Abnormal Psychology Chapter #8

What are the two major types of eating disorders?

1. Anorexia nervosa 2. Bulimia nervosa

Subtypes of DSM-5 Eating Disorders

1. Binge-eating disorder 2. Rumination disorder 3. Pica 4. Feeding-disorder ("Failure to Thrive")

Bulimia facts and stats

1. Majority are female 2. Onset 16-19 y (Although would have been some disordered eating before that) 3. Lifetime prevalence is about 1.1% for females and 0.1% for males 4. 6-8% college women suffer from bulimia 5. Tends to be chronic if left untreated, can often get worse

Anorexia nervosa associated features

1. Marked disturbance in body image 2. Comorbidity with other disorders, considered severe pathology 3. Methods of weight loss can have severe life-threatening medical consequences (Severely dehydrated, low energy but still presence of anxious energy)

Bulimia nervosa associated features (Will be part of diagnosis Q)

1. Most are within 10% of target body weight 2. Most are over concerned with body shape, fear of gaining weight 3. Most are comorbid for other psychological disorders 4. Purging methods can result in severe medical problems ex heart irregularities, dental problems, dehydration 5. (Often secretive about their behaviours and have anxiety when around food)

Factors contributing to eating disorders

1. Psychodynamic factors 2. family situations 3. cognitive behavioural factors 4. biological factors

Causes of eating disorders

1. Sociocultural pressures 2. Biological and genetic vulnerabilities 3. Psychological dimensions (self-esteem, social anxiety, distorted body image) 4. Media influences

Psychological treatment of anorexia nervosa

1. Weight restoration - first and easiest goal to meet 2. Treatment involves education, behavioural, and cognitive interventions 3. Treatment often involves the family 4. Long term prognosis for anorexia is poorer than for bulimia

Anorexia facts and stats

1. majority female (white) from middle to upper middle class families 2. usually develops around age 13 or early adolescence 3. Tends to be more chronic and resistant to treatment than bulimia

DSM-5 subtypes of anorexia

1. restricting type 2. binge eating/purging type

Anorexia nervosa overview and defining features

1. successful weight loss 2. defined as 15% below expected weight 3. Intense fear of obesity and losing control over eating (constriction) 4. Anorexics show a relentless pursuit of thinness 5. Often begins with dieting 6. High mortality rate, don't die of anorexia, die of complications of it

Motivational learning pre-contemplative with anorexia

Anorexia have no intention of changing behaviour need to take "your going to eat or your going to die" approach

Compensatory behaviours

Behaviours done out of guilt to try and reverse what you've done 1. Purging= self induced vomiting, diuretics or laxatives 2. Some exercise excessively whereas others fast

Psychological treatment of bulimia nervosa

CBT is treatment of choice (motivational interviewing) Interpersonal psychotherapy results in long term gains similar to CBT

Bulimia in DSM-5

Dropped subtypes of purging/non-purging because little evidence of difference

Psychological factors

How food is used or seen in a family, often food can be in love which can send the wrong message. Often used to calm down young children so they don't learn skills to self sooth

Medical treatment of Anorexia nervosa

None with demonstrated efficiency, first step is re-feeding

What do they all have in common?

The intense severe fear of gaining weight

What is the theory behind more women than men having eating disorders?

Women ideally slender or underweight, work out to lose weight whereas men idealized as having strong physique with broad shoulders (work out to get muscular)

Both bulimia and anorexia are found

almost exclusively in westernized cultures

Medical Treatment of Bulimia Nervosa

antidepressants can help reduce bingeing and purging but are not efficacious in the long term

Hallmark of bulimia

binge eating

Bulimia nervosa overview and defining features

binge eating followed by a compensatory behaviour

Bulimia most often

binging and purging to reduce anxiety around gaining weight within 10% of average weight

Family situations

children feel very little control over environment

Both involve severe disruptions in

eating behaviour (whether it be restricting or binging)

Depression often comorbid with

eating disorders which links up to negative cognitions

Binge eating

eating excess amounts of food within 2 hours, eating is perceived as uncontrollable without the ability to stop

Both involve extreme fear of

gaining weight, whether it be rational or not

Bioloigcal factors suggest

it has to do with genetics as with fraternal twins only 20% likely

Biological factors

relatives of people with eating disorders up to 6x more likely to develop one themselves, twins 70% chance of developing if other has one

Anorexia most often

restricting, 15% below average body weight

Both have strong

sociocultural origins - westernized views

CB factors

thinking about irrational beliefs, everything would be better if I lost 5 pounds (Focus of CBT would then be to change beliefs of self worth)

Anorexia is present mostly in

women (90%)