Eating Disorders: BED Flashcards Preview

PSYC3018 Abnormal Psychology > Eating Disorders: BED > Flashcards

Flashcards in Eating Disorders: BED Deck (18)
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1

Was BED in the DSM IV

No, it was considered to be a 'diagnosis in need of further study'

It is now included in DSM-V as a diagnosis

2

What are the two qualifying criteria for a binge-eating episode?

A. Recurrent episodes of binge-eating:
> eating, in a discrete period of time, an amount which is definitely larger than what is socially acceptable
> a sense of lack of control over eating during the episode

(some patients have subjective binge-eating -> they feel that just eating a mars bars whilst on a diet is a binge [they still feel bad about their behaviour])

3

What are the other criteria for BED

B. the binge-eating episodes are associated with three (or more) of the following:
> eating much more rapidly than normal
> eating until feeling uncomfortably full
> eating large amounts of feed even when not feeling hungry
> eating alone because they are embarrassed by their behaviour
> feeling disgusted with oneself, depressed, or very guilty afterwards

C. marked distress regarding binge-eating is present

D. the binge-eating occurs, on average, at least once a week for 3 months

E. The binge eating is not associated with any recurrent inappropriate compensatory behaviour - if there is, it is considered BN

4

What qualifies partial and full remission?

Partial: After meeting full criteria, binge-eating occurs less than once a week for a sustained period of time

Full: After meeting full criteria, none of the criteria have been met for a sustained period of time

5

What are the severity specifiers (binge-eating episodes per week)

Mild: 1-3
Moderate: 4-7
Severe: 8-13
Extreme: 14 or more

6

What is the prevalence of BED

Women: 2.5 - 4.5%
Men: 1.0 - 3.0%

Note: closer prevalence in M/F than in any other eating disorder.

When?
> typically begins in early childhood (ie early to mid twenties)

7

What are the risk factors?

> Tends to run in famalies, which suggests genetic influences
> Dieting is greatest risk factor for developing BED
> trauma
> low self-esteem etc

8

What are the triggers fro BED

> negative affect - depression, anxiety etc
> interpersonal stressors
> dietary restraints
> boredom

9

What are the three overarching protective factors?

Personal:
> high self-esteem
> emotional well being
> ability to regulate emotional states
Family:
> eating meals together
> not constantly hooked up on weight and physical attractiveness
Society:

10

What are comorbid disorders?

It is similar to other eating disorders
> depression and anxiety are most common
> substance use and personality disorder are also very common

It is also associated with obesity and the related health conditions

11

How can you assess BED

> Eating Disorder examination (EDE) or the self-report questionnaire (EDE-Q)
> Binge Eating Scale (BES)

12

What are the treatment methods for BED

Psychological therapy - "first line
> Cognitive Behavioural Therapy (CBT)
> Interpersonal Therapy (IPT) - more psychodynamic, focuses on relationships not on the eating behaviour
> Dilectical Behavioural Therapy (DBT) - used to help with emotional and impulse control -> used for other disorders such as borderline personality

Pharmacological treatment
> Selective serotonin reuptake inhibitors (SSRIs)
> Selector noradrenalin reuptake inhibitors (SNRIs)

13

What are the targets of BED

Psychological:
> Have to stop the person from bingeing!
> Sustainable weight loss
> Increase in ability to cope with negative affect - how to deal with feeling down
> Relapse prevention

Pharmacological:
> Lowering impulsivity to eat
> Mood is implicated, so keep moods stable - removing one risk factor

14

Approx what are the binge abstinence rates for the treatment methods?

Average post-treatment 50%, which increases in follow up studies - the longer you practice the treatment, the better at it you become!

15

What is one of the most difficult aspects of treating BED

Ability to help patients cease binge-eating episodes and then continue to lose weight

16

What is the most effective treatment for BED

CBT - it is the most validated and effective treatment, and you can still use it without negatively affecting comorbid conditions

17

What are some of the negative aspects of CBT treatment

> individual CBT is cost and time intensive
> it has only modest effect on weight loss

18

How can we prevent BED

> being more media smart
> CBT - modify thinking styles and behaviour eg student bodies programs
> Cognitive dissonance - be happy with self and own bodies