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Never-Ending Road to Licensure > Feeding/Eating, Elimination, and Sleep-Wake Disorders > Flashcards

Feeding/Eating, Elimination, and Sleep-Wake Disorders Flashcards

1
Q

Pica definition

A

Eating nonfoods that have no nutrition

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2
Q

Considerations when diagnosing pica

A
  1. Developmental level
  2. Cultural practices
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3
Q

Common pica populations

A
  1. Children
  2. Pregnant women
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4
Q

Anorexia Nervosa definition

A

Restricting food that results in low body weight

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5
Q

Anorexia criteria

A
  1. Fear of weight gain
  2. Distortions in perceptions of weight/shape
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6
Q

Anorexia specifiers

A
  1. Type (restricting or binging/purging)
  2. Course (in partial/full remission)
  3. Severity (based on BMI)
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7
Q

Common co-morbidities for anorexia, bulimia, and BED

A
  1. Depression
  2. Anxiety disorder (especially OCD for anorexia), often before eating disorder
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8
Q

Anorexia prognosis

A
  1. Relapses common
  2. Difficult to treat (lack of insight)
  3. Generally better than bulimia, with mixed findings
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9
Q

Eddy et al (2017) study about recovery rates for anorexia and bulimia

A

9 years = anorexia recovery was half of bulimia recovery

22 years = similar recovery

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10
Q

Initial treatment goals for anorexia

A
  1. Healthy weight
  2. Address physical complications
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11
Q

Secondary treatment goals for anorexia

A
  1. Motivation for treatment
  2. Psychoeducation
  3. Identify beliefs, attitudes, emotions
  4. Treat contributing psychological factors
  5. Family support
  6. Relapse prevention
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12
Q

Treatments for anorexia

A
  1. CBT for anorexia
  2. CBT-E for eating disorders
  3. FBT for anorexia
  4. Inconsistent support for medication
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13
Q

CBT for anorexia

A
  1. Post-hospitalization
  2. Behavioral strategies for eating patterns
  3. Reduce body-checking
  4. Replace thinking errors
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14
Q

CBT-E for eating disorders

A
  1. Individualized based on client factors
  2. Assumes core problem is over-valuing weight/shape
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15
Q

FBT for anorexia nervosa

A
  1. Outpatient for medically stable adolescents
  2. Three phases
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16
Q

Three phases of FBT for anorexia nervosa

A
  1. Parent control over weight/nutrition for adolescent
  2. Control gradually returned to adolescent
  3. Address development factors (independence, parent-child relationship)
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17
Q

Medications for anorexia

A
  1. Olanzapine for initial weight gain
  2. Fluoxetine for weight maintenance
  3. Some support for treating co-morbidities rather than anorexia
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18
Q

Bulimia Nervosa definition

A

Binge eating with compensatory behaviors to prevent weight gain

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19
Q

Bulimia criteria

A
  1. Binge and compensatory behavior 1x/week
  2. Symptoms 3+ months
20
Q

Bulimia specifiers

A
  1. Couse (in partial/full remission)
  2. Severity (based on episodes of compensatory behavior per week)
21
Q

Typical weight for anorexia, bulimia, and BED

A

Anorexia - far below average

Bulimia - average or overweight

BED - normal, overweight, or obese

22
Q

Bulimia treatment

A
    1. CBT-E for eating disorders**
  2. Nutritional rehab and CBT*
  3. IPT (longer time to produce results)
  4. FBT for bulimia nervosa
  5. Some evidence for medication
23
Q

Three phases of FBT for bulimia nervosa

A
  1. Disruptive binging and compensatory behaviors, building healthy eating patterns
  2. Collaborative between parent and adolescent due to insight
24
Q

Insight and treatment motivation for anorexia v. bulimia

A

Anorexia - little to no insight, little to no motivation

Bulimia - insight w/ distress and motivation

25
Q

Medications for bulimia

A
  1. SSRIs (fluoxetine) for comorbid depression and reducing binging/purging without depression
  2. Some evidence that combined SSRI and CBT is better
26
Q

