Ab Pysch: Chapter 10
What are some comorbid diseases psychological disorders that align with anorexia nervosa?
-obsessive compulsive disorder and obsessive compulsive personality disorder -they also show symptoms of depression -anorexia also aligns with symptoms of bulimia nervosa
What are some symptoms of anorexia nervosa?
-significantly low weight -DSM5 contains no formal cutoff as to how thin is too thin but suggests a BMI under 18.5 as a useful cutoff in adults -fear of gaining weight -disturbance in experiencing weight or shape: people do not realize their emaciation or a distorted body image -struggling for control, feeling in control of their situation
What are the outcomes of bulimia nervosa?
Bulimia has a more favorable outcome than anorexia because 70 percent of patients are symptom free. 20 percent show improvement but continue to struggle. and one in 10 people are chronically ill. Mortality(meaning dying from the disease) has been thought to be rare for bulimia. Comorbid diseases also get better as the disease gets better. q
What are some comorbid psychological disorders with bulimia nervosa?
Depression is common and is a reaction to the bulimia. Other disorders include anxiety disorders, personality disorders(particularly borderline personality disorder), and substance abuse especially alcohol and or stimulants. The comorbidity with depression is the most significant.
Can eating disorders be prevented?
Dissonance interventions ask participants to complete tasks inconsistent with the thinness ideal, for example, discussing how to help younger girls from becoming obsessed with their performances. Of 481 adolescent girls, randomly assigned to one of these three hour programs vs. an assessment-only or placebo(writing about emotional issues) control group, the prevention conditions led to improvements in body dissatisfaction, internalization of the thin ideal, dieting, and binge eating/purging.
Which gender is ten times more likely to have an eating disorder?
Female
What psychological factors influence the cause of anorexia and bulimia?
Four main things that affect the diseases which would be control issues, depression/dysphoria, body image dissatisfaction, and reactions to dietary restraint. Perfectionism is also a problem, when someone is perceived as a good girl, they want to be in control of something so they are hyperaware of how they look.
How has the standard of beauty affected the surge in eating disorders?
Having role models like Miss America and Playboy models that are 15% lower than their expected weight for their height has enhanced this "culture of thinness." Eating disorders are also more prevalent in north america and asia and western europe. In third world cultures, the bigger you are, it means you are successful because you can afford to eat.
What is purging?
It is designed to eliminate consumed food from the body, the most common form is making yourself throw up. Other ways of purging is the misuse of laxatives, diuretics, and enemas.
What are the outcomes of anorexia nervosa?
Nearly 50 percent of people that have been interfered with and received treatment, maintain a healthy weight. 20% remain significantly underweight. 5% of patients starve themselves to death or commit suicide.
How is binge eating disorder diagnosed?
Obesity is a link between binge eating disorder and it generally means that you have a BMI greater than 30.
What is avoidant/restrictive food intake disorder?
Occurs mostly in infants and is characterized by an apparent lack of interest in food.
What are the symptoms of Bulimia? Describe the case study for Michelle
People with Bulimia nervosa often have a history of anorexia nervosa. Michelle would binge eat ice cream and cookies and then she would be sickened by her lack of self control and she was terrified of gaining weight, so she would walk across the street to an empty bathroom and would force herself to vomit. She would gain weight just so her parents would get off her back. When she went to college, she would let herself gain weight then she would get disgusted with herself, so she would make herself vomit. Her frequent struggles with binge eating, self induced vomiting and purging suggest bulimia nervosa.
What are some biological factors that influence anorexia and bulimia?
Physiologically, weight in maintained around weight set points(fixed weight or small ranges of weight. If one starves themselves, their metabolic rate slows down and it causes them to hold on to all the weight she has. 23% of MZ twins had the same disorder, and 9% of DZ twins. Genes influence personality characteristics that could affect whether or not they could develop an eating disorder. In extremely rare cases, eating disorders have been linked with a specific biological abnormality, such as a hormonal disturbance or a lesion in the hypothalamus that could affect appetite.
What are some medical complications of bulimia nervosa?
Repeated vomiting can erode dental enamel, particularly on the front teeth. Teeth can become chipped and ragged looking. Another possible medical complication is the enlargement of the salivary glands which makes the sufferer's face appear puffy.
Eating Disorders in Males: Box
Reverse anorexia is known as the Adonis Complex which is characterized by excessive emphasis on extreme emphasis on extreme muscularity and often accompanied by the use of anabolic steroids. Mark McGwire was a famous baseball player, and his popularity sparked the usage of steroids, in the US, it went from 3 percent to 12 percent. Whether the ideal image is unrealistically thin or unrealistically muscular, cultural sterotypes about appearance can be risky for both males and females who internalize them.
What does bulimia nervosa have a huge impact on?
Selfevaluation is a key thing is bulimia nervosa, and it is influenced by body and shape and weight which is a symptom shared with anorexia. Self esteem and and daily routines can center around weight and diet.
