Module 52: Dissociative, Personality, and Eating Disorders

Anorexia Nervosa

an eating disorder in which a person (usually an adolescent female) maintains a starvation diet despite being significantly underweight; sometimes accompanied by excessive exercise

Bulimia Nervosa

an eating disorder in which a person's binge eating (usually of high-calorie foods) is followed by inappropriate weight-loss promoting behavior, such as vomiting, laxative use, fasting, or excessive exercise.

DID and the Brain

Abnormal brain anatomy and activity can also accompany DID Brain scans show shrinkage in areas that aid memory and detection of threat Heightened activity appears in brain areas associated with the control and inhibition of traumatic memories

Eating Disorders: A U.S. National Institute of Mental Health-funded study reported that, at some point during their lifetime...

0.6% of Americans met the criteria for Anorexia 1% for Bulimia 2.8% for Binge-Eating

The ten disorders in DSM-5 tend to form three clusters, characterized by...

-anxiety, such as a fearful sensitivity to rejection that predisposes the withdrawn avoidant personality disorder. -eccentric or odd behaviors, such as the emotionless disengagement of schizotypal personality disorder. -dramatic or impulsive behaviors, such as the attention-getting borderline personality disorder, the self-focused and self-inflating narcissistic personality disorder, and—what we next discuss as an in-depth example—the callous, and sometimes dangerous, antisocial personality disorder.

Antisocial Personality Disorder

A personality disorder in which the person (usually a man) exhibits a lack of conscience for wrongdoing, even toward friends and family members. May be aggressive and ruthless or a clever con artist.

Brenda has been diagnosed with bulimia nervosa. Which of the following is a key characteristic of her eating disorder? A. binge eating and purging by self-induced vomiting B. being 15 to 20 percent below her ideal body weight C. loss of appetite, especially for high-calorie foods D. being unaware of the fact that she has an eating disorder

A. binge eating and purging by self-induced vomiting

The experience of a "fugue state" is indicative of a(n) ________ disorder. A. dissociative identity B. panic C. obsessive-compulsive D. mood

A. dissociative identity

Raquel was initially excited to make the cheerleading squad. However, her parents noticed that she stopped eating dinner with them, claiming she had already eaten. She wanted to help make most meals, and had a list of good and bad foods. She began portioning the amount of food she ate, and weighing it. Most concerning was the significant weight drop from a healthy 115 pounds to 90 pounds. Raquel most clearly demonstrates symptoms of: A. bulimia nervosa. B. anorexia nervosa. C. avoidant personality disorder. D. borderline personality disorder.

B. anorexia nervosa.

Last week Tate, who seems to lack a conscience for wrongdoing, went into the hospital for a painful medical procedure. Oddly, he did not seem worried beforehand, and he showed no signs of autonomic nervous system arousal. From all these signs, it is very likely that Tate would be diagnosed as having: A. schizotypal personality disorder. B. antisocial personality disorder. C. borderline personality disorder. D. schizophrenia.

B. antisocial personality disorder.

In a study examining genetic influences on antisocial personality disorder, Adrian Raine compared the PET scans of murderers' brains to the brains of nonmurderers of the same age and sex. Raine reported reduced activity in the murderers' _____________ (a brain area that helps with impulse control). A. pineal gland B. frontal lobes C. medull D. areticular formation

B. frontal lobes

Ever since childhood, Jaime has been eccentric as well as demonstrating odd behavior. She exhibits emotionless disengagement to such a great degree that she would likely be diagnosed with __________ personality disorder. A. narcissistic B. schizotypal C. antisocial D. histrionic

B. schizotypal

Cause of DID?

Both the psychodynamic and learning perspectives have interpreted DID symptoms as ways of coping with anxiety. Some psychodynamic theorists see them as defenses against the anxiety caused by the eruption of unacceptable impulses. In this view, a second personality enables the discharge of forbidden impulses. Learning theorists see dissociative disorders as behaviors reinforced by anxiety reduction. Some clinicians include dissociative disorders under the umbrella of posttraumatic stress disorder—a natural, protective response to traumatic experiences during childhood Many people being treated for DID recall being physically, sexually, or emotionally abused as children

One symptom of a sudden loss of memory is __________ disorder. A. obsessive-compulsive B. bipolar C. dissociative D. panic

C. dissociative

Eating Disorders are NOT a telltale sign of...

