Psych 241 final exam Flashcards
BINGE-EATING DISORDER
DIAGNOSTIC CRITERIA
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Binge eating disorder
Main features
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
Bing eating CLINICAL DESCRIPTION
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
BULIMIA NERVOSA
DIAGNOSTIC CRITERIA
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Main features of bulmia nervosa
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
Bulimia nervosa clinical description
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
medical consequences bulimia nervosa - vomiting
VOMITING:
electrolyte imbalance: imbalance of sodium and potassium levels
Dental enamel erosion
Cardiac arrhythmia
Kidney failure
Parotid (salivary glands) swelling
level
medical consequences bulimia nervosa - laxatives
LAXATIVES:
Electrolyte imbalance
Colon damage
Kidney inflammation
Cardiac complications (cardiac arrest and seizure)
Dehydration that can lead to
problems at the muscular-skeletal
bulimia nervosa: Associated psychological disorders
substance abuse, borderline personality disorder, anxiety, mood disorders
Anorexia nervosa - DSM
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Anorexia nervosa - main features
Fear of gaining weight —– Severe caloric restriction—–Severe weight loss, BMI <18
Distorted body image
Aneorexia nervosa: clinical description
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
BMI normal
between 18-25
anorexia nervosa: medical consequences
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
Anorexia nervosa: associated psychological disorders
substance abuse
anxiety
OCD
Mood disorders
EATING DISORDER
STATISTICS
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
EATING DISORDER
CAUSES
Biological Contributions
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
eating disorder causes
- psychological
- 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
Eating disorder
Cultural considertation
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
Social influence
Family:
more pressure
more concern
one parent may have had it
Friends: high level of body concern
Effects of dieting
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
TREATMENT
Pharmacological Treatment
-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
TREATMENT
Psychosocial Treatments
CBT-E: cognitive - behavioral therapy-enhanced focuses on changing
erroneous believes and behaviors that characterized these
disorders
TREATMENT
Psychosocial Treatments
-bulimia:
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)
TREATMENT
Psychosocial Treatments
-Anorexia
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
