Eating Disorders Test 2

Evidence for anti-fat prejudice in children

-Girls age 3.5-5 years who were given thin, avg., and overweight dolls rated the thin dolls as having most positive characteristics and the "fat" dolls as most negative -Preadolesc. children rate their overweight peers as less likable and as less desirable playmates -Children age 10-11 show greater prejudice against overweight children than against children w other physical differences -As prevalence of obesity inc among children, so does weight stigma -Both boys and girls found pics of overweight less positively than pics of normal weight or thin children. Boys and girls had significantly more positive opinions of thin girls than of pics of either normal-weight or overweight girls. Boys viewed pics of thin and normal weight boys similarly, but held overweight boys in low regard. Suggests thinness may be salient property for judging "goodness" of girls, whereas for boys important to simply not be fat.

Describe association between dieting and disordered eating.

-Girls dieting at initial assessment were 8x more likely to have developed ED at 12-month follow up than girls not dieting -Most modern cases of AN begin following a diet -Link between dieting and binge eating -Most patients with BN recall going on diet before first binge episode (70-81%) -Presnell and Stice (2003) found BN individuals placed on diet lost weight and showed reduction in bulimic symptoms -Among men and women with BED, 55-81% report binge eating before first diet compared to 9-17% with BN- some individuals binge without dieting

Health risk explanation for why thin is good

-Health risks assoc. with obesity -According to this view, thin is beautiful bc represents health and youth- qualities associated with reproductive fitness -However, not compelling bc thin ideal promotes amenorrhea; more room for body to go above expected weight and be healthy than below

Gender differences in dieting

-Males less likely to report dieting to lose weight than females -High school girls attempting to lose weight were on average normal weight; boys overweight

Why is obesity more common among individuals of low SES?

-May be driven in part by increased density of fast food restaurants/mini marts in poor neighborhoods (inexpensive, high fat food) -Bias against the overweight in hiring and promotions -

Results of study regarding therapy for overweight versus normal or underweight patients with eds

-Patients w eds who were normal/underweight, elicted more fear, more emotional distance, more confrontation, less caring, and less sense of responsibility for therapy from therapists

Findings of the King, Touyz, and Charles (2000) study on the impact of beauty shape concerns on perception of celebrities

-Photos of thin and heavy female celebrities were altered to produce six distorted photos (3 thinner, and 3 heavier) -For thin celebs, college women with higher levels of body concern selected photos showing thinner-than-actual bodies whereas women with lower levels of concern selected more accurately. Suggest body image concerns contribute to biased perception of media images pushing an even thinner ideal than they actually present -College women regardless of body shape concern selected photos of heavy celebs showing heavier-than-actual bodies as the true photos. Suggesting that when media images don't portray thin ideal, women may exaggerate the deviation from that ideal in their perceptions

Bruch's Psychodynamic Model of Fam Influence

-Posited mothers of girls who developed AN had difficulty accurately identifying & appropriately responding to their needs when they were infants -Mismatch between infants' needs (or drive states) and mothers' responses impaired the development of the girls' ability to identify and interpret their own internal states resulting in alexithymia/poor interoceptive awareness -Adapt needs to what perceived provided by their environment- becoming "perfect daughter" -Suffered from feelings of profound ineffectiveness

Operant conditioning and disordered eating behaviors

-Positive reinforcement- desirable conseq. of a behavior inc. the likelihood that this behavior will occur again -dieiting accompanied by initial weight loss, compliments and attention (positive social reinforcement)

Evidence for/against Baruch's Psychodynamic Model of Fam Influence

-Prospective studies have confirmed the importance of poor interoceptive awareness in predicting ED symptoms in adolescents -High perfectionism has also received considerable support as a risk factor for EDs -Other components (e.g. feelings of ineffectiveness) have received less support unless combined with other risk factors -Evidence these risk factors are a result of infant experiences limited

Beauty ideals for men

-Recent decades have seen an increasingly lean and muscular ideal or men portrayed through popular media

Garner et. al's findings on articles on Playboy centerfold models between 1959-1978

-Shifted from a voluptuous hourglass figure to a "tubular look" with a significantly lower waist-to-hip ratio -Wights as a % of expected weight decreased significantly

How do historical changes influence beauty ideals?

