L7: Eating Disorders Flashcards
Name DSM criteria of Anorexia
A. underweight
B. intensive fear of gaining weight
C. disturbance in the way in which one’s body weight or shape is experienced
What are the 2 subtypes of anorexia?
-, restrictive subtype
- binge / purging subtype
Name DSM criteria of bulimia
A. objective binge eating episodes
B. inadequate compensatory behaviours
C. self evaluation is unduly influenced by body shape & weight
Name DSM criteria of binge eating disorder
A. recurrent episodes of bing eating (characterized by eating more than what most ppl would eat in similar time & circumstandces + sense of lack of control)
B. min 3 of folloiwng: eating much more rapidly than normal, eating until feeling uncomfrtably full, eating large amounts of food when not feeling physically hungry, eating alone because of embarassment, feeling disgusted w oneself, depressed, or very guilty after overeating
C. marked distress regarding binge eating is present
D. no inadequate compensatory behaviours
What do all eating disorders have in common?
overevaluation of weight & shape
Name DSM criteria of Avoidant Restrictive Food Intake Disorder
persistent failure to meet appropriate nutrional and/or energy needs
1. weight loss
2. nutirtional deficiency
3. tube feeding
4. marked interference w psychosocial functioning
no body image disturbance or fear of weight gain
- sensory based avoidance
- arousal or interest based avoidance
- concern of fear based avoidance
What are the prevalence rates of different EDs?
- most prevalent: binge eating disorder & other specified feeding & eating disorder (OSFED, very prevalent! 50% of treatment, 75% of general pop)
- then in order: bulimia, anorexia, arfid
- incidence of anorexia stable, bulimia is going down over time
- most in teenagers & women (90%)
- lost of overlap & switching between EDs and subtypes
What is the need for control like in anorexia?
- recurrent time consuming and intrusive thoughts that cause anxiety & distress
- content of the obsessions can differ, however often similar
- obsessions & compulsions similar to those in OCD, BDD
- rigid thinking styles
- perfectionism, extreme need for control
- compulsive behaviours & obsessive thoughts
Name controlling behaviours in ED
- body checking
- counting (calories etc)
- rituals & rules (cutting food into small pieces before eating, arranging food a certain way on a plate, only eating foods in a specific order, only using specific plates/utensils to eat foods, disassembling food items, only eating at specified times etc
-> prevent weight gain & escape from/suppression of negative emotions (binges)
How is binge eating an “escape for awareness”?
- binge eating < escape from negative mood
- alleviates emotional stress
- attentions drawn awy from emotional distress
- narrowing the focus to the immediate environment (food)
- feelings of numbness
- chewing helps to forget
- loss of control over eating “i have no choice”
- the only thing on their mind is food
- “i deserve something nice”
What are the cognitiive control impairments in anoerxia/general EDs?
rigid thinkings tyles
- deficits in mental flexibility (disturbed set shifting)
- holding on to old habits (see canvas background)
- extreme focus on details/difficulties seeing the whole picture (weak central coherence)
What is the role of habits in anorexia?
- many negative consequences (social life, physical consequences) but continue harmful habits despite this -> compulsive
- starvation begins as goal directed action at weight loss, but then rigid habtis develop
- habits are positively reinforced by weight loss & being in control & enhanced by increased reward sensitivity due to starvation
- they are negatively reinforced by avoidance behaviour concerning weight gain & consumption of energy rich food
- starvation also leads to stress which leads to accelerated habit formation
- so due to this strong reinforcement, habits become compulsive
What is the first stage of eating disorder (positive consequences or reinforcement)?
- provides feelings of control
- weight loss
- increased reward sensitivity due to starvation
- relieves anxiety in short term
- increased self esteem
- “this is what i do best, better than others”
- stronger ego & identity, feeling “special”
- identity becomes highly related to eating behaviour
- prevention weight gain
-escape from negative emotions
-> ALL REINFORCE THE HABITS
What are the second stage negative consequences of food restriction/being underwieght
psychologies consequences
- negative mood increases (depression, anxiety, loneliness, guilt, disgust, shame)
- stress
- obsessive behaviours increasing
- more rules
- problems with concentration
- emotional numbness
- body avoidance
social consequences
- social isolation, avoidance of social contacts
- difficulties in social engagment
- conflicts w parents or spouses
- avoidance of situations involving eating or body exposure
- avoidance of physical activities
- not being able to work/go to school
physical consequences
- consequences of undereating: lanugo (white body hair), poor blood circulation (acrocyanosis)
- consequences of vomiting: russels sign, bite marks on hand, erosion teeth, swelling of glands
- conseqeunces of binge eating: obesity
- invisible signs: hypoglycemia (low blood sugar), heart problems, low blood pressure, low heartbeat, loack of growth in children, amenorrhea (can lead to infertility), orthostatic hypotension, refeeding syndrome, osteoprosis, kidney problems, low electrolytes
What are the mortality rates of EDs? How many recover?
- ED has highest mortality of all psychiatry disorders
- mortality ratio: 6 for AN, 2 for BN and 2 ARFID
- 50% fully recover, 30% recover partially, 20% chronic
