Chapter 11- Eating Disorders Flashcards
(121 cards)
1
Q
What is Anorexia nervosa?
A
A disorder marked by the pursuit of extreme thinness and by extreme weight loss
2
Q
What characterizes having anorexia nervosa?
A
Maintains a significantly low body weight, intensely fears becoming overweight, has a distorted view of their weight and shape, excessively influenced by their weight and shape in their self-evaluations, overestimate their actual proportions
3
Q
What is restricting-type anorexia nervosa?
A
Reduce their weight by restricting intake of food, eventually show almost no variability in diet
4
Q
What are other behaviours people with anorexia nervosa engage in?
A
Force themselves to vomit after meals, or abuse laxatives and diuretics
5
Q
What is peak onset age for anorexia nervosa?
A
Between 14 and 20 years old
6
Q
What is the typical way anorexia nervosa begins?
A
Diets often can trigger anorexia, or after a stressful event
7
Q
What is the mortality rate of people with anorexia nervosa?
A
6% become so seriously ill that they die, usually from medical problems brought on by starvation, or from suicide
8
Q
What is the primary motivator for people with Anorexia nervosa?
A
Fear, afraid of becoming obese, of giving into their desire to eat, of losing control of the size and shape of their bodies
9
Q
True or false people with anorexia are preoccupied with food?
A
True, they spend considerable time thinking and reading about food, planning their limited foods, often dreaming about food and eating
10
Q
True or false preoccupation with food may be a result of food deprivation rather than its cause?
A
True
11
Q
What is a popular assessment technique used to test the tendency to overestimate body size?
A
Research participants look at a photograph of themselves though an adjustable lens. Asked to adjust lens until the image that they see matches their actual body size
12
Q
How do people with anorexia nervosa perform on the test?
A
Stop the lens when the image was larger than they actually were, up to 20% larger
13
Q
True or false, people with anorexia nervosa can develop maladaptive attitudes?
A
True, often they strive for perfection, feel guilty for eating and believe themselves to be a better person if they deprive themselves
14
Q
True or false, people with anorexia nervosa can have certain psychological problems?
A
True, common psychological problems include depression, anxiety, obsessive-compulsive disorder, low-self esteem, insomnia, or other sleep disturbances and substance abuse
15
Q
What sort of medical problems occur as a result of the starvation habits of anorexia nervosa?
A
Lowered body temperature, low blood pressure, body swelling, reduce bone mineral density, slow heart rate, amenorrhea, electrolyte and metabolism imbalance, heart failure, circulatory collapse
16
Q
What is amenorrhea?
A
the absence of menstrual cycles
17
Q
What sort of physical problems occur as a result of the starvation habits of anorexia nervosa?
A
Skin becomes rough, dry, and cracked. Nails become brittle. Hands and feet to be cold and blue. Can loose hair from the scalp, and grow lanugo
18
Q
What is lanugo?
A
Fine silky hair that grows on their trunk, extremities, and face. The body does this to maintain body heat
19
Q
What is bulimia nervosa?
A
A disorder marked by frequent eating binges followed by forced vomiting or other extreme compensatory behaviours to avoid gaining weight
20
Q
How else is bulimia nervosa known?
A
Binge-purge syndrome
21
Q
What is a binge?
A
An episode of uncontrollable eating during which a person ingests a very large quantity of food rapidly and chews minimally, rarely tasting the food
22
Q
How long does a binge episode last?
A
Over a limited period of time, often two hours, during which the person eats much more food than most people would eat during a similar time span
23
Q
What are compensatory behaviours in bulimia nervosa?
A
Force vomiting, misusing laxatives, diuretics, or enemas, fasting, or exercising excessively
24
Q
What is peak onset age for bulimia nervosa?
A
Between 15 and 20 years old
25
Difference between anorexia and bulimia?
Anorexic people have a low weight, whereas, bulimic people usually stay within a normal range of weight (may fluctuate markedly within that range)
26
Exception of bulimia in relation to weight (IMPORTANT)
Although most stay within a relatively normal range, some become seriously underweight and eventually qualify for a diagnosis of anorexia nervosa instead
27
How often do people with bulimia have binge episodes?
