Week 7 - Feeding & Eating Disorder; Sleep-Wake Disorders, and Substance Use Disorders Flashcards
What are ‘feeding and eating disorders?’
Psychological disorders involving disrupted eating patterns and maladaptive ways of controlling body weight.
What is ‘Anorexia Nervosa?’
An eating disorder primarily affecting young women, characterized by the maintenance of abnormally low body weight, distortions of body image, and intense fears of gaining weight.
What does ‘prevalence mean?’
The measure of a condition in a population at a given point in time (in this document referred to as point prevalence ); can also be measured over a period of time (e.g. a year).
What does ‘period prevalence’ mean?
Porportion of a population that has the characteristic at any point during a given time period of interest. “Past 12 months” is a commonly used period.
What is the prevalence of ‘Anorexia Nervosa?’
0.4% 12-month prevalence; meaning .10 times more
prevalent in females.
What are the essential features of ‘Anorexia Nervosa?’
Energy intake restriction, fear of gaining weight or becoming fat, distorted self-perceptions.
What are the common symptoms of ‘Anorexia Nervosa?’
Amenorrhea, lanugo, dry skin, brittle nails, intolerance/sensitivity to cold temperatures, cardiovascular and gastrointestinal problems.
What is ‘amenorrhea?’
Absence of menstruation - a possible sign of anorexia nervosa.
What is ‘Osteoporosis?’
A physical disorder caused by a calcium deficiency that is characterized by extreme brittleness of the bones (from the Greek osteon, meaning “bone,” and the Latin porus, meaning “pore”).
What is ‘lanugo?’
Is fine, soft, unpigmented hair that is often present in fetuses, newborns, and certain disease states. While IT is a normal finding in fetuses, its presence in an older person might be an indication of underlying pathology
What are the specifiers of ‘Anorexia Nervosa?’
Restricting type, and the binge-eating/purging type.
What is the major distinction between the subtypes of anorexia?
The distinction between the subtypes is supported by differences in personality patterns. Those with eating/purging type tend to have problems related to impulse control (binge eating habits, substance abuse, stealing); they tend to alternate because of periods of rigid control and impulsive behaviour. Those with restrictive type tend to be rigidly and obsessively controlled about their diet and appearance.
What is the ‘Restricting Type/specifier’ of Anorexia Nervosa?
During the last 3 months, the individual has not engaged in recurrent episodes of binge eating or purging behaviour (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas). This subtype describes presentations in which weight loss is accomplished primarily through dieting, fasting,
and/or excessive exercise.
What is the ‘Binge-eating/purging type/specifier’ of Anorexia Nervosa?
During the last three months, the individual has engaged in recurrent episodes of binge-eating or purging behaviour (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas).
What is ‘bulimia nervosa?’
An eating disorder is characterized by a recurrent pattern of binge eating followed by inappropriate compensatory behaviours to prevent weight gain and accompanied by persistent overconcern with body weight and shape.
What are the common symptoms of ‘Bulimia Nervosa?’
*Irritations of skin about mouth and hand (due to contact with stomach acid)
* Blockage of salivary ducts
* Decay of tooth enamel and dental cavities
* Stomach acid may damage taste receptors in the mouth (decreased sensitivity to the aversive taste of vomit)
* Abdominal complaints; stress on the pancreas (development of pancreatitis)
* Muscular weakness, cardiac irregularities, sudden death, lost of menstruation
How does the ‘binge-eating/purging type” specifier in anorexia differ from bulimia?
Although repeated binge eating and purging cycles occur in bulimia, bulimic individuals do not reduce their weight to anorexic levels.
What is an example of a ‘systems perspective?’
In terms of eating disorders, families are organization systems that are meant to resist overt change; within this perspective, an anorexic girl may be seen as maintaining dysfunctionality by displacing attention from family conflicts and marital tensions onto themselves. The girl might be identified as the problem when it is actually a dysfunctional family unit.
What is a ‘systems perspective?’
View that problems reflect the systems (family, social, school, ecological, etc.) in which they are embedded.
In terms of “losing weight,” which diagnosis is more “successful,” Anorexia Nervosa or Bulima Nervosa?
Anorexia, primarily because while both include purging, bulimia involves eating large amounts of food and using compensatory measures like purging. Purging only reduces caloric intake by approx. 50%. Generally, those with bulimia, generally, remain within 10% of their normal weight.
What are some examples of “compensatory measures?”
Self-induced vomiting, using laxatives and/or diuretics, fasting, exercise.
What are the cultural considerations regarding eating disorders?
Found overwhelmingly in Western cultures/influence. Some studies have shown African American adolescents to have less body dissatisfaction, few weight concerns, and a more positive self-image.
What are the psychological influences of eating disorders?
Women with anorexia often have significantly higher perfectionistic attitudes compared to healthy controls. Bulimia women tend to be both perfectionist and dichotomous (“black or white”) in their thinking patterns. Bulimic women also tend to struggle with interpersonal relationships.
