Psych 241 final exam

Question 1

BINGE-EATING DISORDER

DIAGNOSTIC CRITERIA

Answer 1

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Question 2

Binge eating disorder
Main features

Answer 2

Episodes of binge eating
- eating large amount in short term & loss of control

BE is associated with at least 3 of: -eating rapidly
-eating till uncomfortably full -eating a lot, but not hungry
-eating alone, because embarrassed -feelings of self-disgust
c. Severe distress
d. a & b at least 1/week for 3 months
e. No compensatory behaviours to prevent weight gain

Question 3

Bing eating CLINICAL DESCRIPTION

Answer 3

20% of obese individuals in weight-loss program

share some of the concern about body weight and shape

Binging is often a strategy to alleviate “bad moods”

severity depends on the number of episodes from mild (1-3/week) to Extreme,
(14/week or more)

• not as highly associated with dieting and thinness

Question 4

BULIMIA NERVOSA

DIAGNOSTIC CRITERIA

Answer 4

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Question 5

Main features of bulmia nervosa

Answer 5

Recurrent episodes of binge eating

• Eating large amount in short time AND
• Sense of lack of control during episode

b. Inappropriate behaviours to prevent weight gain
c. a & b at least 1/week for 3 months
d. Body weight deeply affects self-evaluation
e. Not only in the context of anorexia nervosa

Question 6

Bulimia nervosa clinical description

Answer 6

severity: depends on the number of episodes from mild (1-3/week) to Extreme, (14/week or more)

-the majority of individuals with BN are within 10% of their normal weight

-Purging is not an effective method to reduce caloric intake

vomiting→max 50% of the calories laxatives→little effect since they act long after the binge

Question 7

medical consequences bulimia nervosa - vomiting

Answer 7

VOMITING:
electrolyte imbalance: imbalance of sodium and potassium levels
Dental enamel erosion
Cardiac arrhythmia
Kidney failure
Parotid (salivary glands) swelling
level

Question 8

medical consequences bulimia nervosa - laxatives

Answer 8

LAXATIVES:
Electrolyte imbalance
Colon damage
Kidney inflammation
Cardiac complications (cardiac arrest and seizure)
Dehydration that can lead to
problems at the muscular-skeletal

Question 9

bulimia nervosa: Associated psychological disorders

Answer 9

substance abuse, borderline personality disorder, anxiety, mood disorders

Question 10

Anorexia nervosa - DSM

Answer 10

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Question 11

Anorexia nervosa - main features

Answer 11

Fear of gaining weight —– Severe caloric restriction—–Severe weight loss, BMI <18

Distorted body image

Question 12

Aneorexia nervosa: clinical description

Answer 12

Mild: BMI ≥ 17 kg/m2
Moderate: BMI 16– 16.99 kg/m2 Severe: BMI 15– 15.99 kg/m 2 Extreme: BMI < 15 kg/m 2

-individuals with AN are often proud of their weight loss and ability to control themselves → reluctant to seek treatment

-20% die as result of the disorder (disorder with highest mortality rate)

• Suicide attempts occur between 30-40% of patients

Question 13

BMI normal

Answer 13

between 18-25

Question 14

anorexia nervosa: medical consequences

Answer 14

Medical Consequences
amenorrhea (cessation of menstruation)
Dry skin
Brittle hair or nails,
Sensitivity to cold temperature
Lanugo (downy hair on limbs and cheeks)
Cardiovascular problem (low blood pressure and heart rate)

If BINGE-EATING/PURGING TYPE→same as bulimia nervosa

Question 15

Anorexia nervosa: associated psychological disorders

Answer 15

substance abuse
anxiety
OCD
Mood disorders

Question 16

EATING DISORDER
STATISTICS

Answer 16

PREVALENCE
0.5-1.5% Canadians have an eating disorder
90-95% are women who live in urban areas

ONSET
Typically, 15 to 19 years;

COURSE Chronic

Question 17

EATING DISORDER
CAUSES

Biological Contributions

Answer 17

Biological:

CAUSES
* Higher incidence in identical twins compared to fraternal twins

may inherit non-specific traits: (emotional instability, poor impulse control)→higher responsiveness to stressful life events and eating impulsively is an attempt to relieve stress and anxiety

Other inherited traits/behaviours:
* BMI
* Purging
* Concern overeating

Question 18

eating disorder causes
- psychological

Answer 18

• Anxiety
• Diminished confidence in their own-abilities and sense of personal control
• Low self esteem
• Dissatisfaction with one’s own body and/or overweight
• Perfectionism
• Difficulty tolerating negative emotions

Question 19

Eating disorder

Cultural considertation

Answer 19

These disorders are more common in Western countries (but
seem to increasing in Eastern countries)

-Immigrants who have recently move to Western countries tend
to show an increase in these disorders

-Culturally the ideal body shape is transferred via media
exposure:
* especially true for women → overweight men are 2-5 times more common as
television characters than overweight women
* Media Exposure is associated with eating disorders

Question 20

Social influence

Answer 20

Family:
more pressure
more concern
one parent may have had it

Friends: high level of body concern

Question 21

Effects of dieting

Answer 21

High rate of adolescents dieting to lose weight (up to 60% of
women and 30% of men)

• Studies show that adolescents who are dieting have higher
  likelihood to develop eating disorders → it is one of the main risk
  factors

Effects of dieting:
-may lead to binging
-decrease self-esteem
-increase food preoccupation and negative mood

Question 22

TREATMENT
Pharmacological Treatment

Answer 22

-anorexia: currently no drug treatment is effective, antidepressants
are used to treat associated symptoms (e.g., anxiety, depression)

-bulimia: antidepressant medications (e.g., SSRI) reduce the
frequency of binge eating and purging. Most effective in
combination with psychological treatments

Question 23

TREATMENT
Psychosocial Treatments

Answer 23

CBT-E: cognitive - behavioral therapy-enhanced focuses on changing
erroneous believes and behaviors that characterized these
disorders

Question 24

TREATMENT
Psychosocial Treatments
-bulimia:

Answer 24

Cognitive aspects: teaching patients about consequences of overeating
and purging and the ineffectiveness of vomiting and laxative abuse.

• Behavioral aspects: eat small, manageable meals multiple times a day
  with short interval (less than 3 hours).
• Coping strategies to avoid binging and/or purging are identified
• CBT-E is the most effective, followed by interpersonal psychotherapy (IPT).
• Family therapy especially for families with adolescents affected by the
  disorder is effective
• Group psychoeducation → providing info on the disorder and strategies
  (e.g., meal planning)

Question 25

TREATMENT
Psychosocial Treatments
-Anorexia

Answer 25

First goal → restore patients’ weight (serious cases require hospitalization)

• Focus on maladaptive thoughts and feelings:
  anxiety about being overweight
  control over eating
  belief that thinness defines self-value
• One factor that defines effectiveness of treatment is readiness for change
• Family therapy is effective to eliminate the negative and dysfunctional
  communication