psychopathology - final exam (chapter 8 set)

stats for eating disorders

- ballet dancers are 25% likely to have eating disorders, 75% don't - people may have genetic/biological vulnerability examples of people shown in class: - valerie luyanova

anorexia and depression

- depression in 33%, 60% lifetime prev. of depression - substance abuse common and associated with suicides - highest mortality rate for any disorder

a psychological factor of eating disorders

- feelings of lack of control

a psychological factor of eating disorders

- high social anxiety

bulimia facts/stats

- most people w bulimia are within 10% of their body weight - higher rates for white women up until their mid 20s compared to black women

a psychological factor of eating disorders

- problems coping with negative emotion

a psychological factor of eating disorders

- reinforcement (positive and negative) ** people receive positive reinforcement for weight loss, using scale, and eating less to be thinner** INTENSE ANXIETY AFTER EATING **negative reinforcement through reduction in anxiety and physical discomfort through binging and then purging, using laxatives, etc.** ANXIETY RELIEVED BY PURGE/RESTRICTION

bulimia nervosa - medical complications

- salivary gland enlargement (puffy face) -erosion of dental enamel - electrolyte imbalances (Na, K, Ca) = seizures, arrhythmias and kidney failure -laxatives = constipation and colon damage

a psychological factor of eating disorders

- semi-starvation leads to preoccupation with food - binges

eating disorders are caused in a variety of ways throughout society

- social media influencers, retail stores, dance or specific sports, etc. caused by societal factors: - self esteem linked to thinness clash: weight trends and "ideal" standards - 20-30% pf americans are overweight - ideal (models, actresses) getting thinner may be improving a little in past few years - friendship cliques significantly define attitudes towards body image and dieting

etiology of eating disorders

- sociocultural appears stronger than psychological or biological factors

Eisler study -1997

- study with girls less than 19 - those in fam treatment, 90% benefit (maintained for 5 years) - family therapy works better than individual therapy - lower recovery rates than bulimia

societal factors in the etiology and cause of eating disorders

- western phernomenon and only recently found cross culturally, seems to be increasing -study with egyptian women in cairo and london universities (12% eating disorders in London only) - since the 60s, disorders particularly high in groups where there is pressure to be thin - dancers: 25% 11-14 yr old ballet dancers - gymnasts, skaters, actresses, models - gay males - wrestlers, jockeys

DSM criteria bulimia nervosa - attempts to compensate for calorie intake

-2/3 purge: laxative, vomiting - some also compensate with excessive excercise, fasting Example - princess diana

anorexia stats

-95% female - caucasian - middle to upper class - onset about age 13 outcome: -20% will die - 1/2 of these are suicides (50% higher rate than general population)

Bulimia characteristics

-95% female -caucasian -middle to upper class -onset 16-19 years 6-8% on college campuses meet criteria 50% college - occasional binges -75% have anxiety disorder -50-70% mood disorder at some point in disorder - mostly reaction to bulimia - substance abuse common

a psychological factor of eating disorders

-distorted perceptions of body shape

anorexia medical consequences

-dry skin and hair end of ovulation - sensitive to cold - downy hair on limbs and face - less common than bulimia - either restrict intake or binge-purge (1/2 binge and purge) - usually begins in adolescence after an episode of dieting or stress - often preoccupied by food - pride selves on control over food and eating

a psychological factor of eating disorders

-low self esteem, perfectionistic

family factors of eating disorders

-successful, hard-driving, concerned about appearances, conflicts/negative feelings repressed - disorder worsens family dynamics -

Anorexia

.6% lifetime prevalence - intense pursuit of thinness and fear of obesity - weight must be 15% below expected (average 25-30% below) -amenorrhea (eliminated in DSM-5) *meaning the absence of at least 3 menstrual cycles* - inapproriate evaluation of body or denial of seriousness of weight loss

DSM criteria bulimia nervosa - binges

1% lifetime prevalence for diagnosis you need binges BINGES: - large intakes of food: typically high fat foods in 2 hour period - feeling that eating is out of control -1x/week for 2 months (2x in DSM iv - excessive preoccupation with body shape and weight, fear weight gain

genetic factors of eating disorders

2,163 twin study -23% MZ had bulimia -9% DZ had bulimia -increased risk for anorexia, as well - inherit emotional instability, impulsitivity (contributes to low serotonin levels)

Binge eating disorder

Ipt outcomes = cbt outcomes - medications dont improve CBT outcomes

bulimia v anorexia

anorexia = positive reinforcement bulimia = negative reinforcement

treatment for eating disorders

antidepressant medications - not effective w anorexia - bulimia: 47% and 65% stopped binging and purging (no long term effects) psychological for bulimia: - CBT: educate, small meals throughout the day, cognitive therapy had to change attitudes, coping strategies - CBT both binge and purge declined by 90% at 1 year, 36% had stopped binging and purging, others had occasional episodes - interpersonal and CBT are effective therapies

study of ideal standard for women - 1959 - 1989

at 85 percent expected weight, many of the playboy and miss america women were considered anorexic - in the 80s, the level stayed the same for 10 years showing they are significantly underweight - overall in the 70s, the ideal standard for women became very skinny when the sex symbol before was marilyn monroe

treatment for eating disorders - anorexia

goal: weight gain, change dysfunctional attitudes regarding weight and body treatment: includes the family if possible, deal with dysfunctional patterns with food and body image

bulimia specific types

purging type: person regularly engages in self induced vomiting or the misuse of laxatives, diuretics, or enemas non-perging type: the person has used other inappropriate compensatory behaviors, such as fasting or exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas

anorexia - two types

restricting type: during the episode of anorexia, the person does not regularly engage in binge eating or purging behavior (no vomiting/laxatives used) Binge-eating/purging type: person has regularly engaged in binge eating or purging behavior

reciprocal gene environmental model

the same social anxiety, low self esteem, perfectionism, etc. also attracts you to risk factors and social media that will influence your perception of body image