Four stages of CBT-E for bulimia

A
  1. Engage, self-monitor, education, establish eating pattern
  2. Review progress, revise plan as needed
  3. Address over-value of weight/shape and other triggers/factors
  4. Maintain progress, relapse prevention
27
Q

Telehealth v. in-person for bulimia

A

Both positive outcomes for acceptability and retention

Better abstinence and lower rates of cognitive distortions in face-to-face

28
Q

Binge-Eating Disorder (BED) definition

A

Eating larger amounts than typical with a sense of being out of control

29
Q

BED criteria

A
  1. 3+ symptoms (rapid eating, eating until uncomfortably full, large amounts w/o hunger, alone/hiding, negative emotions)
  2. Episodes 1x/week
  3. Symptoms 3+ months
30
Q

BED specifier

A
  1. Severity (based on episodes per week)
31
Q

BED prevalence

A

2-3x more common in women than men

32
Q

BED v. bulimia

A

BED - no compensatory behaviors, better treatment response, followed by dieting

Bulimia - compensatory behaviors, poorer treatment response, preceded by dieting

33
Q

BED treatment

A
  1. CBT-E*
  2. IPT
  3. Some evidence for medication
  4. Focus on binging before or alongside weight loss
34
Q

Medications for BED

A
  1. SSRIs (fluoxetine, paroxetine, sertraline)
  2. Topiramate
  3. Lisdexamphetamine
  4. Less effective than CBT alone or combined CBT and medication
35
Q

Enuresis criteria

A
  1. Involuntary peeing in bed or clothing
  2. 2+ times/week
  3. Symptoms 3+ months OR distress/impairment
  4. Not due to substance, medical conditions
  5. 5+ years old (age or developmentally)
36
Q

Enuresis specifiers

A
  1. Subtype (nocturnal only, diurnal only, both)
37
Q

Enuresis treatment

A
  1. Moisture alarm*
  2. Desmopressin (high risk for relapse when discontinued)
38
Q

Insomnia Disorder criteria

A
  1. 1+ symptoms
  2. 3+ nights/week
  3. Symptoms 3+ months
  4. Symptoms despite sufficient opportunity to sleep
  5. Distress or impairment
39
Q

Insomnia types

A
  1. Sleep-onset
  2. Sleep maintenance
  3. Late insomnia

Combination of three types is most common

40
Q

Subjective reports of insomnia

A

Tend to overestimate time awake and underestimate time asleep

41
Q

Insomnia treatment

A
  1. Cognitive-behavioral w/ stimulus control, sleep restriction, sleep hygiene, relaxation, cognitive therapy, etc.
42
Q

Narcolepsy criteria

A
  1. Sleep or naps 3+ times/week
  2. Symptoms 3+ months
  3. Cataplexy, hypocretin deficiency, or REM latency <15 minutes
43
Q

Narcolepsy common co-occurring problems

A
  1. Hallucinations before sleeping or after waking
  2. Sleep paralysis when falling asleep or waking
44
Q

Narcolepsy treatment

A

Behavioral strategies combined with medications to improve alertness and reduce cataplexy

45
Q

Medications for narcolepsy

A
  1. Modafinil and armodafinil (newer)
  2. Antidepressant (venlafaxine, fluoxetine, clomipramine) for cataplexy
  3. Sodium oxybate (if unresponsive to others)
46
Q

Non-Rapid Eye Movement Sleep Arousal Disorders

A

Incomplete waking w/ difficulty fully waking and little memory of episodes

  1. Sleepwalking
  2. Sleep terrors
47
Q

Nightmare Disorder criteria

A

Nightmares:
1. Extended
2. Dysphoric
3. Well-remembered
4. Threats to safety

Typically occur during REM or second half of major sleep

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