-Times when women are more likely to work outside of the home are associated with thinner ideals of beauty -Financial prosperity and abundance of food linked to associating beauty with thinness -Thinness as a commodity

Trends of rate of obesity in US

-US population has grown increasingly overweight -May be leveling off over recent years -Prevalence of obesity: 34% in 2007-2008 and 2011-2012

Stroop Test

-Used to evaluate attentional processes in women with eating disorders -Words such as thigh, hips, stomach, candy and chocolate are printed in different colors, and the speed with which participants can name the colors is assessed -Studies provide evidence of attentional biases, women with ED slower to name the ink color for names of food or body parts than for neutral objects

Roles of hypothalamus

-central role in appetite and weight control -regulates body functions such as sexual activity, circadian rhythm, thermal regulation, fluid balance

Neuropeptides and AN

-lower leptin, higher neuropeptide Y, higher ghrelin than controls

Neuropeptides and BN

-lower leptin, higher neuropeptide Y, less robust changes in ghrelin and cck and glucagon-like peptide 1 and peptide yy

Carbohydrate-craving model

-proposed inadequate 5-HT function produced carbohydrate craving that caused binge eating episodes -diets that diminished tryptophan intake could lead to diminished 5-HT production -binge eating high carb foods attempt at self-medication for low 5-HT production -later studies fail to support hypothesis

Leptin

-receptors found in the arcuate nucleus and paraventricular nucleus of the hypothalamus -produced by ob gene -released from fat tissue; more fat in the body, more leptin in the blood -lower levels lead to increased sensitivity to signals that lead to increased food intake

Peptide YY

-released from lower in intestinal tract -levels rise more slowly -satiety peptide that delays onset of next eating episode

Ghrelin

-released from stomach -diurnal variation -levels decrease after food intake an rise slowly during the periods leading up to subsequent meals during day -hunger hormone that stimulates eating

Cholecystokinin

-released in small intestine following food ingestion -binds to receptors on vagus nerve in stomach -postmeal release trigger brain mechanisms inhibiting appetite and food intake -causes contraction of the pyloric sphincter, muscle that controls rate food passes from stomach to small intestine

Glucagon-like peptide 1

-similar to CCK -triggers stimulation of vagus nerve -short term satiation peptides that signal when eating episode should stop

Name and provide an example of the three kinds of disinhibitors

1. Cognitive 2. Affective 3. Pharmacological

Effects of "fat talk"

1. When elicits reassurance, the positive reinforcement increases the likelihood of future fat talk and reassurance seeking 2. Communicates that a healthy weight is fat and thereby endorses an unhealthy, thin ideal

SWAP-200 Q Sort

200 cards with descriptive statments Sort into 1/8 piles 0=N/A 7=Very true

The basal metabolic rate accounts for _____% of energy expenditure.

70-75%

AN v. BN Trends for Tellegan's 3 Dimensions of Personality

AN: high levels of constraint, low levels of positive emotionality, high levels of negative emotionality BN: Low levels of positive emotionality, high levels of negative emotionality, lower constraint No differences for BED compared with control

Kilbourne's theory for emphasis on thinness in culture

-Consumer-drive economy requires constant invigoration of buying; advertising encourages people to spend money -Convince people that there is something that they need to have -Need for affiliation is a particularly good base for generating new needs -Media generate a need to subscribe to certain beauty ideals by creating impression that one is deficient in a way that will limit prospects for affiliation -The presence of body dissatisfaction in a majority of adolesc. girls and women is necessary to turn those same women into good consumers

Iowa Gambling Task

-Developed to evaluate decision-making in response to rewards and punishment -4 Piles of cards (ABCD) with A & B largest rewards and losses -Those w AN, BN, and BED shown worse learning

Social learning model of family influence

-Disordered eating attitudes and behaviors might be learned from family members just as many other attitudes/behaviors -EDs run in families

"Fat talk"

-Disparaging remarks about one's own body made to peers to create solidarity around a shared concern -Risk factor for disordered eating

What is the evidence of sociocultural influences of eating disorders?