* A diminished sense of control,
* Tendency toward perfectionism
* Black or white thinking
* High self-judgment
* Struggles with independence
What are the cognitive influences of bulimia nervosa?
Women with bulimic tendencies tend to have a dysfunctional cognitive style that may lead to exaggerated beliefs.
What are the biological influences of eating disorders?
There is some evidence of a genetic link; the hypothalamus (as it regulates eating) and serotonin (a decrease in production may be a factor in bingeing and impulsivity, it is also involved in regulating mood and appetite, especially for carbs).
Binge-Eating Disorder (BED)
Eating disorders characterized by repeated episodes in which binge eating occurs but is not followed by purging.
* Associated with severe obesity
* Have similar concerns about shape and weight
* Later onset; more common in males
* Tends to occur later in life
Pica
Eating one or more nonnutritive, nonfood substances on a persistent basis over a period of at least 1 month.
* Could be paper, cloth, hair, soil, chalk, gum, metal, ash
What are the sociocultural influences of eating disorders?
Parental and societal influences. Have close but troubled relationships
* Families can be successful, but hard
driving, concerned about external
appearances, and eager to maintain
harmony (Attie et. al., 1985)
* Mothers tend to demonstrate
perfectionism may have low levels
of nurturance and empathy
* Standards of the ideal female body
are often unrealistic
* Increase in diets and exercise trends
* Link between chronic dieting and
bingeing and food preoccupation
Multimodal Treatment includes:
CBT – target eating behaviours, attitudes
around body weight and shape
* Interpersonal therapy – target interpersonal
functioning (helping with their ability to create healthy relationships)
* Family therapy – focus on relationships and
communication (aiding a dysfunctional family)
What is ‘Sleep Efficiency (SE)?’
Commonly defined as the ratio of total sleep time (TST) to time in bed (TIB), plays a central role in insomnia research and practice. The significance of SE is understandable because it captures a core problem for those suffering from insomnia—spending too much time in bed trying to sleep.
What are the ‘Sleep Stages?’ How do they differ?
- Stage 1: low amplitude, high-frequency waves
- Stage 2: sleep spindles (batch of high-frequency waves) & k-complexes (a biphasic wave that stands out from the rest of the wave)
- Stage 1 &2 = “light sleep”
- Stage 3: “slow wave sleep” or “deep sleep.” there are high amplitude delta waves that make up about 20% of the brain active - overall restfulness
*REM Sleep: resembles waking activity, most vivid dreams
How long is a sleep cycle? How many do we typically cycle through in a night?
Sleep cycles repeat 4-5 times per night, each cycle lasts around 90-110 minutes.
* Order: 1-2-3-2-1-REM-1-2-3-2-1-REM-1-2-3-2-1-REM
What is ‘REM Sleep?’
REM (rapid eye movement) sleep is the sleep stage associated with dreaming characterized by the appearance of rapid eye movements under closed eyelids. Hypocretin neurotransmitter is involved in arousal and wakefulness.
What is a ‘neuropeptide?’
An amino acid found in cerebrospinal fluid that plays a role in neuronal transmission and the modulation of brain circuits or regions.
What is ‘breathing-related sleep disorders?’
Sleep disorders in which sleeping is repeatedly disrupted due to difficulties breathing normally.
What is ‘Insomnia Disorder?’
Dissatisfaction with sleep quality
or quantity associated with:
* Difficulty initiating sleep
* Difficulty maintaining sleep
* Early-morning awakening with
inability to return to sleep
* Occurs at least 3 nights per week
* Present for at least 3 months
How prevalent is ‘Insomnia Disorder?’
25% of Canadians report symptoms of insomnia
What is ‘Hypersomnolence Disorder?’
Excessive sleepiness during the
day; may sleep a lot but never feel
refreshed. Daytime sleep with intended or
unintended naps.
* Sleep-wake disorder involving a persistent pattern of excessive sleepiness during the day.
What is ‘Narcolepsy?’
Sleep attacks in when a person suddenly falls asleep without warning. Sometimes paired with cataplexy.
* Can occur multiple times per day
* Sleep for an average of 15 minutes
* Sudden irresistible episodes of sleep (sleep attacks)
What is ‘cataplexy?’
- brief, sudden loss of muscular control
- Can last from seconds to 2 minutes
- Often preceded by a strong emotion
What is ‘Sleep Paralysis?’
The brief period after awakening when the person can’t move or speak.
What is ‘Hypnogogic Hallucinations?’
- Vivid experiences that begin at
the start of the sleep and are
generally very realistic - Often involve visual, touch,
hearing, and even the sensation
of body movements
What is ‘apnea?’
Temporary cessation of breathing.
What is ‘Obstructive sleep apnea-hypopnea (OSA)?’
Type of breathing-related disorder involving repeated episodes of either complete or partial obstruction of breathing during sleep.
What is ‘Circadian Rhythm Sleep-Wake Disorders?’
Disruptions of sleep are caused by a mismatch in sleep schedules between the body’s internal sleep-wake cycle and the demands of the environment.
