Module 10 - Eating Disorders Flashcards
What is the difference between an objective binge and a subjective binge?
Objective = eating a large amount of food (larger than most individuals would eat under similar circumstances) in a specific time period (e.g., less than two hours).
Subjective = eating small or normal amounts of food during these episodes (such as one chocolate bar).
True or False?
Eating disorders have the highest mortality rate of all the psychiatric disorders.
True.
(The most common causes of death among individuals with eating disorders are starvation and nutritional complications (e.g., electrolyte imbalance or dehydration), and suicide.)
Flip to see Diagnostic Criteria for Anorexia Nervosa (AN)
A) Restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health. Significantly low weight is defined as a weight that is less than minimally normal or, for children and adolescents, less than that minimally expected.
B. Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.
C. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.
What are the 2 subtypes of Anorexia Nervosa (AN)?
Restricting type: During the last 3 months, the individual has not engaged in recurrent episodes of binge eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas). This subtype describes presentations in which weight loss is accomplished primarily through dieting, fasting, and/or excessive exercise.
Binge-eating/purging type: During the last 3 months, the individual has engaged in recurrent episodes of binge eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas).
True or False?
The restricting subtype of AN has a poorer prognosis than the binge/purge type.
False.
It’s the opposite. The binge-eating/purging subtypehas a poorer prognosis.
Flip to see DSM criteria for Bulimia Nervosa (BN).
A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
1. Eating, in a discrete period of time (e.g., within any
2-hour period), an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances.
2. A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
B. Recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting; mis- use of laxatives, diuretics, or other medications; fasting; or excessive exercise.
C. The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for 3 months.
D. Self-evaluation is unduly influenced by body shape and weight.
E. The disturbance does not occur exclusively during episodes of anorexia nervosa.
What is binge-eating disorder (BED)?
Recurrent episodes of binge eating (they do not engage in inappropriate compensatory behaviours.)
Individuals must also report at least three of the following features associated with binge-eating episodes: eating very rapidly; eating until uncomfortably full; eating large amounts of food even when not hungry; eating alone because of embarrassment about the amount of food consumed; and feeling disgusted, depressed, or guilty after binges.
One of the primary differences between anorexia and bulimia is __________.
Body Weight.
Individuals with anorexia nervosa are always underweight by definition, individuals with bulimia are typically within their normal weight range.
What are some Physical Complications of AN and BN?
AN - Osteoporosis, Cardiovascular problems, Decreased fertility, Lethargy, Dry skin and hair loss, Heightened sensitivity to cold, Lanugo (fine downy hair) may grow for warmth. Amenorrhea: Absence of at least three consecutive menstrual periods. Difficulties concentrating Increases in irritability. Impaired renal function, Cardiac arrhythmia - Potentially fatal.
BN - Erosion of tooth enamel due to stomach acid during self-induced vomiting. Russell’s Sign: Scrapes or calluses on the backs of hands or knuckles. Electrolyte Imbalance: Particularly hypokalemia (low potassium). Cardiovascular and Renal Issues: Gastric rupture, Cardiac arrhythmias – potentially fatal.
What are genetic and biological factors in the etiology of eating disorders?
Genetics play a significant role in the development of eating disorders.
Individuals with anorexia and bulimia demonstrate signs of serotonin dysregulation. Ie: it appears that anorexia nervosa is associated with reduced serotonin activity (specifically, reduced density of serotonin transporters in women).
True or False?
Women more susceptible to the development of an eating disorder.
True.
Females are more susceptible to dysregulation in the serotonin system than are males. For example, it appears that dieting alters brain serotonin function in women, but not in men.
What is the socio-cultural factor theory of etiology for eating disorders?
These disorders are (to at least some extent) a product of the increasing pressures for women in Western society to achieve an ultra-slim body. Internalization of these thin media images is believed to be a causal risk factor for the development of an eating disorder.
Family Factor Etiology:
When the family environment is critical or coercive, or weight/shape and appearance are prominent themes in the household, the risk of eating disorders increases.
What are the personality/individual factors involved in etiology of eating disorders?
Personality traits such as perfectionism, obsessiveness, neuroticism, negative emotionality, avoidance of harm, and general avoidance characterize both patients with AN and BN.
Individuals with anorexia nervosa are often characterized by high levels of constraint, perseveration and rigidity, and low levels of novelty seeking, whereas individuals with bulimia nervosa often exhibit high impulsivity, novelty and sensation seeking, and characteristics over- lapping with borderline personality disorder.
Studies have found a high incidence of victims of sexual abuse among individuals with eating disorders. Additionally, research evidence suggests that having experienced a traumatic event is more strongly associated with development of an eating disorder characterized by binge eating and purging than with eating disorder symptoms characterized by restriction only.
True.