-EDs more common in industrialized nations -EDs more common in women than men -ED incidence increase in 20th century

Family Systems Model: Families with AN

-Emeshment within the family -Overprotection of children (resulting in rigid boundaries seperating family members from extrafamilial relationships and concern over bodily function-physical symptoms, eating, and dieting) -Girls in emeshed families have no outlet, stifled in attempts to achieve independence -Conflict somaticized (expressed as physical conditions)

Family Systems Model

-Explained EDs as manifestation of disturbed family relationships -Families made of subsystems (spousal, parental, sibling) involving diff roles/repsonsibilities -Boundaries can range from emeshed to disengaged

Pope et. al action figure study

-Found significant increases in the chest-to-wast ratio over time -Unrealistically muscular ideals contribute to excessive exercise and steroid abuse in men

Psychoanalytic Theory and AN

Symptoms are defenses to reduce conflict b/w ego and id

High negative urgency

Tendency to act impulsively when distressed

Harm avoidance

Tendency to avoid punishment by inhibiting behavior

Persistence

Tendency to continue behavior that is not immediately rewarded and has been linked to ambition, obstinacy, and obsessive compulsive behaviors

Reward dependence

Tendency to continue rewarded behavior

Positive emotionality

Tendency to enjoy and actively engage in work and social interactions. Low positive emotionality is characterized by high levels of introversion or a tendency to keep to one's self

Negative emotionality

Tendency to experience negative mood states (e.g. sadness, anxiety, anger). Low negative emotionality is characterized by tendency to be calm/unflappable

Constraint

Tendency to inhibit impulses and show caution, restraint, an conventionalism. Low constraint is tendency to act impulsively.

Novelty seeking

Tendency to pursue rewards

Non-organic failure to thrive

-Children of women suffering from AN at inc. risk -Do not gain adequate weight, no medical reason found

Minnesota Starvation Study

-Conducted a study on the conseq of starvation and examined methods of safe refeeding in preparation for return of prisoners of war after WW2 -Healthy objectors to the war recruited for study -Participants placed on a diet and exercise regimen designed to reduce their weight by 75% of their previous weight -Initially participants lost weight quickly -As study continued, weight loss slowed and analyses of mens physiological functioning revealed a significant drop in their basal metabolic rate -By diminishing the amount of energy expended in maintaining the body, men became more efficient in their use of calories -Experienced increases in depression, introversion, apathy, food related obsessions and rituals -After diet, 29% reported beginning binge eating episodes

Set-point theory

-Emerged to explain why organisms resist weight loss -Our bodies have evolved weight defending mechanisms to withstand periods of famine -Such mechanisms could be triggered by dieting and make weight loss more difficult than is portrayed by weight loss programs

Gender differences in body image concerns

-Females report greater level of dissatisfaction with weight and shape and a greater desire to lose weight than males

Hsu's theory for emphasis on thinness in culture

-Financial prosperity after Industrial Revolution lead to abundance of food that disrupted traditional positive correlation b/w wealth & weight -In societies where wealth assoc. with fatness, beauty assoc. with fatness -In societies where wealth assoc. with thinness, beauty assoc. with thinness -In industrialized nations, significant neg. correlation between socioeconomic status & weight -The strong assoc. between wealth and thinness for women may explain greater prevalence of ED (particularly BN) in women in industrialized nations nations and why rates of eating pathology inc. as cultures become Westernized

Garner et. al's findings on articles on Miss America contestants between 1959-1978