May have between 1 and 30 binge episodes per week
28
What are the feelings experienced during binging
relieve of the unbearable tension to eat "forbidden foods" but then feels extreme self-blame, shame, guilt, and depression, as well as feared of gaining weight
29
Vomiting as a compensatory behaviour following a binge
Vomiting fails to prevent the absorption of half of the calories consumed during the binge. Also affects one's general ability to feel satiated, leading to greater hunger and more frequent and intense binges
30
Laxatives or diuretics as a compensatory behaviour following a binge
Also largely fails to undo the caloric effects of bingeing
31
What is the typical way bulimia nervosa begins?
Diets often can trigger bulimia
32
What is a result of being placed on a very strict diet?
Often results in binging
33
Similarities between Anorexia and Bulimia?
Typically begin after a period of dieting, people are fearful of becoming obese, driven to become thing, preoccupied with food, weight, appearance, and struggling with depression, anxiety, obsessiveness and the need to be perfect, and substance abuse. Both have disturbed attitudes toward eating
34
Similarities in the way anorexic and bulimic people think?
The belief that they weigh too much and look too heavy regardless of their actual weight or appearance
35
What is body dissatisfaction?
Evaluate weight and shape negatively, single most powerful contributor to dieting and the development of eating disorders
36
Differences between anorexia and bulimia?
Both worry about the opinions of others, however, those with bulimia tend to be more concerned about pleasing others, being attractive to others, and having intimate relationships. Bulimic people tend to be more sexually experienced and active than people with anorexia nervosa. Bulimic people have more mood swings
37
Personality disorder and bulimia?
1/3 of those with bulimia display characteristics of a personality disorder (borderline personality disorder or avoidant personality disorder).
38
Medical differences between anorexia and bulimia?
Almost all women with anorexia are amenorrheic, whereas, only half of women with bulimia are amenorrheic or have irregular menstrual periods
39
Medical problems specific to those with bulimia?
Vomiting leads to dental problems (breakdown of enamel and loss of teeth), vomiting and/or chronic diarrhea can result in potassium deficiencies, leading to weakness, intestinal disorders, kidney disease or heart damage
40
What is binge-eating disorder?
A disorder marked by frequent binges without extreme inappropriate compensatory acts
41
True or false most overweight people engage in repeated binges?
False, most do not. Their weight results from frequent overeating and/or a combination of biological, psychological, and sociocultural factors
42
How is binge-eating disorder similar to anorexia and bulimia?
The binges that characterize this pattern are similar, the amount of food eaten and the sense of loss of control experienced during the binge. Also preoccupied with food, weight, and appearance
43
How are people with binge-eating disorder characterized?
Base their evaluation of themselves largely on their weight and shape; misperceive their body size and are dissatisfied with their body, struggle with feelings of depression, anxiety, and perfectionism, may have substance abuse
44
Differences between binge-eating disorder and the other two disorders
With binge-eating disorder, they aspire to limit their eating but are not as driven to thinness, does not necessarily begin because of dieting.
45
When do people typically develop binge-eating disorder?
In their twenties
46
What is the multidimensional risk perspective
A theory that identifies several kinds of risk factors that are thought to combine to help cause a disorder. The more factors present, the greater the risk of developing the disorder
47
What are the most common factors?
Biological, psychological and sociocultural
48
What does the multidimensional risk perspective contend?
Risk factors for eating disorders unfold over the course of development (similar to developmental psychopathology perspective). Interactions between these factors is important
49
True or false different risk factors and combinations of factors may lead to the same eating disorder?
True
50
What are Psychodynamic factors?
Ego deficiencies, including a poor sense of independence and control
51
Who is Hilde Bruch?
Developed a largely psychodynamic theory of eating disorders. She argued that disturbed mother-child interactions lead to serious ego deficiencies in the child and to sever perceptual disturbances that jingle helps produce disordered eating
52
Who does Hilde Bruch argue is an effective parent?
