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PMI > week 4 > Flashcards

week 4 Flashcards

1
Q

What is the definition of anorexia?

A

severe loss of appetite

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2
Q

What is the definition of nervosa?

A

emotional reasons

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3
Q

What are the DSM-IV criteria for anorexia?

A

A. Refusal to maintain 85% of normal body weight
B. Intense fear of being overweight, when they are significantly underweight
C. Disturbance in the way in which one’s body weight is experienced
D. Amenorrhea

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4
Q

What are the DSM-IV subtypes of anorexia?

A
  • restricting type

- binge eating/purging type

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5
Q

What are some associated features of anorexia?

A
  • Depressed mood, social withdrawal, irritability, insomnia, diminished interest in sex.
  • Obsessive-compulsive features
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6
Q

What is the prevalence of anorexia?

A
  • More common in industrialised societies
  • 0.5-1% of females.
  • 10-20:1 gender ratio
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7
Q

What is the mean age of onset for anorexia?

A

17

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8
Q

What is the long-term mortality rate for anorexia?

A

10% (although medical complications and suicide impact on mortality rates)

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9
Q

What are the physical consequences of anorexia?

A 
Mild anemia
Dehydration
Fluid and electrolyte disturbances
Reduced resting energy expenditure
Constipation
Abdominal pain
Cold intolerance; hypothermia; reduced body temperature
Lethargy and muscle weakness
Hypotension
Dry, cracking skin
Lanugo: fine downy body hair on face and neck
Brittle fingernails
Bradycardia: increased/decreased heart rate 
Peripheral edema: yellowish discolouration of skin
Dental enamel erosion – due to vomiting
Impaired renal function
Cardiovascular problems 
Osteoporosis
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10
Q

Describe the psychoanalytic aetiology of anorexia

A
  • Eating is a substitute for sexual expression

- Reflection of conflict between wanting to attain independence and selfhood within the family and a fear of growing up

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11
Q

Describe the learning aetiology of anorexia

A

Weight phobia or striving to effect image of slimness emulated and modeled by society

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12
Q

Describe the genetic aetiology of anorexia

A
  • Occur at higher rates in first degree biological relatives

- MZ twins higher concordance than DZ twins

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13
Q

Describe the biochemical aetiology of anorexia

A
  • Disturbance in hypothalamic functioning
  • However, not known whether disturbance is the cause of anorexia, result of weight loss and caloric restriction, or result of emotional distress of patient
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14
Q

Describe the family systems aetiology of anorexia

A
  • Deflecting attention away from family conflict
  • Families try to be too positive and do not acknowledge conflicts
  • Triangulation = over communication from both parents with the child, but not enough communication between the parent
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15
Q

What is the behavioural method of treating anorexia?

A 
Examples are:
		• Not allowed to weigh themselves
		• Food schedules
		• Small meals
		• Watching them eat
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16
Q

How is family therapy used to treat anorexia?

A
  • changing the patient role of the anorexic
  • redefining the eating problem as an interpersonal one
  • preventing the parents from using their child’s anorexia as a means of avoiding conflict
17
Q

What drug has been used in an attempt to treat anorexia?

A

Chlorpromazine - (limited success)

18
Q

What are the subtypes of bulimia?

A

Purging & non-purging

19
Q

What are the DSM-IV criteria for bulimia?

A

A. Recurrent episodes of binge eating.
B. Recurrent inappropriate compensatory behaviours in order to prevent weight gain.
C. Behaviour occurs on average at least twice per week for 3 months.
D. Self evaluation is unduly influenced by body shape and weight.
E. The disturbance does not occur exclusively during episodes of anorexia nervosa.

20
Q

What is the prevalence of bulimia?

A
  • occurs in 1-3% of adolescent females
  • 1:10 gender ratio
    However, because of its nature, rates of bulimia are extremely underestimated
21
Q

What are the associated features of bulimia?

A
  • depression
  • anxiety
  • substance abuse or dependence
    personality disorders (borderline PD most common)
22
Q

What are the physical consequences of bulimia?

A
  • Fluid and electrolyte abnormalities
  • Loss of dental enamel; chipped teeth; increased dental cavities
  • Menstrual irregularity or amenorrhea
  • Dependence on laxatives to produce bowel movements
  • Sore throats
  • Swollen salivary glands
  • Nutritional deficiencies
  • Dehydration
  • Purging type more likely to have physical problems than non-purging type
23
Q

What are the main differences between anorexia and bulimia?

A
  • Bulimia within normal weight range
  • Many individuals with anorexia do not purge
  • Appetite can be decreased in anorexia – increased in bulimia
  • Amenorrhea occurs less often in bulimia
24
Q

Describe the genetic aetiology of bulimia

A

Increased frequency of bulimia, mood disorders and substance abuse and dependence in first-degree biological relatives

25
Q

Describe the biochemical aetiology of bulimia

A
  • Abnormalities in endogenous opioids

* Nature of mechanism still uncertain

26
Q

Describe the stress theory aetiology of bulimia

A
  • bulimics perceive they have lack of control, experience higher levels of anxiety, and have coping deficits
  • Alexithymia= a personality construct characterized by the sub-clinical inability to identify and describe emotions in the self.
27
Q

Describe the cognitive theory aetiology of bulimia

A

Overconcern with body weight, size, and shape; body image distortion; desire to be thinner; and perception of being out of control when eating

28
Q

Describe the social factors aetiology of bulimia

A

Lower perceived social support; more negative interpersonal interactions and higher levels of conflict; lower social skills and social competence

29
Q

How is CBT used to treat bulimia?

A
  • Cognitive restructuring: thinking about relationship with food. 79% median reduction in frequency of bingeing.
  • Exposure response prevention:
    • Technique tries to prevent or delay purging after bingeing
    • Mixed results
    • Benefits of cognitive restructuring enhanced by addition of response prevention
30
Q

What drug is used to treat bulimia?

A

Antidepressants.

PMI (6 decks)

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