Lecture 7: Eating Disorders Flashcards
What are the criteria of anorexia nervosa
- underweight
- intense fear of gaining weight
- disturbance in the way in which one’s body weight or shape is experienced
What are the criteria for bulimia nervosa
- objective binge eating episodes
- inadequate compensatory behaviors
- self-evaluation is unduly influenced by body shape and weight
T/F: the prevalence of eating disorders has gone up in the past 40 years
False, it has gone down actually
How much percentage op people recover fully from an ED, how many recover partly and for how many is it chronic
Fully; 50%
Partly; 30%
Chronic; 20%
What is the common factor in all of the eating disorders
Overevaluation of weight and shape
What are 6 examples of rigid thinking styles in eating disorders
- deficits in mental flexibility
- holding on to old habits
- extreme focus on details
- difficulties in seeing the whole picture
- perfectionism, extreme need for control
- compulsive behaviors and obsessive thoughts
What are 3 examples of controlling behaviors in EDs
- body checking
- counting
- rituals and rules
How can binge eating function as a reinforcement
- it can function as an escape from negative mood (negative reinforcement)
- alleviates emotional stress (negative reinforcement)
This is because - attention is drawn away from emotional distress
- narrowing the focus to the immediate environment
What are the 2 stages
First stage; positive consequences; provides feelings of control, relives anxiety in short-term, increased self-esteem because this is something they can do, escaping negative emotions
Second stage; negative consequences; physiological, social and physical
What are 7 examples of psychological consequences
- negative mood increases
- stress
- obsessive behaviors increasing
- more rules
- problems with concentration
- emotional numbness
- body avoidance
What are 7 examples of physical consequences
- lanugo
- poor blood circulation
- erythema ab Inge (caused by hot water; dark spots on the body)
- marks on hands (from inducing vomiting)
- erosion teeth
- swelling of glands (in the face)
- consequences that can’t be seen (eg. Heart problems, underweight, lack of growth, kidney problems)
What are 6 examples of social consequences
- social isolation
- difficulties in social engagement
- conflicts
- avoidance of situations involving eating/body exposure
- avoidance of physical activities
- not being able to go to work/school
what are 4 barriers to seeking help in EDs
- lack of knowledge about the illness
- acknowledgement of ED
- shame, fear of stigmatisation, problems with disclosure
- lack of knowledge of treatment
what are 3 options for treatment of EDs
- Proud2Bme = e-community by and for experts by experience, positive and recovery focused
- Featback = online self-help program for everyone who struggles with ED symptoms, automated monitoring and feedback system
- Cognitive Remediation Therapy (CRT) = aims to improve memory, planning skills, central coherence and flexibility; uses certain exercises to develop more flexible thinking styles
explain the structure/content of a session of CRT
Structure:
1. Task - explanation and execution
2. Reflection - which thinking strategies were used
3. Translation - link to daily life
Improvement of cognitive flexibility by training set shifting abilities and central coherence
CRT is about how people think, little to do with food/weight/shape –> people like this about it
what are the guidelines regarding treatment for anorexia/bulimia nervosa
First choice; outpatient treatment (eg. CBT) –> focus on weight recovery, abstinence from eating/purging, restoration of negative body image and dysfunctional cognitions
Intensive treatment when outpatient does not lead to prolonged weight recovery
Youth; first choice is multi-family treatment
explain what was done in the REaCH intervention
1) cue awareness; psychoeducation
2) creation of new behavioural routines; behavioural analysis of target behaviours
3) suppression of maladaptive habits
4) emotion regulation; evaluating progress
what are 4 strategies for habit change (suppression of maladaptive habits)
- habit reversal; counteractions
- stimulus control; alterations of environment to encourage/discourtage behaviour
- urge exposure; seek urge and practice suppression
- emotion regulation; skills such as relaxation, connection with values, awareness and distress tolerance
what are 6 biological factors related to restrictive-type eating disorders
1 - genetic predisposition
2 - gender; female-male = 10-1
3 - obsessive-compulsive or autism spectrum traits
4 - behavioural susceptibility to appetite dysregulation
5 - metabolic vulnerability
6 - environmental influences in the perinatal period
what are 7 psychological factors related to restrictive-type eating disorders
1 - personality traits (rigidity, attention to detail, intolerance of uncertainty, perfectionism)
2 - cognitive rigidity
3 - high ability to delay reward
4 - reduced theory of mind
5 - increased sensitivity to social ranking/threat
6 - reduced ability to interpret/reciprocate in social interaction
7 - body image disturbance
what are 6 psychosocial factors related to restrictive-type eating disorders or bulimic spectrum eating disorders
1 - parental eating problems
2 - peer stress (eg. bullying)
3 - trauma
4 - culture (industrialised/western)
5 - thin idealisation/fat talk
6 - middle-to-high socioeconomic status
what are 5 behavioural factors related to restrictive-type eating disorders or bulimic spectrum eating disorders
1 - overcontrol of weight and eating
2 - overconcern with BMI
3 - coping by avoidance or perfectionism
4 - social isolation
5 - impaired physical/mental quality of life
what are 5 biological factors related to bulimic spectrum eating disorders
1 - genetic predisposition
2 - gender; female-male = 3-1
3 - metabolic vulnerability
4 - ethnicity; increased prevalence in asians
5 - behavioural susceptibility to appetite dysregulation
what are 5 psychological factors related to bulimic spectrum eating disorders
1 - childhood adversity
2 - ADHD traits (impulsivity and paying attention)
3 - inability to delay reward
4 - social cognition problems with emotional avoidance
5 - body image disturbance