Effective parents accurately attend to their children's biological and emotional needs
53
Who are ineffective parents?
Fail to attend to their children's needs or fail to correctly interpret the children's actual condition. They define their children's needs rather than allow the children to define their own needs.
54
What happens when a parent inaccurately interprets the children's actual condition?
If they feed their children when the child is anxious rather than hungry, it may cause the child to be confused and unaware of their own internal needs, not knowing for themselves when they are hungry
55
What is a cause of a child's inability to relay on internal signals?
Fail to develop genuine self-reliance and are not in control of themselves, to overcome this they seek excessive control over their body size and shape and over their eating habits pg 323 (if need more info)
56
What do people with eating disorders do?
Inaccurately interpret internal cues and emotional cues
57
What is alexithymic? how does it describe people with eating disorders?
Have great difficulty putting descriptive labels on their feelings
58
What else does Hilde Bruch contend?
people with eating disorders rely excessively on the opinions, wishes and views of others
59
What are cognitive-behavioural factors?
Deficiencies including: improperly labeling internal sensations and needs and excessive levels of control over their body size, shape, and eating habits is because of a broad cognitive distortion
60
What is this broad cognitive distortion?
People with Anorexia and Bulimia judge themselves based on their shape, weight and their ability to control these two things. Known as their "core pathology"
61
What is the result of their "core pathology"?
Results in all other aspects of the disorders, including the repeated efforts to lose weight and the preoccupation with shape, weight and eating. They display cognitive deficiencies.
62
The link between eating disorders and depression?
Especially those with bulimia nervosa have symptoms of Depression. Suggest that depressive disorders can contribute to developing eating disorders.
63
What are the four pieces of evidence to suggest the link between eating disorders and depression?
1. Qualify more for a clinical diagnosis of major depressive disorder than people in the general population
2. Close relatives seem to have a higher rate of depressive disorders
3. The depression-related brain circuit of many people with eating disorders show abnormalities that are similar to those of people with depression
4. Sometimes helped by the same antidepressant drugs that reduce depression
64
What are the biological factors of eating disorders?
Suggest that certain genes may cause some people to be susceptible to eating disorders. The possible role of dysfunctional brain circuits in people with eating disorders
65
What is interconnectivity problems (abnormal communications)
Interconnectivity problems between structures in a particular circuit, abnormal anatomy or operation of the individual structures in that circuit, or abnormal levels of activity by the neurotransmitters that carry messages from the neurons in one structure to the neurons in another
66
What is insula?
A structure (in the anxiety-related circuit) is abnormally large and active in people with eating disorders
67
What is the orbitofrontal cortex?
A structure (in the obsessive-compulsive-related circuit) is abnormally large
68
What is the straitum?
A structure (in the obsessive-compulsive-related circuit) is hyperactive
69
What is the prefrontal cortex?
A structure (in the anxiety circuit, OCD circuit, and depression circuit) is abnormally small
70
Activity of neurotransmitters in eating disorders?
Activity levels of serotonin, dopamine, and glutamate are abnormal
71
What is still unclear for researchers?
Unclear whether eating disorders are caused by the dysfunctions in the brain circuits related to anxiety, OCD, and depression disorders OR if the dysfunctions in those circuits are actually the result of eating disorders
72
What is the hypothalamus?
A part of the brain that helps regulate various bodily functions, including eating and hunger
73
What is the lateral hypothalamus?
A brain region that produces hunger when activated
74
What is the ventromedial hypothalamus?
A brain region that depresses hunger when activated
75
Relation between hypothalamus and eating?
These areas of the hypothalamus are activated by chemicals from the brain and body, depending on whether the person is eating or fasting
76
What is Glucagon-like peptide-1 (GLP-1)?
A natural appetite suppressant
77
What have biological theorists argued in relation to eating disorders?
The hypothalamus, related brain structures, and chemicals such as GLP-Q, comprise a "weight thermostat" in the body, which is responsible for keeping an individual at a particular weight level (weight set point)
78
What is weight set point?
The weight level that a person is predisposed to maintain, controlled in part by the hypothalamus
79
What determines a person's weight set point?