-Miss America contestants became increasingly thin relative to their expected weight -Across the period of observ., contestants and winners weighed less than what would be expected for their height -Until 1968, contests on avg. weighed at least 86% of expected weight -After 1968, avg. weights fell below 86% of expected weight -Relationship between avg. and winner's weight inconsistent up until 1970 -After 1970, all winners had lower weight for height than the average for contestants of the same year -From 1970 on, all Miss America winners, without exception, weighed less than 85% of what would be their expected height -Alarming ideal for feminine beauty, since weighing less than 85% of what was expected for one's height was threshold for diagnosing AN in DSM-4 -Contestants and winners became increasingly thinner relative to population norms, for decades following the 1980 article

Personality v. temperamant

A stable way in which individuals perceive, react to, and interact with their environments that is influenced by biology and experience

AN v. BN Trends for Cloninger's 4 Dimensions of Personality

AN: Low novelty seeking, high harm avoidance, high persistence BN: High novelty seeking, high harm avoidance BED: Less clear cut, high novelty seeking, high harm avoidance, no difference than obese controls

Psychoanalytic Model of Fam Influence: Why was AN interpreted as a fear of sexual maturity?

Bc of the emergence of AN symptoms near onset of puberty & view of neurotic illnesses as stemming from unconscious sexual conflicts

What is the behavioral inhibition system?

Harm avoidance

Name the two important systems that the hypothalamus and pituitary gland are involved in

HPA axis (a=adrenal) & HPG axis (g=gonadal)

Family Systems Model: Emeshment

Poor differentiation of boundaries Ex: Parent seeking advice from child on how to deal w frustration of other parent's behaviors

Black and Hispanic men show a ___________ association between obesity and income

Positive

Tellegan's three personality dimensions

Positive emotionality Negative emotionality Constraint

How does the frequency of friend's dieting influence UWCB and drive for thinness?

Positively associated

Dichotomous thinking

black and white thinking; cognitive distortion

Neurotransmitters

chemicals that facilitate communication between brain cells

Vagus nerve

cranial nerve that sense signals directly to brain, and stimulating the vagus nerve stimulates neurons projecting from the brainstem to various parts of the brain

Conseq of diminished 5-HT

dysphoria, increased appetite, decreased impulse control

Perpetual and cognitive distortions

experiences and thoughts that do not correctly reflect reality

Negative reinforcement v punishment

positive reinf- increase behavior to achieve conseq negative reinforcement- increase behavior to avoid negative conseq punishment- decrease behavior to avoid negative conseq

Examples of neurotransmitters

serotonin (5HT), norepinephrine, dopamine

Decreased basal metabolic rate is associated with _____________________.

slowed pulse, decreased respiration, lowered blood pressure, decreased temp, etc.

In term of Hsu's (1990) theory, the particularly strong assoc. between ___________ and ___________ for women may explain the overall greater prevalence of ED (particularly BN) in women in industrialized rather than non-industrialized nations and why rates of eating pathology inc. as cultures become more westernized.

thinness and wealth

The release of dopamine from ______ to _______ of the brain is central involved in the experience of reward as well as in learning cues

ventral tegmental area to the nucleus accumbens

Cultural context shapes ___________________, and ______________________ influence behaviors.

Beliefs and values; beliefs and values

Ecological

During course of participant's day to day lives

What happened in the 20th century in industrialized nations that would particularly influence women?

Emergence of thin ideal

The ______ is a structure in the brain that plays a central role in appetite and weight gain

Hypothalamus

Greater conflict in mother-infant feeding assoc. with _______________.

Lower weight in child

Which theory provided the first description of how parents contributed to development of eating disorders in children?

Psychoanalytic Model of Family Influence

Objectification

The process of how the commercialization of beauty treats women's bodies as objects

Name examples of neuropeptides

leptin, chloecystokinin, peptide YY, and glacagon-like peptide 1- decrease appetite through activation of medial hypothalamus neuropeptide Y and ghrelin- increase appetite by stimulating the lateral hypothalamus

Which is more difficult when dieting: attaining initial weight loss or maintaining weight loss? Why?

maintaining weight loss; dieting may contribute to binge eating which then contributes to weight gain

