final study Flashcards
(129 cards)
1
Q
causal agent
A
microorganisms that use a host’s resources to reproduce, resulting in an immune response or physiological disruption
2
Q
host
A
organism that is the target of an infecting action of a specific infectious agent
3
Q
pathogen
A
microorganisms that cause disease
4
Q
what are the major groups of pathogens that infect humans
A
viruses, bacteria, protozoa, fungi, helminths, prions (6 total)
5
Q
what age group is most affected by infectious diseases?
A
neonatal (0-27 days) & postnatal (1-59 months)
6
Q
zoonotic diseases (zoonosis/zoonoses)
A
infectious diseases caused by pathogens that spread between animals (usually vertebrates) and humans
7
Q
virulence
A
the severity of a disease brought on by a pathogen
8
Q
Koch’s postulates
A
a set of criteria that establish whether a particular organism is the cause of a particular disease
- Pathogen must always be found in persons with the disease
- Pathogen must be isolated and grown in pure culture
- The culture should cause the disease when introduced into a healthy individual
- Pathogen can be isolated from second individual and grown in culture
9
Q
viruses
A
DNA or RNA surrounded by protein
10
Q
obligate parasites
A
a parasitic organism that cannot complete its life-cycle without exploiting a suitable host
11
Q
bacteria
A
single-celled prokaryotic organism (no nucleus)
12
Q
how do bacteria reproduce
A
duplicating DNA and dividing
13
Q
how many genera of bacteria and how many are known to cause disease in humans
A
400, 40
14
Q
protozoa
A
- Single-celled eukaryotic organisms (has a cell nucleus) - Able to evade host’s immune defenses
- Infections are difficult to treat and symptoms may be chronic because their cellular structures are similar to host mammal
15
Q
vectors
A
any agent which carries and transmits an infectious pathogen into another living organism
16
Q
fungi
A
- Eukaryotic organisms (have a cell nucleus)
- 70,000 species, though only a few are harmful to humans
- Low virulence, unless host is immunocompromised
17
Q
variability in fungi
A
yeasts, spores
18
Q
Helminths (worms)
A
Multicellular organisms, difficult to treat, tough outer coatings
19
Q
which helminths cause disease in humans
A
Roundworms, tapeworms, flukes
20
Q
transmission of helminths through…
A
Intermediate hosts and water, soil, food
21
Q
Prions
A
Infectious proteins
- Unclear how they replicate: no RNA or DNA
Transmissible spongiform encephalopathies
- Humans:
– Creutzfeld-Jakob disease
– Kuru
- Non-human:
–Bovine spongiform encephalopathy
– Scrapie
Transmission
- Exposure to brain tissue and spinal cord fluid from infected individuals
- Untreatable and fatal
22
Q
Direct transmission
A
Epithelial cells– exploitation of most permeable part of host’s body
- Skin, reproductive tract, respiratory and digestive systems
23
Q
Droplet transmission
A
Microbes are spread in mucus droplets that travel short distance (less than 1 meter)
- Coughing, sneezing
24
Q
Vector-borne
A
Intermediate species or material that can take a pathogen from one host to another
- Insects, animals (zoonosis), food, water, fecal-oral, utensils, needles
25
Factors favoring selection for higher virulence -- evolution of virulence (paul ewald)
- Intermediary disease vectors
- Transmission does not require host to be mobile
26
Factors favoring selection for lower virulence -- evolution of virulence (paul ewald)
- Causal human-to-human transmission
- Transmission requires host to be mobile
- Domesticating diseases requires disrupting modes of transmission, which will create conditions for the pathogen to evolve to mildness
27
First line defenses against pathogens
- Skin
- Mucous membranes
-- Cilia
-- Coughing and sneezing
-- Secretions of the skin and mucous membranes
-- Low pH of stomach acid
28
symptoms of pathogens
- Vomiting and diarrhea; coughing and sneezing
- Fever
- Iron sequestering
To treat or not to treat?