Genetic inheritance and early eating practices
80
What is the weight set point theory?
When people diet and fall to a weight below their weight set point, their brain starts trying to restore the lost weight. Hypothalamic and related brain activation produce a preoccupation with food and a desire to binge. Also trigger bodily changes that make it harder to lose weight and easier to gain weight, however little is eaten
81
How does anorexia nervosa occur (biological explanation)
The person manages to "shut down the inner thermostat" and control their eating almost completely. If unable then they engage in a binge-purge or binge-only pattern
82
How does societal pressures contribute to eating disorders?
Western standards of female attractiveness are partly responsible, preference towards a thin female frame. Western standards also create a climate of prejudice against overweight people
83
True or false anorexia nervosa and bulimia nervosa are more common among women higher on the socioeconomic scale?
True, however, in recent years more concern about thinness is occurring has increased to some degree in all socioeconomic classes
84
How does family environment contribute to eating disorders?
Contribute to the development and maintenance of eating disorders. Factors include: emphasizing thinness, physical appearance and dieting, Abnormal interactions and forms of communication within a family
85
What is enmeshed family pattern?
Developed by Salvador Minuchin, a theory that proposes that a family system in which members are over involved with each other's affairs and overly concerned about each other's welfare. Foster dependency, leading to eating disorders to seek independence
86
What does Salvador Minuchin argue?
The adolescent child's independence threatens the family harmony, the family may subtly force the child to take on a "sick" role- to develop an eating disorder, which enables the family to maintain its appearance of harmony.
87
What are multicultural factors that contribute to eating disorders? Racial and Ethnic differences
The shift in the eating behaviours and eating problems of minorities is partially related to their acculturation, become more oriented to western culture ideals. Initially less concerned then white people, now increasingly more concerned
88
What are multicultural factors that contribute to eating disorders? Gender differences
Males account for only 10% of all people with anorexia and bulimia. Reasons: Society's double standard for attractiveness. Emphasis on a thin appearance is aimed more at women. Different methods of weight loss favoured by the two genders (women prefer dieting which is a onset to developing an eating disorder).
89
What is muscle dysmorphia/ reverse anorexia nervosa?
Common in men, strive for a ultra muscular body through excessive weight lifting and abuse of steroids. 1/3 engage in dysfunctional behaviours such as binge eating.
90
Common reasons why men develop eating disorders?
The requirements and pressures of a job or sport, body image
91
What are the two goals for treating eating disorders?
Correct the dangerous eating pattern as quickly as possible. Address the broader psychological and situational factors that have led to and maintain the eating problem
92
What does treatment aim for?
Help people regain their lost weight, recover from malnourishment, and eat normally again.
93
What is nutritional rehabilitation?
A phase of treatment that focuses on helping patients gain weight quickly and return to health within week
94
What occurs in life-threatening cases?
May need to face tube and intravenous feelings on a patient who refuses to eat
95
What other treatment do clinicians use?
Behavioural weight-restoration approaches which offer rewards whenever a patient eats properly or gains weight
96
What is the most popular nutritional rehabilitation approach?
Combination of supportive nursing care, nutritional counselling, and a relatively high-calorie diet
97
What is motivational interviewing?
A treatment intervention that uses a mixture of empathy and inquiring review to help motivate clients to recognize they have a serious psychological problem and commit to making constructive choices and behaviour changes
98
How are lasting changes achieved?
Must overcome their underlying psychological problems. Therapists use a combination of education, psychotherapy and family therapy. Psychotropic drugs, particularly antipsychotic, are sometimes used when patients do not respond to other forms of treatment (limited benefit)
99
What is cognitive behavioural therapy for anorexia nervosa?
A combination of cognitive and behavioural interventions, techniques designed to help clients appreciate and alter the behaviours and thought processes that help keep their restrictive eating going.
100
What is the behavioural part of treatment for anorexia nervosa?
Clients are required to monitor their feelings, hunger levels, and food intake and the ties between these variables
101
What is the cognitive part of treatment for anorexia nervosa?