Roles of 5-HT

mood, appetite, impulse control

With regard to temperament, harm avoidence is similar to _____ and novelty seeking is similar to ______

neuroticism; openness to new experience

Characteristics of the negative implicit attitudes about fat

-Automatic (often outside conscious awareness) -Universal -Difficult to change for the better -Easy to change for the worse -Can influence our behavior without our awareness

Study examining influence of Western television on beliefs, values, and behaviors of adolesc. girls in Fiji

-Baseline assessments w/in one month of introduction of tvs into home; follow-up in 3yrs with a new cohort -Baseline: girls report low level of body dissatisfaction, dieting, and purging, and place little importance on being thin -Culture celebrates feeding as expression of familiar care; being thin assoc. with lacking love and the care of family -3 Yr. Follow-up: Girls expressed beliefs that success, wealth, and independence were related to being thin and desired to be thin -Went from 0% of girls engaging to purging behavior, compared to 11% 3 yrs. later -% of girls with elevated scores on measures of disordered eating more than doubled -Study provides evidence that exportation of Western cultural values through television may be accompanied by exportation of eating disorders -Evidence for role of cultural factors in emergence of eating pathology

Findings on mother-infant interactions on ED

-Children of women who suffered from AN at increased risk for inorganic failure to thrive -Women with ED histories more anxiety, rigidity, and conflict ab feeding their child -Related to pattern of low-weight in children in ED group

What would psychoanalytic treatment of AN entail?

"putting an end to the hatred of femininity by helping the woman learn to accept and act out the traditional female role"

Dieting trends in college students

-% who want to lose weight, exceeds % who describe themselves as overweight -% describe themselves as overweight, exceeds % actually overweight

How do the associations between actual weight and body dissatisfaction differ between males and females?

-Among girls 9-18, those above 50th percentile for BMI reported greater body dissatisfaction than girls below 50th percentile -Boys same age, those above 75th percentile and those below the 10th percentile expressed the greatest body dissatisfaction -As girls aged became increasingly dissatisfied w their weight and shape such that girls w healthy weights began to express body dissatisfactions

Brumberg's theory for emphasis on thinness in culture

-Association between thinness as an aesthetic ideal and periods in which women have been encouraged to adopt responsibilities outside the home beyond roles as wives/mothers

Why do women face discrepancy between ideal weight and current weight?

Because ideal weight is underweight, and current weight overweight for average US woman

Tryptophan

An amino acid required to make 5-HT that is found in food and can cross blood-brain barrier

Antecedents, responses to prevent conflict, & types of episodes of Stein et. al's study on mother-infant feeding conflict

Antecedents: 1. Infant indicated desire to feed him/herself while mother indicated desire to feed infant 2. mother expressed concern over manner of infant's eating (e.g. mess making) 3. Infant refused offered food -------- Responses to prevent conflict 1. Mother acknowledges infant's cues 2. Mother puts aside her own desires 3.Infant disengages --------- Episodes 1. Antecedents end in conflict with index group 2. Antecedents don't end in conflict in index group 3. Antecedents don't end in conflict in control group

Focus of 5-HT research on AN and BN

BN- inadequate 5-HT contributes to binge eating AN- overfunction as possible explanation of self-starvation

Constraint is similar to ___________

Conscientiousness

Physiology of weight control is a balance between ___________.

Energy intake (eating) and energy expenditure (resting metabolic weight plus activity level)

Family Systems Model: Disengagement

Existence of boundaries that create isolation among family members.

Positive emotionality is similar to ______________

Extraversion

T/F: The incidence of AN and BN has decreased over recent decades.

False

T/F: Overweight people are more likely to have positive attitudes towards other overweight people.

False; negative attitudes towards overweight are held by people regardless of their own weight

According to the psychoanalytic model of family influence, what were characteristics of the family? How did they impact the child?

