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2nd Semester Nursing > Psych Eating Disorders > Flashcards

Psych Eating Disorders Flashcards

1
Q

What part of the brain regulates appetite?

A

hypothalamus

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2
Q

Primary characteristic of anorexia nervosa

A

Body image disturbance - belief that they’re fat when they’re obviously very thin.

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3
Q

What are the BMI ranges for mild-mod-severe anorexia?

A 
Mild = 17kg
Moderate = 16-16.99
Severe = 15-15.99
Extreme = less than 15
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4
Q

How does anorexia affect the family dynamic?

A

Focus is centered on the anorexic. Other people lose patience or get ignored.

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5
Q

Which is more common - bulimia or anorexia nervosa?

A

Bulimia

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6
Q

A binge is how many calories in how much time?

A

1000 cal in less than 2h

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7
Q

DSM V categories for bulimia

A

Mild: 1-3/wk
Moderate: 4-7/wk
Severe: 8-13/wk
Extreme: 14+/wk

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8
Q

Criteria for diagnosis of bulemia?

A

Binge/compensation 2x weekly for 3+mos

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9
Q

What are the compensatory behaviors for bulimia?

A

Vomiting
Laxatives
Diuretics
Fasting

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10
Q

NTs for bulimia vs NTs for anorexia?

A

Bulimia: Serotonin & norepinephrine

Anorexia: high endogenous opioid levels

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11
Q

Binge-eating disorder is characterized by

A

Large food binges
No attempt to rid the body of excess calories

Eating without hunger
Extremely rapid eating

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12
Q

Body Dysmorphic Disorder

A

Preoccupation with perceived flaws

Repetitive mirror-checking, grooming, skin-picking, comparing appearances

Distress d/t preoccupation

Not explained by concerns about fat/weight.

Not an eating disorder.

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13
Q

What kind of food do bulimics and binge-eaters prefer?

A

Carbohydrates/sweets

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14
Q

Possible meds for binge-eating disorder?

A

Venlafaxine/desfenlafaxine

Topiramate

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15
Q

Possible meds for obesity?

A

Prozac
CNS stimulants
Lorcarserin
Phentermine/topiramate

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16
Q

Meds with some success treating anorexia nervosa?

A

Aripiprazole

Maybe Olanzapine/Risperidone

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17
Q

Common themes between eating disorders

A

Low self-esteem
Fear of maturity
Conflict avoidance
Anxiety

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18
Q

What does elder abuse consist of?

A

Violation of personal rights

Abandonment

Material and financial exploitation

Neglect of care needed

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19
Q

Signs/Symptoms of child abuse

A

Disturbed growth/development

Ambivalence/denial

Sleep/eating disturbances

Bedwetting

Anxiety/depression/aggression

Sexualized play

Unexplained marks/bruises

Frightened of parents

Absence from school

Begs/steals food/money

Dirty, BO, insufficient clothes

saying “no one is home”

Refusing to change for gym

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20
Q

ACES predispose you to…

A 
Depression
Anxiety
Substance Abuse
Risk for Suicide
Heart disease
Hypertension
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21
Q

What is adjustment disorder?

A

Maladaptive reaction to a stressor (that can be identified) that affects functioning:

Can be with: 
-mood (depression)
-anxiety
(Or both)
-conduct disturbance
-emotional AND conduct disturbance

Happens w/in 3 months of stressor and ends w/in 6 months.

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22
Q

Define Acute Stress Disorder

A

Dissociative symptoms (amnesia, depersonalization, de-realization, numbing, detachment, lack of emotional response) occur during or w/in 4 weeks following event

Last for 2days-4weeks.

(Difference btw ASD and PTSD is onset and duration)

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23
Q

Both PTSD and ASD share what symptoms?

A
  • avoidance of feelings/thoughts/people associated with trauma
  • intense emotional reactions (fear, horror, helplessness)
  • dissociation
  • hyperarousal
  • re-experiencing of trauma
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24
Q

What sorts of events can ASD and PTSD develop after?

