Exam 3 Abnormal Psychology Chapter 10 powerpoint

How do long-term outcomes for the treatment of anorexia nervosa compare to long-term outcomes for the treatment of bulimia nervosa? A. The long-term success is greater for bulimia nervosa. B. The long-term success is greater for anorexia nervosa. C. Although there is a higher mortality rate for anorexia, the success of treatment is otherwise better for anorexia. D. There is no difference in long-term outcomes for treating these disorders.

A

With respect to the role of genetics in eating disorders, it is most likely that A. genetics might influence some personality characteristics that increase the risk for eating disorders. B. anorexia is inherited, but not bulimia. C. eating disorders are responses to cultural pressures and are totally unrelated to genetics. D. bulimia is inherited, but not anorexia.

A

__________ is a form of treatment that does not address eating disorders directly and was actually used as the placebo treatment in several early studies. Still, this form of treatment has been found to be more effective after 12 months than therapies that are directed at eating disorders. A. Interpersonal therapy B. Education about nutrition and health C. Antidepressant medications D. Antianxiety medications

A

The heritability of anorexia nervosa and bulimia nervosa indicates that there appears to be A. genes that are solely responsible for the disorders. B. a genetic component to both disorders. C. no direct genetic link to the disorders. D. genes that always trump environmental influences in producing the disorder.

B

When thinking about comorbid conditions in regard to a client just diagnosed with bulimia nervosa, you are most concerned about the possibility of A. bipolar disorder. B. depression . C. borderline personality disorder. D. psychopathy.

B

Why is the successful treatment of bulimia using interpersonal psychotherapy as surprising? A. Interpersonal psychotherapy leads to poor impulse control. B. Interpersonal psychotherapy does not directly address eating disorders. C. Interpersonal psychotherapy does not focus on difficulties in close relationships. D. Relapse is common when interpersonal psychotherapy is discontinued.

B

Select the statement below that is FALSE regarding binge eating disorder. A. It lacks the compensatory behaviors of bulimia nervosa. B. Little is known about associated mortality or morbidity rates. C. It had always been accepted as a formal psychiatric diagnosis. D. It may be a chronic condition.

C

The only FDA-approved drug for an eating disorder is fluoxetine, and it is prescribed for A. anorexia nervosa. B. eating disorder not otherwise specified. C. bulimia nervosa. D. binge eating disorder.

C

What is a weight set point? A. the ideal weight for a certain height and skeletal type B. the rate at which the body expends energy C. the dangerously low weights that individuals with eating disorders attempt to reach D. the small interval around which the body attempts to maintain its weight

D

- wanted to evaluate whether cognitive behavior therapy had specific effects beyond the general benefits of psychotherapy. - chose interpersonal therapy as a credible placebo, because interpersonal problems often are associated with bulimia nervosa. But they hypothesized that cognitive behavior therapy would outperform the interpersonal approach. -When Fairburn and colleagues (1991) evaluated outcomes shortly after treatment, they found that cognitive behavior therapy was more effective than interpersonal therapy in changing dieting behavior, self-induced vomiting, and attitudes about weight and shape. Yet, a very different picture emerged at 12-month follow-up. The cognitive behavior therapy group maintained fairly stable improvements, but the interpersonal therapy groupcontinued to improve. At one-year follow-up, in fact, interpersonal therapy equaled cognitive behavior therapy (Fairburn et al., 1993).

Fairburn/Colleagues

treatment that is utilized for anorexia; where parents take complete control over meals, food and eating

Maudsley Method

With anorexia, what are other comorbid psychological disorders?

OCD/OCPD

True or False: Four psychological factors in the development of eating disorders are issues of control and perfectionism, dysphoria combined with a lack of interoceptive awareness, body image dissatisfaction, and reactions to dietary restraint. Biological contributions to eating disorders include the body's attempts to maintain weight set points, and genetic influences on body weight and shape. There is no clearly effective treatment for anorexia nervosa, which may require inpatient treatment, although a new form of family therapy shows promise among adolescents.

True

True or False: The prevalence of both anorexia nervosa and bulimia nervosa has increased dramatically in recent decades, particularly among young women. Our society's gender roles, standards of beauty, and pubertal changes in body shape and weight all contribute to the onset of eating disorders in young women.