Father- kind but passive Mother- aggressive and "castrating" (overpowering and controlling); Unfit model for femininity Girls feared becoming women like their mothers Fear symbolized as fear of oral impregnation (becoming pregnant via the mouth) Girls suffering from AN thought to have unconscious hatred of femininity stemming from their unconscious pre-Oedipal mother conflict. Attempt to regress into the safety of childhood

Binge eating as positive reinforcement

Foods consumed during binge episodes often used by parents as rewards for god behaviors

Describe the psychoanalytic model of AN and BN

Identification with kind, passive father, Hostility towards aggressive, castrating mother---> Sexual role conflict----->AN (rejection of femininity and fear or oral impregnation) or BN (over identification with femininity, desire for pregnancy)

Role of HPA axis

Implicated in responses to stress

Garner et. al's findings on articles in magazines marketing specifically to women between 1959-1978

In 6 popular women's magazines, the avg. number of articles on weight loss diets increased from 1.4 to 2.5 per month from the first to second decade of observations

Proband

Individual w ed

Restraint Hypothesis

Individuals who become chronic dieters (restrained eaters) lose ability to determine when hungry/full. Feelings of hunger and satiation (physiological controllers of food intake) cannot take place of cognitive control when interrupted resulting in consumption of unusually large amount of food

Role of HPG axis

Involved in release of sex hormones and masturbation

Overweight as a moral weakness

Just as refraining to eat fattening food is perceived as virtuous, overweight seems to mark moral weakness by indicating an inability to resist temptation

Evidence for/against the Psychoanalytic Model of Family Influence

Maturity Fears- sub scale of the EDI -Lower maturity fears predicted recovery among AN patients; Higher maturity fears predicted the onset of an ED 10-years following college -Longitudinal studies suggest that a fear of adulthood may contribute to the presence of an ED -Unclear if risk factor for ED or general risk factor for a range of mental disorders

Index infants were ____ likely to disengage than control.

More. No control infant disengaged in response to an antecedent.

Brain cells

Neurons

Negative emotionality is similar to __________

Neuroticism

Name the 5 Factors in the Five Factor Model of Personalit

Neuroticism- Anxious v. calm Extraversion-Social outgoing v. reserved Openness to experience-flexible v. conservative/conventional Agreeableness- altruistic v. self-oriented Conscientiousness- self-disciplined/hardworking v. freewheeling/lazy

What is the behavioral activation system?

Novelty seeking

Cloninger's 4 Dimensions of Personality

Novelty seeking, harm avoidance, reward dependence, and persistence

Name and define the three facets of body image.

Perception, cognition, and affect -Perception: seeing and feeling the body dimensions such as weight and shape (e.g. "I look fat" or "I feel fat"), independently of actual weight or shape; Doesn't require a particular judgement -Cognition: evaluations and thoughts related to body size (e.g. "I weigh more than I should" or "I should lose weight"); Need not be related to actual weight -Affect: Emotions related to weight or shape (e.g. "I must be thin to feel happy" or "When I am unhappy I feel fat)

Where does the term "nervousa" come from?

Reflects psychoanalytic understanding of underlying causes of AN as a form of neurotic anxiety

Peer socialization v. selection

Socialization- spreading of symptoms from one individual to the next Selection- birds of feather clock together; selection of peers with similar weight concerns/eating behaviors

"Modern cult of thinness"

Societal overevaluation of thinness for women, actively promoted through print, television, film, and media causes eating disorders

_____ is responsible for inhibiting appetite/food intake and ___ is responsible for increasing appetite and food intake

Ventromedial, lateral

Effects of damaging ventromedial hypothalamus versus lateral hypothalamus

Ventromedial- produces increased food intake and sig. obesity Lateral- decrease in food intake, weight loss

Selective abstraction

When a part comes to represent the whole

Do men or women hold more negative stereotypes of the overweight and obese?

Women

Positron Emission Tomography (PET)

a method of brain imaging that permits researchers to view the distribution and density of neurotransmitter receptors in the brains of living participants

Garner et. al study on the trends from 1959-1978 in the following three representations of feminine beauty: __________.

articles in magazines marketed specifically to women, Playboy centerfold models, and Miss America Pageant contests and winners

Neuropeptide Y

helps increase food intake in response to weight loss increases food intake inhibited by leptin elevated in patients with AN and BN