Serrita's Anorexia: Case Study from the book
She was described as a sweet person by her teachers. She is 5'2, and when she first went to a clinician she weighed 81 pounds. She could discuss all the nutrition facts and caloric content of all the food she had consumed. She had not meunstrated in over six months. She steadfastly denied that she needed to gain weight.
How many feeding and eating disorders does DSM5 recognize?
Six major types
What social factors influence the cause of anorexia and bulimia?
Standards of beauty and the premium placed on young women's appearance contribute to causing eating disorders. Troubled family relationships also cause and can increase vulnerability to the culture of thinness. Sexual abuse can also influence the risk of getting an eating disorder.
How can you treat anorexia nervosa?
The first goal of treatment is to make the patient gain weight. Hospitalized patients may have intravenous feeding tubes. The second goal is to try to address the broader eating difficulties. Family therapy is more helpful than individual treatment.
What are the frequencies of anorexia and bulimia?
The frequency of these disorders vary, but both appear to have increased since the 1960s and 1970s. The annual incidence of anorexia went from being 1 new case per million people to 54 new cases per 1 million people. Anorexia is far more common among certain groups, however, particularly young women, where the incidence still may be increasing.
Is Binge Eating a Mental Disorder? Is Obesity?
The inclusion of binge eating disorder has been criticized by some. Psychiatrists say that 12 binges in three months is just the manifestation of gluttony, however most experts seem to have embraced the new diagnosis. In contrast, obesity has not been classified as an eating disorder. Why? Obesity is a risk for a lot of different complications. Obesity accounts for over 9% of health expenses and is expected to consume 16% by 2030. It also heightens risk for mood disorders, anxiety disorders, eating disorders, and PDs. Calling obesity a mental disorder is controversial because if it were to be called that, suddenly 32.2% of adults and 17.1% of children would have an eating disorder. Why further stigmatize obese people by saying they have a mental disorder? DSM5 includes "night eating syndrome" It tries to distinguish binge eating disorder from obesity in other ways. DSM5 says that binge eaters are most focused on weight and have more psychological problems than obese individuals. Is binge eating disorder a way of letting obesity in through the back door of DSM5? The AMA officially recognized obesity as being a disease which labeled a large group of people as sick and eligible for insurance reimbursements.
What are the cohort effects of women born in different times for bulimia nervosa?
The lifetime prevalence of bulimia nervosa was far greater among the women born after 1960 than it was for those born before 1950. The risk for women born between 1950 and 1959 was intermediate between the two. The risk of developing the disease goes down with age. Bulimia has a lifetime prevalence or 1.5 percent among U.S. Women according to both DSM5 and national surveys. About 50 percent of all people with anorexia nervosa engage in episodes of binge eating and purging, and many cases of bulimia have cases of anorexia nervosa.
How can bulimia nervosa be treated?
The three most effective is cognitive behavior therapy, interpersonal psychotherapy, and antidepressant medications. CBT leads to a 70% to 80% reduction in binge eating and purging. Key goals of this treatment are to develop realistic expectations about eating, weight concerns, and binge eating, as well as clear strategies for coping with relapses in advance. Interpersonal therapy was used as a placebo for CBT, but it actually wound up helping patients as well, but not as much as the CBT. Antidepressant meds are somewhat effective in treating bulimia however medication alone does not help.
How is anorexia nervosa diagnosed?
There are two subtypes. 1. restricting type: includes people who have not engaged in binge eating or purging in the last three months 2. Binge eating/purging type: defined by regular binge eating and purging. The validity of the subtypes is questionable because they do not differ in terms of comorbidity, recovery, relapse, or mortality.
What is the age of onset for eating disorders?
They typically begin in adolescence. Typically when young women start their period, the addition of some weight is normal but it can trouble a young woman.
What are some medical complications of anorexia nervosa?
abdominal pain, intolerance to cold, lethargy, lanugo(which is a thin layer of downy hair on their face or trunk of their body), another dangerous part is electrolyte imbalance which can lead to cardiac arrest or kidney failure
What is binge eating?
consuming an amount of food that is clearly larger than most people would eat under similar circumstances in a fixed period of time, for example less than two hours. Binges are typically done in secret. It is typically triggered by an unhappy mood, which may begin with an interpersonal conflict, self criticism about weight or appearance, or intense hunger following a period or fasting. A key diagnostic trait is the lack of control during a binge, and some individuals experience a "feeding frenzy" where they lose total control.
What is anorexia nervosa?
extreme emaciation, anorexia literally means loss of appetite
What is a cohort?
group that shares some features in common, for example, year of birth; thus cohort effects are differences that distinguish one cohort from another.
What is Bulimia nervosa?
repeated episodes of binge eating, followed by inappropriate compensatory behaviors such as self-induced vomiting, misuse of laxatives, or excessive exercise. Weight is in the normal range.
What is rumination disorder?
repeated regurgitation of food, sometimes with rechewing and often occurs in infants, sometimes in the context of neglect and/or intellectual disabilities
What is amenorrhea?
the cessation of meunstration and it used to be a core symptom of anorexia nervosa