key psycho-biological processes regulating sleep?
- Circadian Processes: Control alertness throughout the day.
- Homeostatic Processes: Sleep pressure increases the longer one stays awake.
How do circadian and homeostatic processes interact?
They work together to regulate sleep-wake cycles, ensuring the body gets adequate rest.
What happens to these processes in people with insomnia?
- Dysregulation causes difficulties falling and staying asleep.
- Symptoms must occur 3+ nights per week for at least 3 months for diagnosis.
What are common maladaptive coping behaviors for insomnia?
- Sleeping in (delays circadian rhythm).
- Going to bed before feeling sleepy.
- Taking daytime naps (reduces nighttime sleep drive).
How can eating disorder behaviors negatively impact sleep?
- Excessive exercise before bed → Increases arousal, delays sleep.
- Using sleep to avoid eating/stress → Reduces sleep drive at night.
- Binge-eating episodes at night → Disrupts digestion, delays bedtime.
- Restrictive eating patterns → Causes hunger, makes sleep difficult.
- Night eating syndrome (NES) → Perpetuates insomnia.
How does worrying and negative affect maintain both insomnia and eating disorders?
- Insomnia patients worry and ruminate, increasing arousal.
- Eating disorder patients experience similar cognitive patterns, sustaining both disorders.
What biological effects of sleep deprivation influence eating behaviors?
- Acute sleep deprivation → Increases cravings for high-calorie foods.
- Chronic sleep loss → Alters leptin (satiety) and ghrelin (hunger) levels.
How can insomnia lead to disordered eating behaviors?
- Being awake when others sleep may lead to eating as a coping strategy.
Why is addressing insomnia important in eating disorder treatment?
- ED treatment requires regular eating schedules → Sleep disruptions can interfere.
- Cognitive impairment from insomnia → May hinder therapy progress.
- Insomnia increases risk for comorbid conditions (e.g., anxiety, depression, substance use disorders).
How can insomnia impact recovery and relapse prevention?
- Persistent insomnia increases the likelihood of relapse in mental health disorders after successful treatment.
What is the main takeaway from Christensen et al.’s study? Insomnia and eating disorders
Eating disorders and insomnia share biological and cognitive mechanisms, reinforcing each other in a bidirectional manner. Treating sleep disturbances may enhance eating disorder recovery.
What is the importance of sexual functioning? - zemishlany
Proper sexual functioning is a major component of quality of life and helps maintain satisfying intimate relationships.
How common is sexual dysfunction in the general population?
It affects 43% of women (mainly low sexual desire) and 31% of men (mainly erectile dysfunction and premature ejaculation).
Why do many people with sexual dysfunction not seek help?
Due to embarrassment or the belief that it is not a medical problem.
Why is sexual dysfunction more common in psychiatric patients?
Mental disorders, medications, and neurotransmitter imbalances contribute to sexual dysfunction.
Which neurotransmitters are involved in sexual function and also in psychiatric disorders?
Dopamine, serotonin, epinephrine, norepinephrine, and acetylcholine.
How does dopamine affect sexual function?
Increases sexual desire, erection, orgasm, and satisfaction. Dopamine agonists enhance, while dopamine blockers suppress sexual function.
How does serotonin (5-HT) affect sexual function?
Activation of 5-HT2 receptors worsens all phases of sexual response. SSRIs reduce nitric oxide, impairing arousal and orgasm.
How do epinephrine and norepinephrine impact sexual function?
- Epinephrine inhibits erections in men but enhances arousal in women.
- Norepinephrine increases erectile response
How does acetylcholine influence erections?
Facilitates erections by relaxing corpus cavernosum smooth muscles.
Why do patients with schizophrenia experience sexual dysfunction?
Due to negative symptoms (anhedonia, avolition, blunted affect) and dopamine imbalances.
What percentage of men and women with schizophrenia experience sexual dysfunction?
- 82% of men (low libido, erectile dysfunction).
- 96% of women (low pleasure, orgasm issues).
How do antipsychotics affect sexual function in schizophrenia patients?
- Typical antipsychotics → worsen sexual function (dopamine blockade).
- Atypical antipsychotics → fewer sexual side effects.
- Viagra (sildenafil) → effective in less deteriorated patients.
How does depression affect sexual function?
Causes low libido, difficulty maintaining arousal, orgasm issues, and erectile dysfunction in men.
How do SSRIs impact sexual function?
- 34-78% of SSRI users experience sexual dysfunction.
- Main effects: orgasm inhibition, reduced libido, and arousal issues.
What are possible solutions for SSRI-induced sexual dysfunction?
- Switch to bupropion (increases dopamine).
- Reduce SSRI dose.
- Drug holiday (skip medication for 1-2 days before sex).
- Use sildenafil (Viagra).
How does anxiety contribute to sexual dysfunction?
- Causes performance anxiety → worsens erectile dysfunction (ED).
- Leads to self-esteem issues, intimacy avoidance, and emotional distress
What is the connection between social phobia (SP) and sexual dysfunction?
- SP patients experience reduced erectile capacity, late sexual debut, and avoidance of intimacy.
- Women report lower desire, arousal, and satisfaction.
How does PTSD affect sexual function?
- PTSD patients frequently experience ED, premature ejaculation, and low libido.
- Sexual dysfunction correlates with anger and hostility in PTSD patients.
How do SSRIs impact sexual function in PTSD patients?
- Worsen desire, arousal, and frequency of sexual activity.
How do eating disorders impact sexual function?
- Anorexia Nervosa (AN) → low libido, fear of intimacy, disgust toward sex.
- Bulimia Nervosa (BN) → More sexual activity than AN but still lower than controls.
What are long-term sexual consequences in recovered anorexia patients?
- Less likely to be in relationships.
- Lower sexual esteem, inhibited desire, and anorgasmia
How does Borderline Personality Disorder (BPD) affect sexual function?
- Unstable relationships, abandonment fears, impulsivity.
- Sexual trauma is common.
- Avoidance of intimacy due to trauma-related memories.
What percentage of BPD patients report sexual relationship difficulties?
- 61% of BPD patients vs. 19% of other personality disorder patients.
- 76.8% of BPD patients with sexual issues reported childhood sexual abuse.
What is the recommended approach for treating sexual dysfunction in patients with schizophrenia?
- Adjust medication to the lowest effective dose.
- Switch to drugs with fewer sexual side effects (e.g., atypical antipsychotics).
- Use psychotherapy to improve relationships.
- Add PDE-5 inhibitors (e.g., sildenafil) for ED
What is the main conclusion of the study? - Zemishlany, disorders and sexual disfunction
Sexual dysfunction is highly prevalent in psychiatric disorders and worsened by psychotropic medications. Proper diagnosis and tailored treatment are essential.
