Chapter 11 Flashcards
(29 cards)
Anorexia Nervosa
Checklist
- Purposefully takes in too little nourishment, results in low body weight below age group/gender
- Fearful of gaining weight, works to prevent weight gain despite low weight
- Distorted body perception & perception of danger is distorted
Demographics
- 75-90% female
- Peak age onset: 14-20 years
- Between 0.6-0.4% of females display symptoms thru life
- 6% pass from medical complications
- Suicide rate 5x the norm
Main Subtypes of Anorexia Nervosa
Restricting type
- At least 1/2
- Lose weight by cutting out some things, eventually eliminating nearly all food
- Almost no variability in diet (safe foods —> restriction)
Binge-eating/purging
- Lose weight by forcing themselves to vomit after meals or by laxatives
- Goal to lose caloric intake
Amenorrhea
Absence of period/menstruation
Clinical View of Anorexia Nervosa
- Motivation: fear of becoming obese/losing control
- Preoccupation w/ food
- Distorted thinking
- Maladaptive perception (I will become better if I don’t eat, I will avoid guilt if I don’t eat)
- Co-morbities (perfectionism, OCD, depression, anxiety, etc.)
- Medical problems
- Amenorrhea
- Metabolic + electrolyte imbalances
- Skin, nail, and hair problems
- Lower body temp, blood pressure, heart rate, dentistry
Bulimia Nervosa
Checklist
- Repeated binge eating episodes
- Repeated performance of behaviors such as vomitting, exercise, etc. to prevent weight gain
- Symptoms weekly for 3 months
- Appraisal of oneself
Demographics
- 75-90% female
- 15-20 years of age (lasts years)
- Weight usually stays w/in normal range
- Can be periodic, 0.5-5.0 develop full
Binges (Bulimia Nervosa)
- Uncontrollable eating, very large quantity of food
- Often in secret, usually w/ sweet, high calorie, soft textured food
- Relief when eating
- Followed by extreme self blame, shame, guilt, depression, & weight gain fear
- Cycle of bingeing and purging
Compensatory Behavior (Bulimia Nervosa)
- Vomiting (fails to prevent absorption of 1/2 calories consumed)
- Affects ability to know if full
- Laxative/diuretics use (caloric usually not undone)
Compare/Contrast Anorexia & Bulimia
Similarities
- Distorted body perception
- Fear of becoming obese
- Preoccupation w/ food, weight, and appearance
- Disturbed eating
- Comorbidity
- Heightened suicide risk
Differences (bulimia)
- More common concern about pleasing others (rather than self)
- Dental problems
Anorexia
- Pleasing self
- Amenorrhea
Bulimia
- Pleasing others
- Dental problems
- Mood swings
Binge-Eating Disorder
Checklist
- Recurrent binge episodes (at least 3)
- Unusually fast eating
- Absence of hunger
- Uncomfortable fullness
- Secret eating (shame)
- Feelings of self-disgust, guilt, depression, etc.
- Significant distress
- Episodes: at least weekly for 3 months
- Absence of compensatory behaviors (self-induced vomiting, laxative, etc.)
- Not the same as obesity
- Around 1/2 are overweight
- Most overweight people don’t engage in repeated binges
Demographics
- 2-7% of population
- At least 64% are female
- Later onset
Psychodynamic Factors that Increase ED Risk (Ego Deficiencies)
- Bruch: disturbed mother-child interactions lead to serious ego deficiency
- ex: crying kid given a sandwich because “they must be hungry”
- Child doesn’t know how to react to their emotions & seek control w/ eating habits
- Feel unable to establish the independence they desire
Cognitive-Behavioral Factors that Increase ED Risk
- Little control over life may result in excess control in body size
- Core cognitive distortion: people w/ anorexia/bulimia judge themselves (shape/weight) and their ability to control it
Biological Factors that Increase ED Risk
- Not a lot of evidence therefore not widely accepted
Hypothalamus
- Lateral hypothalamus (LH): produces hunger
- Ventromedial hypothalamus (VMH): reduces hunger
- Not working properly
Weight Set Point
- Genetic & early eating practices
- Keeps an individual at specific weight
- Weight above set point: VMH activated + hunger lowered + metabolic rate raised
- Weight below set point: LH activated + hunger produced + metabolic rate lowered
- Make it harder to lose weight but easier to gain weight (however little is eaten)
Societal Pressures that Increase ED Risk
- More common in Western countries (due to standards of female attractiveness)
- Preconceived opinions against overweight people
- More time on social media
Family Environments that Increase ED Risk
- Emphasis on thinness, appearances, and dieting
- Mom dieting/perfectionistic
- Abnormal communication
- Over-involvement/
- Teenager’s normal push for independence threatens family closeness
- Eating dinner together
Multicultural Factors that Increase ED Risk
Gender Differences
- Males 10% of all EDs
- Different methods of weight loss (men: exercise, women: diet)
- Men can develop due to job/sports
- Reverse anorexia or muscle dysmorphia w/ men
Racial/Ethnic Differences
- Young African American women eating behaviors more positive than non-Hispanic White American women
- Increase in Asian American Females
Treatments for Anorexia
- Weight restoration
- Motivational interviewing
- Behavior weight restoration
- Cognitive-behavioral (long-lasting)
- Family therapy
Weight-Restoration Treatment (Anorexia)
Nutrition Rehabilitation
- Phase of treatment used to help return to health w/in weeks
- Partial day hospitals/outpatient settings
Intravenous Feedings
- In life threatening situations
- Creates distress + distrust
Motivational Interviewing (Anorexia)
- Mixture of empathy + review to help motivate clients to recognize they have a serious eating problem and commit to making choices + change
- The client’s choice/idea to change, not anybody elses
Behavior Weight Restoration (Anorexia)
- Offer rewards whenever patients eat properly or gain weight
- Offer no rewards whenever they eat improperly or fail to gain weight
Cognitive-Behavioral (Anorexia, Long-Lasting)
- Achieves long lasting changes by reducing risk of relapse
- Required to monitor feelings, hunger levels, food intake
- Taught to identify “core pathology”
- Recognize need for independence + teach them appropriate ways to exercise control
- Change their attitudes about eating + weight
Core Pathology (Cognitive-Behavioral Treatment for Anorexia)
A deep-seated belief that they should be judged by their weight
Family Therapy (Anorexia)
- Important
- Therapist meets w/ family and points out troublesome family patterns + helps members make changes
- Separation + boundaries
Treatments for Bulimia
- Cognitive-Behavioral Therapy
- Group Therapy
- Antidepressants
Cognitive-Behavioral Therapy (Bulimia)
Behavioral Techniques
- Diaries (emotions/triggers for bingeing)
- Exposure and Response Prevention (ERP)
Cognitive Techniques
- Recognize + change maladaptive attitudes towards food, eating, weight, shame
- Challenge negative thoughts that precede a binge
- Helps as many as 75%