True

True or False: Overall, cognitive behavior therapy leads to a 70 percent to 80 percent reduction in binge eating and purging. Between one-third and one-half of all clients are able to cease the bulimic pattern completely, and the majority of individuals maintain these gains at six-month to one-year follow-up (Agras, Walsh, Fairburn, Wilson, & Kraemer, 2000; Fairburn, Jones, Peveler, Hope, & O'Connor, 1993). Cognitive behavior therapy also may be effective in group (Mitchell et al., 1990) and self-help formats (Carter & Fairburn, 1998), although individual therapy is more effective (Thompson-Brenner, Glass, & Westen, 2003). However, recent study of adolescents with bulimia found that family-based treatment produced higher abstinence rates at the end of treatment and at six-month follow-up but not at one-year follow-up (Le Grange et al., 2015). All classes of antidepressant medications are somewhat effective in treating bulimia nervosa; however, medication alone is not the treatment of choice. Binge eating and compensatory behavior improve only among a minority of people treated with antidepressants, and relapse is common when medication is stopped (McElroy et al., 2010). Most importantly, research shows that cognitive behavior therapy is more effective (Hay & Claudino, 2010; Walsh et al., 1997; Wilson et al., 1999). One exception may be treating bulimia in a primary care setting, where most patients fail to complete self-help cognitive behavior therapy programs but are more likely to take their antidepressant medication (Walsh, Fairburn, Mickley, Sysko, & Parides, 2004). Overall, cognitive behavior therapy is the first-line treatment for bulimia, antidepressant medication may be a useful supplement, and interpersonal therapy is a slower acting alternative (Wilson, 2010).

True

True or False: About five years following diagnosis, 70 percent of patients are free of symptoms, 20 percent show improvement but continue to struggle, and 1 in 10 are chronically ill (Keel, 2010). In contrast to anorexia, mortality has been thought to be rare for bulimia, but research has found elevated rates, particularly for taking one's own life (Crow et al., 2009). Comorbid psychological disorders also tend to improve with improvements in bulimia nervosa (Keel & Mitchell, 1997). Predictors of continued binge eating include a longer duration, greater emphasis on shape and weight, childhood obesity, poorer social adjustment, persistent compensatory behavior, and comorbid alcohol abuse (Fairburn et al., 2003; Keel, 2010).

True

True or False: Cognitive behavior therapy is an effective first-line treatment for bulimia, while interpersonal psychotherapy and antidepressant medication also can be effective secondary treatments. Anorexia and, to a lesser extent, bulimia can be chronic, with a continuation of eating dysfunction even when some symptoms improve. Recent research provides hope for the prevention of disordered eating, especially the efforts focused on maintaining healthy weight or creating dissonance about the culture of thinness

True

-this is considered to be reversed anorexia and is regularly seen in men; emphasis on muscles/abuse of steroids

adonis effect

absence of menstrual cycles; reaction to the loss of body fat and associated physiological changes -reaction to loss of body fat -does not differentiate between women who meet other criteria-also common with bulimia

ammorhea

-extreme diet -below normal weight -denial of disorder and is proud of their diet -rigid self control -binge and purging -prevalent among high SES/young/female

anorexia

extreme emaciation, a disturbed perception of one's body, and an intense fear of gaining weight.

anorexia

refusal to maintain a minimally normal body weight; - term means loss of appetite, but they do in fact experience hunger

anorexia

Treatment for Bulimia: 1. ___________ Medication (however not the treatment of choice) 2. What is an important component of treatment?

antidepressant, therapy

What are comorbid psychological disorders of bulimia?

anxiety/depression/personality disorder/substance abuse

What are comorbid psychological disorders of bulimia?

anxiety/depression/personality disorder/substance abuse (cluster b;All of these may precede or follow the eating disorder;Eating disturbances are more severe and social impairment greater with comorbidity )

-shape and weight concerns -need to control eating -dietary restrictions/other weight loss methods -increased hunger -compensatory behaviors

binge eating

eating an amount of food that is clearly larger than most people would eat under similar circumstances in a fixed period of time (2hr period, objectively large amount of food-1000 calories?) -lack of control -fat/high carbohydrate -triggered by unhappy mood -subjective vs. objective mood -eating in secret

binge eating

-more of dieting disorder -characterized by regular binge eating behaviors but without the compensatory behaviors that are part of bulimia -under investigation -common in people who are overweight/obese

binge eating disorder

What are the two components (or symptoms) of bulimia?

binge eating/inappropriate compensatory behavior

Most successful prevention efforts do not directly focus on ______ ______ or __________ eating. Attack _________ ideal directly or focus on promoting __________ eating rather than eliminating unhealthy habits. (question regarding: can eating disorders be prevented?)

body image, disordered, thinness, healthy

-binge eating -compensatory behavior -normal weight -aware of problem -secretive/ashamed of problem -distressed by lack of control

bulimia

-consume a large quantity of food -inappropriate compensatory behaviors -eating in secret -people are normally of normal body weight -excessive emphasis on weigh and shape

bulimia

-episodes o eating and compensatory behaviors to balance out the excessive caloric  intake -purging/diuretics/excessive exercise/fasting

bulimia

binge eating and compensatory behavior (purging or excessive exercise), and undue focus on weight and shape.

bulimia

characterized by repeated episodes of binge eating, followed by inappropriate compensatory behaviors such as self-induced vomiting, misuse of laxatives, or excessive exercise.