- Individual comfort vs. evolutionary adaptation vs. public health
29
immune system functions
1. recognize pathogen
2. destroy pathogen
3. communication between cells of the immune system to coordinate 1 and 2
30
how to identify "self" versus "non-self"
which cells require an immunological response and which do not
31
problems with "self/non-self dichotomy"
- Many cells in the body are non-self and are not pathogenic
- Many cells in the body are self and are pathogenic
32
criterion of continuity
Immune system recognizes strong discontinuities in molecular patterns, whether endogenous or exogenous origin
33
two interactive systems in human immunity
innate and adaptive
34
features of the innate system
- quick response (minutes to hours)
- broad recognition of pathogens
- principle cells/recognition: phagocytes
- secreted molecules: cytokines, histamine
- disposal: phagocytosis
- no memory
- inborn
35
features of the adaptive system
- responds slowly (days)
- high specificity of recognition of pathogens
- principle cells: lymphocytes, white blood cells, T cells, B cells
- recognition: b-cell for extracellular, t-cell for intracellular
- secreted molecules: antibodies (produced by b-cells), cytokines (produced by T-cells)
- disposal: b-cells (antibody initiated or phagocytosis), t-cells (cytotoxic t-cells, helper t-cells via B-cell or macrophage activation
- has a memory
- acquired with exposures (vertebrates only)
36
recognition systems of the innate system
Macrophages (phagocytes) have cell surface receptors (epitopes) that have broad recognition for molecular patterns of pathogens
Macrophages engulf pathogens and destroy them through the process of phagocytosis
37
recognition system of the adaptive system
lymphocytes recognize specific epitopes in pathogens
38
epitope
sections of pathogen proteins that are identifiable as non-self
- system can remember 100 million epitopes
39
antigen
large molecule or cell with epitopes on its surface
40
adaptive immune system: mechanism of action
lymphocytes (type of white blood cell) recognizes a single epitope (part of antigen), proliferation occurs and lymphocytes also replicate in response to pathogen
- b-cells, t-cells, and memory cells play a role
41
b-cells
found in bone marrow, monitors extracellular spaces --- (e.g. blood and other fluids)
- antibodies: immunoglobulins
b-cell recognizes antigen --> proliferation of antibody (Y-shape) --> antibody binds to antigen --> "labels" pathogen for destruction by other cells of the innate system
42
immunoglobulins
IgA, IgD, IgE, IgG, IgM
43
t-cells
recognizes intracellular pathogens through the major histocompatibility complex (MHC)
44
Major Histocompatibility Complex (MHC)
Molecules that move pieces of pathogenic proteins out to the surface of the cell where T-cells can recognize them
- T-cell with matching receptor binds to MHC + protein and marks for destruction
- Genes that code for MHC are most variable in human genome
45
destruction of pathogenic cells
Inflammation
- Mast cells release histamine, which increases permeability of blood vessels allowing greater access of immune cells to infected sites
Innate system
- Phagocytes (e.g. macrophages)
Adaptive system
- Cytotoxic-T-cells (viruses) and helper T-cells (stimulate macrophages and B-cells)
46
what happens when the immune system responds to non-threatening antigens
allergic immune response
- non-threatening antigens: allergens
47
hypotheses to explain atopic disease rates increasing over time and higher among industrialized populations
Hygiene and helminth/ “Old Friends” hypotheses
48
pathogen recognition and destruction: innate immune system
- First immune response after pathogen has penetrated the body’s barrier defenses
- Macrophages have surface cell receptors that have broad recognition for molecular patterns of pathogens
- Macrophages engulf pathogens and destroy them through the process of phagocytosis
49
Pathogen recognition and destruction: Adaptive immune system; antibody-mediated immunity
- B-cells floating in blood or other fluids directly recognize extracellular pathogens via antibodies on the B-cell surface
- Each B-cell makes one kind of antibody that matches only one antigen
- Binding of antigen to antibody results in B-cell activation
Proliferation of antibodies
- Antibodies can disable pathogen; or
- “Labeling” of pathogen for destruction of phagocytes (innate system)
- Production of memory B-cells to respond quickly with antibody if same pathogen encountered again
50
Pathogen recognition: adaptive immune system; cell-mediated immunity
T-cells recognize intracellular pathogens via antigen-presenting cells that contain Major Histocompatibility Complex (MHC) molecules
- MHC molecules move pieces of pathogenic proteins out to the surface of the cell where T-cells can recognize them
- T-cell with matching receptor binds to MHC + a pathogenic protein and depending on the pathogen:
- Cytotoxic T-cells destroy the pathogen containing cell; or
