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2nd Semester Nursing > Psych Eating Disorders > Flashcards

Psych Eating Disorders Flashcards

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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
Q

PTSD definition

A

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
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26
Q

Arousal symptoms of PTSD - what are they caused by?

A

Increased noradrenergic and dopaminergic system activity

Decreased serotonergic activity

27
Q

What are PTSD arousal symptoms?

A
  • increased startle
  • anxiety
  • restlessness
  • irritability
  • sleep disturbances
  • memory/concentration impairment
  • anger outbursts
  • survivor guilt
  • hypervigilance
28
Q

In what ways do PTSD sufferers re-live the flashbacks?

A

Intrusive memories

Nightmares

Illusions

Flashbacks

29
Q

How is the hippocampus damaged in PTSD sufferers?

A

From high glucocorticoid levels and prolonged exposure to stress.

Alters stress response, memory and fear conditioning.

30
Q

What causes blunting, physical analgesia and depersonalization in PTSD?

A

Increased endogenous opiate release

31
Q

What causes the re-experiencing of trauma that PTSD sufferers experience?

A

Activation of amígdala, locus ceruleus, hypothalamus, thalamus and HPA axis …

Has to do with memory coding/retrieval

32
Q

Will estrogen and testosterone increase or decrease in PTSD sufferers?

A

They’ll increase secondary to a down-regulation of corticotrophin-releasing harming release.

33
Q

What are the characteristics of a healthy reorganization process after violence/trauma?

A

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
Q

What are the characteristics of Recoil?

A

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
Q

What are the goals for treating PTSD?

A
  • reduce symptoms
  • improve functioning
  • strengthen resilience
  • relieve comorbid symptoms
  • integrate traumatic experience
  • prevent relapse
36
Q

Pharmacology: what would you use to reduce conditioned fear/anxiety?

A

Benzodiazapines

Maybe Buspirone

37
Q

Pharmacology: what would you use to help diminish the peripheral autonomic response?

A

Clonidine

Propranolol

38
Q

Pharm: what would you use do decrease hyperarousal, nightmares, mood swings, and explosive outbursts?

A

Valproic Acid

39
Q

What would you use to decrease repetitive behaviors, images and somatic states?

A

SSRIs

  • specifically
  • Paroxetine*
  • Sertraline*
40
Q

What are risk factors for experiencing partner abuse?

A
  • Witnessing parental violence
  • prior victimization
  • early puberty
  • early use of drugs/alcohol
  • exposure to media/internet violence
41
Q

What are the 4 phases in the cycle of abuse?

A
  1. Tensions building
  2. Incident occurs
  3. Reconciliation
  4. Calm
42
Q

Perpetrator behaviors in the tension-building phase?

A
  • 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
Q

What are the victim’s behaviors in the tension-building phase?

A
  • 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
Q

Perpetrator behaviors in serious battering incident?

A
  • 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
Q

Victim behaviors in a serious battering incident?

A
  • 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
Q

Honeymoon phase, perpetrator behaviors?

A
  • 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
Q

Honeymoon phase victim behaviors?

A
  • 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
Q

What interventions would you focus in the Impact stage?

A

-crisis intervention:

  • simple directions
  • avoid accusations
  • provide physical safety
  • provide emotional security
  • provide phone number for crisis intervention
49
Q

Interventions in recoil stage?

A
  • Support groups
  • Short-term counseling
  • validation of victim and their rights
  • referrals to therapies/victim groups
50
Q

Interventions in Reorganization stage?

A

Long-term counseling for anxiety, PTSD, depression

51
Q

What is the biological/psychological source of personality disorders?

A

There isn’t one that they know of.

52
Q

What’s the difference between cluster A, B, and C (personality disorders)?

A

A: odd/eccentric
B: dramatic/emotional/erratic
C: Anxious/fearful

53
Q

What cluster does Borderline PD fall into?

A

Cluster B (dramatic, emotional, erratic)

54
Q

Why are you most likely to see BPD in an inpatient unit?

A

Self-harm

55
Q

When would you see medication in a personality disorder?

A

When it is used for a comorbidity - doesn’t treat BPD.

56
Q

What is BPD characterized by?

A
  • 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
Q

What would Naltrexone be used for in BPD?

A

Self-harm behaviors

58
Q

What would Lithium, Depakote or Carbamazepine be used for in BPD?

A

Rapid mood swings

59
Q

What would SSRIs be used for in BPD?

A

Emotionally dysregulation

60
Q

What would antipsychotics be used for in BPD?

A

Aggressiveness, violence
Extreme impulsivity

Cognitive-perceptual symptoms (paranoia, etc…)

61
Q

Antisocial Personality Disorder is characterized by…

A

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
Q

What are risk factors for antisocial personality disorder?

A

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
Q

What are some nursing interventions for antisocial personality disorder?

A

Consistent limit setting

Fostering responsibility and accepting consequences

Identification of real feelings.

2nd Semester Nursing (18 decks)

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