*Tutorial 7 - Eating Disorders Flashcards
Why is it important to effectively treatment AN?
Highest mortality rate out of all the DSM - 25%
What are some of the challenges in treating and researching AN?
No real effective treatment currently
Higher attrition - because many don’t want to be treated as treating involves food
No brief treatments deemed effective
In studies, small initial pool of participants who want to join studies
Running an RCT: ethical issues, could die on waiting list
FIX CARD
What were the aims of the ANTOP study?
Assess efficiacy of two outtreatment things
1. focal something
compared CBT, treatment as usual and something
Control group: indv. design treatment
interpersonal
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What were the results from the ANTOP study?
What do they suggest about treatments for adults with AN?
What are some implications?
All, it worked but not that much more.
Enhanced CBT most effective in terms of weight gain speed
What are some of the strengths and limitations of the ANTOP study?
maybe therapy isnt having much effect
regression of the mean - ppl only seek help when in crisis
ppl in ano tend not to spontaneously recovery, so is possible all treamtents were doing same thing
big sample size, 250
takes a long time to do this trial, the more expensive
BMI unreliable, no idea what is going on in their head, and there is a lot of variation in BMI
could instead do a scan to find weight/muscles etc.
but also psyc measures more important
lots of ppl dropped out, no true control group
30% attrition rate is a lot
What are the advantages/disadvantages for behavioural programs for weight gain?
not allowed home if not gained weight - conditioning
Negative reinforcement, removal of privileges when weight drops
creates environment where there is a lot of resistance. once theyre out, there is no reinforcement, you would expect relapse
What are the advantages/disadvantages of group treatment?
One of the patients taking responsibility / feeling responsible for one of the other patients
learning how to cheat the system together
“sympathy purging” excuse
support each other mentally, to help social needs
eating together may make eating more social
perhaps knowing others normalise it
can bring comparisons about - competetiveness
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In the documentary “Wasting away”, what diagnosis is most appropriate for Holly?
Secretly dieting and purging for years, had BN? no she doesn’t binge. she was also underweight, so anorexic, binge perge type
What are the challenges in establishing a therapeutic alliance with AN patients?
A lot of the anger patients have are taken out of the health profressionals
mandatory reporting
trust
List some serious medical, psychological and social problems associated with AN?
brain shrinks, depression, perfectionism, laxative overdose, osteoporosis, fainting, loss of energy
not able to have kids, death, loss of period, lanugo hair, hypothermia, fear or anxiety around weight gain
sequili - results of stuff. cognitive impaired. hard to challenge cognitions like that.
Social problems - adverse reactions from friends, lying to therapist, damage relationships, missing out on school, family life, trouble communicating, guilt and powerlessness, so effective MORDSLEY FAMILY THERAPY - shared accountability of problems
In the documentary “Wasting Away”, what were some possible causes listed for AN?
Well family can maintain it. perfectionism, selective attn to things, body image in media, need for control, coping mechanism
NOTE:
maybe email Francis?
I am still struggling with what a binge even refers to…like how subjective it can be to qualify…
also is diagnostic instability only high (out of the eating disorders) for AN and BN?
(if so, how can it not be transdiagnostic?)
ANSWER: because CBT is dif. in every disorder:
to treat AN you restructure their thoughts about their strict rigidness, and teach them about being malnourished. With BN you teach them about the ineffectiveness of vomiting etc and dangers of it and then it’s about keeping trying silly diets they can’t sustain. they need to stop GOING oN diets. AN patients need to GET OUT OF there dieting behaviour.