bulimia

____________ HAS A more favorable course than _________.

bulimia, anorexia

-westernized emphasis on thin ideals -culture bound syndrome -social learning -information sharing -personality ( low self esteem/perfectionism/more impulsive) -society: ▪ Unpleasant Emotions ▪ Concerns about Shape/Weight ▪ Strict Dieting ▪ Bingeing ▪ Compensatory Measures

causes of bulimia

◦ Causes unintentional bias; focuses on body name and what will make me feel better ▪ Feel better by losing weight ▪ Diet=Restrict ▪ Crave the foods you do not have ▪ Food has an addictive quality to it; triggeres  in limbic system; something that keeps us alive; in doing so, people may use that to compensate for bad feelings ◦ RESTRICTIOn: ▪ Go into a binge

causes of bulimia

In terms of social factors, what do young people generally report of their families?

cohesive/non-conflictual.

-vomitting -laxatives -excessive exercise

compensatory behaviors

In terms of social factors, what do young people with bulimia report?

considerable conflict and rejection in their families, difficulties that also may contribute to their depression.

Psychological Factors in bulimiaL: 1. struggle for ________ 2. lack ________ awareness 3._______ emotion regulation, 4. negative body image 5. low self esteem (preoccupied with social self) 6. dietary restraints

control, interoceptive, poor

Bulimia has been found to be a _______ bound syndrome; westernized societal emphasis on thin ideals.

culture

Medical Complications of Bulimia -repeated vomiting can erode ________ enamel - rupture of the _______ -________ of salivary glands, -Repeated vomiting can also produce a ________ reflex that is triggered too easily and perhaps unintentionally.

dental, esophagus, enlargement, gag

- "Quick-fix" diets rarely work, and dieters are likely to be left with a sense of failure, disappointment, and self-criticism. -this also may directly cause some of the symptoms of anorexia nervosa-feeling out of control after a period of fasting

dietary restraints

What does interpersonal psychotherapy focus on in bulimia?

difficulties in close relationships

been replicated in a "real world" setting; ttack the thinness ideal indirectly, or promote healthy eating rather than stopping unhealthy habits -sk participants to complete tasks inconsistent with the thinness ideal; for example, discussing how to help younger girls from becoming obsessed with their appearance. -mphasizes the benefits of eating well and exercising

dissonance intervention

participants complete tasks inconsistent with the thinness ideal.

dissonance intervention

Interpersonal therapy ______ not address eating disorders and was originally a _______ treatment.

does, placebo

CBT for Bulimia (Christopher Fairburn)--> Three Treatment Stages: 1) __________ and _________ strategies to normalize eating. 2. Address the client's broader dysfunctional beliefs about self 3. Attempt to consolidate gains/prepare client for expected relapses in the future

education/behavioral

What is a shared symptom between anorexia and bulimia?

excessive emphasis on weight/shape

What is a symptom shared with anorexia nervosa and bulimia?

excessive emphasis on weight/shape (Symptom shared with anorexia nervous; self esteem and much of daily routine is centered around weight/diet/Does not occur during episodes of anorexia)

What is the most obvious characteristic of anorexia?

extreme emaciation

What presents a challenge for the treatment of anorexia?

fear of gaining weight

An intense _______ of ______ weight is a defining characteristic of anorexia and fear is not soothed by losing weight.

fear, gaining,

severe disturbances in eating behavior

feeding/eating disorder

Other treatments of anorexia could include __________ therapies and various ______ therapies. There is some evidence that suggests ________ therapy is more effective than _______ therapy.

feminist, CBT, family, individual

-Anorexia nervosa is rare in the general population (0.4%) -It is far more common among certain segments of the population, however, particularly among young women (10 times more common among women) -BN impacts 1.5% of American women and is greater for women born after 1960. -BED impacts 3.5% to 4.9% of women and 2.0% to 4.0% of men. -About 50% of individuals with AN engage in binging and purging. And cases of BN have a history of AN.

frequency of eating disorders

What are the two treatment goals for anorexia?

help patient gain minimal amount of weight, address broader issues around eating/ personal difficulties

The onset of eating disorders has provoked much speculation about their etiology including __________ changes, ________ struggles and various sexual problems.

hormonal, autonomy

storage of fat

hyperlipogenesis

-purging -self induced vomitting -misuse of laxatives -diuretics -enemas -excessive excesive -fasting -purging has only limited effective in reducing caloric intake -occurs at least once a week for 3 months

inappropriate compensatory behaviors

hearing about it from friends or reading material on the disorder

information sharing

Treatment for Anorexia: What does Bruch's modified psychodynamic therapy increase?

interoceptive awareness and correct distorted perceptions

What is an effective treatment for bulimia?