A

One that threatens

  • self
  • others
  • resources
  • sense of control
  • sense of hope
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25
PTSD definition
After 1+months (and lasting for more than 1 month): - social, interpersonal, occupational functioning are impaired - person reduces involvement with external world - goal is avoiding memories of the trauma
26
Arousal symptoms of PTSD - what are they caused by?
Increased noradrenergic and dopaminergic system activity Decreased serotonergic activity
27
What are PTSD arousal symptoms?
- increased startle - anxiety - restlessness - irritability - sleep disturbances - memory/concentration impairment - anger outbursts - survivor guilt - hypervigilance
28
In what ways do PTSD sufferers re-live the flashbacks?
Intrusive memories Nightmares Illusions Flashbacks
29
How is the hippocampus damaged in PTSD sufferers?
From high glucocorticoid levels and prolonged exposure to stress. Alters stress response, memory and fear conditioning.
30
What causes blunting, physical analgesia and depersonalization in PTSD?
Increased endogenous opiate release
31
What causes the re-experiencing of trauma that PTSD sufferers experience?
Activation of amígdala, locus ceruleus, hypothalamus, thalamus and HPA axis ... Has to do with memory coding/retrieval
32
Will estrogen and testosterone increase or decrease in PTSD sufferers?
They’ll increase secondary to a down-regulation of corticotrophin-releasing harming release.
33
What are the characteristics of a healthy reorganization process after violence/trauma?
Gradual decrease in anxiety, fear, anger Starts with review/organization of what happened and why (includes blame and justification) Progresses to regaining a sense of control and self-protection Progresses to resolution of grief. Lasts from months to years. If resolution doesn’t occur, anything that remains qualifies as PTSD.
34
What are the characteristics of Recoil?
Struggle to adapt Periods of acting normal As phase progresses, there’s a desire to talk about details/feelings about trauma. Need for support and temporary dependence. Last weeks to months. Gradual awareness of full impact.
35
What are the goals for treating PTSD?
- reduce symptoms - improve functioning - strengthen resilience - relieve comorbid symptoms - integrate traumatic experience - prevent relapse
36
Pharmacology: what would you use to reduce conditioned fear/anxiety?
Benzodiazapines Maybe Buspirone
37
Pharmacology: what would you use to help diminish the peripheral autonomic response?
Clonidine | Propranolol
38
Pharm: what would you use do decrease hyperarousal, nightmares, mood swings, and explosive outbursts?
Valproic Acid
39
What would you use to decrease repetitive behaviors, images and somatic states?
SSRIs * specifically - Paroxetine* - Sertraline*
40
What are risk factors for experiencing partner abuse?
- Witnessing parental violence - prior victimization - early puberty - early use of drugs/alcohol - exposure to media/internet violence
41
What are the 4 phases in the cycle of abuse?
1. Tensions building 2. Incident occurs 3. Reconciliation 4. Calm
42
Perpetrator behaviors in the tension-building phase?
- excessive expectations - blaming - doesn’t try to control behavior - doesn’t acknowledge inappropriate behavior - verbal & minor physical abuse increases - controlling out of fear that partner will leave - interprets partner’s withdrawal as rejection
43
What are the victim’s behaviors in the tension-building phase?
- tries to please - denies seriousness - thinks they can control abuser’s behaviors - blames external factors - thinks they deserve minor abuse - gets scared, tries to hide - calls for help if tension becomes unbearable
44
Perpetrator behaviors in serious battering incident?
- Trigger can be internal or external - occurs in private - threatens harm if victim tries to get help - justifies behavior - minimizes severity of abuse - this relieves tension for abuser
45
Victim behaviors in a serious battering incident?
- might call for help - shock, denial, disbelief - fears more abuse if police arrive or arrest - anxious, ashamed, humiliated, fatigued, depressed - does not seek help for a day or more, lies about cause
46
Honeymoon phase, perpetrator behaviors?
- loving, charming, asks for forgiveness - tells themselves they won’t do it again - believes they’ve taught victim a lesson and that they won’t “act up” again - guilt-trips victim to keep them trapped
47
Honeymoon phase victim behaviors?
- thinks loving behaviors are the real person - wants to believe it won’t happen again - believes that if they stay, abuser will get help - feel guilty about considering leaving - feels trapped in a permanent relationship
48
What interventions would you focus in the Impact stage?
-crisis intervention: - simple directions - avoid accusations - provide physical safety - provide emotional security - provide phone number for crisis intervention
49
Interventions in recoil stage?
- Support groups - Short-term counseling - validation of victim and their rights - referrals to therapies/victim groups
50
Interventions in Reorganization stage?
Long-term counseling for anxiety, PTSD, depression
51
What is the biological/psychological source of personality disorders?
There isn’t one that they know of.
52
What’s the difference between cluster A, B, and C (personality disorders)?
A: odd/eccentric B: dramatic/emotional/erratic C: Anxious/fearful
53
What cluster does Borderline PD fall into?
Cluster B (dramatic, emotional, erratic)
54
Why are you most likely to see BPD in an inpatient unit?
Self-harm
55
When would you see medication in a personality disorder?
When it is used for a comorbidity - doesn’t treat BPD.
56
What is BPD characterized by?
- instability in relationships - alternating extremes of idealizing and devaluation - frantic effort to avoid abandonment/feelings of emptiness - emotional dysregulation - transient stress r/t paranoia or dissociation
57
What would Naltrexone be used for in BPD?
Self-harm behaviors
58
What would Lithium, Depakote or Carbamazepine be used for in BPD?
Rapid mood swings
59
What would SSRIs be used for in BPD?
Emotionally dysregulation
60
What would antipsychotics be used for in BPD?
Aggressiveness, violence Extreme impulsivity Cognitive-perceptual symptoms (paranoia, etc...)
61
Antisocial Personality Disorder is characterized by...
Disregard for the rights of others from about age 15. Illegal actions Deceitful/cons others for pleasure/profit Irritable, irresponsible, lack of remorse or guilt for behaviors Impulsivity Doesn’t assume responsibility for behaviors Difficulty sustaining employment or maintaining relationships
62
What are risk factors for antisocial personality disorder?
ADHD/disruptive behavior disorder or conduct disorder in childhood History of severe abuse Absent/inconsistent discipline Extreme poverty Removal from home Always being rescued when in trouble Maternal deprivation
63
What are some nursing interventions for antisocial personality disorder?
Consistent limit setting Fostering responsibility and accepting consequences Identification of real feelings.

2nd Semester Nursing (18 decks)

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