* Can lead to insomnia or hypersomnia
* Light and melatonin influence our sleep rhythms
What is ‘Parasomnias?’
Disruptive sleep-related disorders. Abnormal movements, talk, emotions and actions happen while you’re sleeping, although your bed partner might think you’re awake. Examples include sleep terrors, sleepwalking, nightmare disorder, sleep-related eating disorder and sleep paralysis.
What is ‘Nightmare Disorder?’
- Recurrent awakenings from sleep
because of frightening dreams - Dreams are recalled vividly upon
wakening - Occur during REM sleep
What is ‘Non-REM Sleep Arousal Disorder?’
Sleep-wake disorders involviing recurrent episodes of incomplete arousal during sleep that are accompanied by sleep terrors or sleepwalking. Comprised of Sleep terrors and sleepwalking.
* Sleep terrors: piercing screams, awake suddenly, don’t remember the dream
* Sleepwalking: walks around while fully asleep
What are ‘Anxiolytics?’
Drugs, such as sedatives and anesthetics, that induce partial or complete unconsciousness and are commonly used in the treatment of sleep-wake disorders. A class of medications used to prevent or treat anxiety symptoms or disorders. They’re sometimes called anti-anxiety medications or minor tranquillizers. Helpful for falling asleep faster, increasing the total length of sleep. and reducing nightly awakening.
These types of medications are habit-forming and can lead to dependency or a substance use disorder. Problems may arise, like the hangover effect, rebound insomnia, reduced effect over time, and dependence.
What are the treatment(s) for ‘apnea?’
CPAPs surgery.
What are the characteristics for psychological treatment for sleep disorders?
CBT for Insomnia, which includes:
* Relaxation training
* Cognitive strategies (e.g., thought-stopping)
* Stimulus control, which includes: strengthening the connection between the bed and sleep, limiting time spent trying to fall asleep, starting with shorter amounts of total sleep and working up to more hours (while waking up at the same time every day with no napping)
What does ‘use’ mean?
Any consumption of a substance.
What does ‘intoxication’ mean?
A substance-induced disorder characterized by clinically significant problematic behavioural or psychological changes caused by the recent ingestion of a substance (state of drunkenness or “being high”).
A reversible syndrome caused by a substance that affects one or moe of the functions:
*memory
*orientation
*mood
*judgement
*behavioural, social, or occupational functioning
What does ‘abuse’ mean?
Use of a substance that deviates from social or medical patterns.
What does ‘misuse’ mean?
Use of a prescribed medication that deviates from recommended usage.
What does tolerance’ mean?
- Phenomenon when, after repeated administration, an increase in the dosage is required for the same effect
What is “delirium?”
State of mental confusion, disorientation, and extreme difficulty in focusing attention.
What is “delirium tremens (DTs)?”
Withdrawal syndrome that often occurs following a sudden decrease or cessation of drinking in chronic alcoholics that is characterized by extreme restlessness, sweating, disorientation, and hallucinations.
What is “tachycardia?”
Abnormally rapid heartbeat.
What does ‘withdrawal syndrome’ mean?
A characteristic cluster of withdrawal symptoms following the sudden reduction or abrupt cessation of use of a psychoactive substance after physiological dependence has developed.
* A substance-specific syndrome that occurs after stopping or reducing the amount of the drug or substance that has been used regularly over a prolonged period.
What does ‘dependence’ mean?
- Physiological – body changes due to repeated consumption and then comes to depend on the substance.
- Psychological – reliance on a substance, regardless of physiologically dependence.
What does ‘addiction’ mean?
Impaired control over the use of a chemical substance accompanied by physiological dependence. Habitual or compulsive use of a drug/behaviour accompanied by distress when not using as well as an irresistible urge to use again
What does ‘physiological dependence’ mean?
State of physical dependence on a drug in which the user’s body comes to depend on a steady supply.
What does ‘psychological dependence’ mean?
Reliance as on a substance, although one may not be physiologically dependent.
How does the DSM describe substance use disorders?
Substance use disorders involve a pattern of recurrent use of a substance that repeatedly leads to damaging consequences and impaired control over the use of a substance and often includes features of physiological dependence on the substance, as manifested by the development of tolerance or abstinence syndrome.
* Recurrent use
*Damaging consequences
* Impaired control over substance use
* Dependence
What does ‘Substance Use Disorder’ mean?
Patterns of maladaptive behaviour involving the use of a psychoactive substance.
What are ‘substance-induced disorders?’
Disorders induced by the use of psychoactive substances include intoxication, withdrawal, syndromes, mood disorders, delirium, and amnesia, psychotic disorders, anxiety disorders, sexual dysfunctions, and sleep disorders. Includes:
* Substance intoxication
* Substance withdrawal
* Substance/Medication - Induced Mental Disorders
What is ‘substance use disorder?’
Patterns of maladaptive behaviour involving the use of the psychoactive substance; leads to damaging consequences.
What are the specifiers in Substance Use Disorders?
Early remission, sustained remission, controlled environment.