Childhood Sexual Abuse

Over the past 50 years, the incidence of anorexia nervosa has steadily increased. This is most clearly attributable to: A. the decreasing emphasis on maintaining stable marriages. B. increasing levels of childhood sexual abuse. C. the onset of adolescence at increasingly younger ages. D. cultural ideals of beauty that increasingly encourage thinness.

D. cultural ideals of beauty that increasingly encourage thinness.

Some _____ theorists see dissociative identity disorder as defenses against the anxiety caused by unacceptable impulses. A. learning B. social-cognitive C. biopsychosocial approach D. psychodynamic

D. psychodynamic

Antisocial Personality Disorder and the Brain

In people with antisocial criminal tendencies, the emotion-controlling amygdala is smaller The frontal lobes are also less active (impulse control); people with antisocial personality disorder exhibit marked deficits in frontal lobe cognitive functions, such as planning, organization, and inhibition They also have a larger and hyper-reactive dopamine reward system, which predisposes their impulsive drive to do something rewarding despite the consequences

Bulimia Nervosa Trends

Mostly women in their late teens/early twenties Unlike anorexia, is marked by weight fluctuations within or above normal ranges, making the condition easy to hide. may also be triggered by a weight-loss diet, broken by gorging on forbidden foods eat in spurts, sometimes influenced by negative emotion or by friends who are bingeing In a cycle of repeating episodes, overeating is followed by compensatory vomiting, laxative use, fasting, or excessive exercise Preoccupied with food (craving sweet and high-fat foods), and fearful of becoming overweight, binge-purge eaters experience bouts of depression, guilt, and anxiety during and following binges (

Psychologists 2 Main Opinions About DID

On one side are those who believe multiple personalities are the desperate efforts of people trying to detach from a horrific existence. On the other are skeptics who think DID is constructed out of the therapist-client interaction and acted out by fantasy-prone, emotionally vulnerable people

Antisocial Personality Disorder and Genes

Twin and adoption studies reveal that biological relatives of people with antisocial and unemotional tendencies are at increased risk for antisocial behavior People with antisocial personalities sometimes spread their genes to future generations by marrying others who have antisocial personalities The genetic vulnerability of people with antisocial and unemotional tendencies appears as low arousal in response to threats. Awaiting aversive events, such as electric shocks or loud noises, they show little autonomic nervous system arousal Long-term studies show that their stress hormone levels were lower than average as teenagers, before committing any crime And those who were slow to develop conditioned fears at age 3 were also more likely to commit a crime later in life

DID Trends

Two or more distinct identities—each with its own voice and mannerisms—seem to control a person's behavior at different times. Thus, the person may be prim and proper one moment, loud and flirtatious the next. Typically, the original personality denies any awareness of the other(s). Rarely violent

Anorexia Nervosa Trends

Usually adolescent females Typically begins as a weight-loss diet Drop significantly below normal weight Yet they feel fat, fear being fat, diet obsessively, and sometimes exercise excessively. About half of those with anorexia display a binge-purge-depression cycle. the families of those with anorexia tend to be competitive, high-achieving, and protective

Antisocial Personality Disorder Trends

Usually males Can display symptoms by age 8 Lack of conscience becomes clear before age 15 [as they begin to lie, steal, fight, or display unrestrained sexual behavior] Not all children with these traits become antisocial adults. Those who do (about half of them) will generally act in violent or otherwise criminal ways, be unable to keep a job, and, if they have a spouse or children, behave irresponsibly toward them People with antisocial personality (sometimes called sociopaths or psychopaths) may show lower emotional intelligence—the ability to understand, manage, and perceive emotions Despite their remorseless and sometimes criminal behavior, criminality is not an essential component of antisocial behavior Antisocial personalities behave impulsively, and then feel and fear little

Dissociate Identity Disorder (DID)

a rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities. Formerly called multiple personality disorder

Fugue State

a sudden loss of memory or change in identity, often in response to an overwhelmingly stressful situation

Dissociative Disorder

controversial, rare disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings

Personality Disorders

inflexible and enduring behavior patterns that impair social functioning

Binge-Eating Disorder

significant binge-eating episodes, followed by distress, disgust, or guilt, but without the compensatory behavior that marks bulimia nervosa