Taught to identify their "core pathology" (belief that they should by judged by their shape and weight and by their ability to control the two. Taught alternative ways of coping with stress and of solving problems. Help clients recognize their need for independence and teach them more appropriate ways to exercise control. Teach them to better identity and trust their internal sensations and feelings
102
What else do cognitive-behavioural therapists seek to help clients with anorexia nervosa with?
To change their attitudes about eating and weight. Guide the client to identify, challenge, and change maladaptive assumptions. Educate about the body distortions and help them to see that their own assessments of their size are incorrect
103
When is cognitive-behavioural treatment most effective at preventing relapses?
When it continues for at least a year beyond a patient's recovery - maintenance therapy strategy
104
What is family therapy?
Help the patient separate their feelings and needs from those of other members of the family. Points out troublesome family patterns and helps members make appropriate changes.
105
True or False recovery from eating disorders is permanent?
False, at least 1.3 of recovered patients have recurrences of anorexic/bulimic/binging behaviour, usually triggered by new stresses
106
What makes recovery rates harder?
the more weight a person has lost and the more time that passes before they seek treatment
107
Treatments for bulimia nervosa?
Nutritional rehabilitation - specifically for bulimic people means helping clients eliminate their binge-purging patterns. Establishing good eating habits. A combination of therapies aimed at eliminating the underlying causes of bulimic patterns. Emphasize education
108
Which treatments prove to be most effective for bulimia nervosa?
Cognitive-Behavioural therapy and antidepressant drug therapy
109
What is cognitive-behavioural therapy specifically for bulimia nervosa?
Employ many of the same techniques as anorexia but tailor them to features distinct of bulimia ( bingeing and purging) and to the specific beliefs of bulimia
110
What are bulimic clients instructed to do?
Keep records of their eating behaviour, changes in sensations of hunger and fullness and the ebb and flow of other feelings. Help clients observe their eating patterns more objectively and recognize the emotions and situations that trigger their desire to binge
111
What is Exposure and response prevention?
To help break the binge-purge cycle, this approach exposes people to situations that would ordinarily raise anxiety and then preventing them from performing their usual compulsive responses until they learn that the situations are actually harmless and their compulsive acts are unnecessary.
112
How is Exposure and response prevention specifically used to treat bulimia nervosa?
Require clients to eat particular kinds and amounts of food and then prevent them from vomiting to show that eating can be a harmless and even constructive activity that does not need undoing. Helps reduce eating-related anxieties, bingeing, and vomiting
113
What else do cognitive-behavioural therapists do?
Help clients recognize and change their maladaptive attitudes towards food, eating, weight and shape. Teach clients to identify and challenge the negative thoughts that regularly priced their urge to binge
114
What is interpersonal psychotherapy?
Treatment that focuses on improving interpersonal functioning. The various forms of psychotherapy (cognitive-behavioural, interpersonal, and psychodynamic) are often supplemented by family therapy
115
How are antidepressant medications used in the treatment of bulimia nervosa?
All forms of antidepressant drugs have been found to help reduce their binges by an average of 67% and vomiting by 56%. Help as many as 40% of people with bulimia
116
True or false people can relapse even when they responded successfully to treatment
True, similar to anorexia relapses in bulimia are triggered by new life stresses
117
Treatments for binge-eating disorders?
Treatment is often similar to those for bulimia. Cognitive-behavioural, and other forms of psychotherapy and in some cases, antidepressant drugs are provided to help reduce or eliminate the binge-eating patterns and to change disturbed thinking.
118
True or false eating disorders have a high risk for relapses
True
119
Prevention of eating disorders?
Development of programs that prevent the onset of eating disorders
120
What is Body Project?
A prevention program that critiques Western's society ultra-thin ideal. Based on cognitive dissonance theory
121
What is cognitive dissonance theory?
A social psychology theory that states when people adopt new attitudes (in this case anti-thinness attitudes) that contradict their other attitudes and behaviours (pro-thinness attitudes, they will experience emotional discomfort - a state of dissonance that they implicitly seek to eliminate by changing their old attitudes and behaviours.