interpersonal therapy

does not address eating disorders directly, but instead focuses on difficulties in close relationships; initially was studied as a placebo treatment.

interpersonal therapy

works side by side with CBT

interpersonal therapy

The two treatments of bulimia include ___________ psychotherapy and ________-__________ therapy.

interpersonal, cognitive behavioral

fine hair on face

lanugo

Medical Complications with Anorexia: __________: FINE HAIR on face Struggle for _______ __________ imbalance, Anemia, impaired kidney functioning, cardiovascular difficulties, dental erosion, etc. Constipation, abdominal pain, intolerance to cold, lethargy

lanugo, control, electrolyte

When do eating disorders begin? what age?

late adolescence/early adulthood

With the treatment of anorexia, there is _______ evidence that supports the effectiveness of any of the therapies. Evidence on the course and outcome of anorexia nervosa further shows the ________ effectiveness of contemporary treatments. Perhaps 5% of patients starve themselves to death or die of related complications, including suicide.

litte, limited

Symptoms of anorexia: 1) Significantly____ Weight 2) ________ of Gaining Weight 3. _________ in evaluating weight/shape 4. Cessation of _________ (Amenorrhea)

low, fear, disturbance, menstruation

-repeated vomitting can erode dental enamel -Repeated vomitting can produce a gang reflex that is triggered too easily and perhaps unintentionally -rupture of esophagus

medical complications of bulimia

-rate at which the body expends energy and a movement toward hyperlipogenesis-storage of fat

metabolic rate

With inappropriate compensatory behaviors in bulimia in occurs at least ______ a week for ____ months.

once, 3

With anorexia, another defining symptom is _________, cognitive or affective disturbance in ________ one's weight/shape _________ body image An i____________ perception of body size and shape

perceptual, evaluating, distorted, inaccurate

For eating disorders, genetics may influence some ________ characteristics that, in turn, increases the risk for bulimia nervosa such as anxiety

personality

low self-esteem, perfectionism, more impulsive, and have higher rates of novelty seeking behavior

personality in bulimia

In terms of comorbid psychological issues, may __________ or __________ the eating disorder. eating disturbances are more _________ and social impairment ________ with _________-.

precede/follow/severe/greater/comorbidity

designed to eliminate consumed food from the body

purging

What is a compensatory behavior in bulimia?

purging, laxatives, exercise

What are compensatory behaviors?

purging/vomiting/laxatives/enema/diuretics/fasting

With comorbid psychological problems, it may be ________ to anorexia, not the _______ of it. _________ is a common __________ reaction to starvation.

reactions, cause, depression, secondary

__________ episodes of binge eating Report of ________ over binge eating Associated with three or more of the following: -eating ________ - eating pass the point of "________ _________" -eating _______ amounts of food when not physically hungry -eating alone due to embarssment -feeling disgusted with oneself/depressed/or guilty Diagnosis of binge eating disorders

recurrent, distress, rapidly , feeling full, large,

What is one of the most obvious and most dangerous symptoms of anorexia?

refusal to maintain a minimally normal body weight. (DSM-V contains no formal cutoff as to how thin is too thin but suggests a BMI (body mass index) under 18.5 is a useful indicator; The average victim of anorexia loses 25 to 30% of normal body weight)

For bulimia, what is common after medication has stopped?

relapse

Biological Factors- Anorexia 1) weight ______ point: : fixed weights or small ranges of weight 2) slowing of ________rate: -rate at which the body expends energy and a movement toward hyperlipogenesis-storage of fat 3) _______ factors can contribute to eating disorders; may influence in ome personality characteristic that, in turn, increases the risk for bulimia nervosa such as anxiety 4. Hypothalamus

set, metabolic, genetic

What are some causes of bulimia?

social learning, personality, information sharing, westernized culture (societal emphasis on the "thin ideals," culture-bound syndrome)

-this contributes to the frequency of eating disorders -Popular attitudes about women in the United States tell us that "looks are everything," and thinness is essential to good looks. -this is relative, not absolute

standards of beauty

In bulimia, what is the central psychological issue in the development of eating disorders (perfectionism)?

struggle for control

Social Factors of Eating Disorders 1. __________ family relationships. 2. _______ influence and their struggles can lead to eating disorders 3. Individuals suffering from anorexia describe their families as ________: members are overly involved in each other's lives

troubled, parental, emmeshed

fixed weights or small ranges of weight

weight set point

With bulimia, self esteem and much of daily routine is centered around _______/_______. -Does not occur during episodes of anorexia

weight/diet

Can there be comorbidity between anorexia and bulimia?

yes

Social Factors of Eating Disorders: ______ women are more likely to develop eating disorders Eating _______ increases with exposure to ________ Eating disorders are more common among white ______ More common in wealthier North America, Western Europe and industrialized countries.

young, disturbance, media, women