- Helper T-cells (TH1 or TH2) are produced which secrete cytokines to activate: Macrophages (TH1) and B-cells (TH2)
51
allergies + reaction
Immune system reaction to foreign substance in the environment that are harmless to most people (allergens)
Reaction:
- Mild: (coughing, sneezing, congestion, wheezing, vomiting, or diarrhea)
- Severe: (anaphylaxis)
52
allergen examples
Dander, mold, pollen, insect bites/stings, drugs, foods (peanuts, shellfish, milk, eggs)
53
asthma
Chronic disease of the branches of the windpipe (bronchial tubes), characterized by recurrent attacks of breathlessness and wheezing
During an asthma attack, the lining of the bronchial tubes swells, causing the airways to narrow and reducing the flow of air into and out of the lungs
54
what triggers asthma
Indoor allergens
- (e.g. house dust, mites in bedding, carpets, stuffed furniture, pollution, and cat dander)
Outdoor allergens
- (e.g. pollen and molds)
Tobacco smoke
Chemical irritants in the workplace
Air pollution
55
asthma stats
- WHO estimates that 235 million people currently suffer from asthma
- Asthma is the most noncommunicable disease among children
- Most asthma-related deaths occur in low- and lower-middle income countries
- Asthma is under-diagnosed and under-treated
56
where is asthma prevalent
highest: UK
- Scotland, England, New Zealand, Australia, Canada, US are also high
57
hygiene hypothesis
Improvements to hygiene result in fewer childhood diseases, altering the development of the immune system
Birth: TH2 (b-cells)
Older siblings: many infections (TH1 - macrophages)
No allergies: TH1
Allergies: still TH2
Only child: few infections
Exposure to pathogens that trigger TH1 responses → prevents TH2 responses from overreacting
Look at it like a two side scale with TH1 (intracellular pathogens) and TH2 (extracellular pathogens) on either side of the scale → increase in one will decrease the other
No exposure to TH1 stimuli → TH2 responses are left unchecked and atopic reactions can be triggered by harmless antigens
*** Increased IgE production → greater number of TH2 ***
Blood usually has a small amount of IgE antibodies, higher amounts can be a sign that the body overreacts to allergens, which can lead to an allergic reaction
58
Helminth (“Old Friends”) Hypothesis
Reduced exposure to helminths may result in underdeveloped or overactive immune systems
- “Old Friends” – helminths have been evolving with humans for thousands of years
no helminths: IgE is left unchecked and will overreact to allergens
helminths present: TH2 response stimulated
- High “background” IgE levels
- Worms secrete anti-inflammatory cytokines to combat IgE
59
The action of MHC molecules
1. MHC transporter molecules pick up viral proteins in the infected cell
2. MHC + protein transported to cell surface
3. MHC + protein recognized by T-lymphocyte receptor; T-lymphocyte delivers “lethal hit”
60
Vaccination
The administration of antigenic material to stimulate an individual’s immune system to develop adaptive immunity to a pathogen
61
Passive immunity
Uses pre-formed antibodies from other individuals
62
Active immunity
Provokes the immune system to generate memory cells which provide long-term protection against pathogens
- Live attenuated (e.g. MMR) or inactive vaccines (e.g. Flu)
- Vaccines made from parts of pathogens (e.g. Hep B)
mRNA (e.g. COVID-19)
- Others
63
Herd immunity
Indirect protection from infectious disease that occurs when a large percentage of a population has become immune to an infection, thereby providing a measure of protection for individuals who are not immune
64
what groups of people cannot receive vaccinations
- Infants
- Immunocompromised
- Allergic
65
B-cell response to vaccination: primary response
1. B-cell detects the antigen on the cell surface of the vaccine material (e.g. Attenuated measles virus)
2. B-cells multiply creating clones
3. B-cells become plasma cells (B-cells that produce antibodies) or memory B-cells
4. Plasma B-cells secrete large amounts of antibodies and tag the vaccine material (e.g. attenuated measures virus) for destruction by other cells of the immune system
5. The primary response takes place over several days
66
B-cell response to vaccination: secondary response (during exposure to pathogen)
When a vaccinated individual is exposed to the pathogen to which they are vaccinated against:
1. the memory B cells very quickly recognize the antigen
2. Memory B-cells rapidly multiply
3. Memory B-cells develop into plasma cells and produce a large amount of antibody
4. Antibodies tag the pathogen for destruction by other cells of the immune system
67
Partnering for Vaccine Equity (PAVE) Grant
- Using a Health Equity framework– developing tools to reach the groups that have the lowest uptake and trying to learn why
- Using the money to develop advertising campaigns to combat misperceptions and increase vaccine rates in the country
68
Rapid Community Assessment
surveying members of underserved groups and interviewing community leaders about vaccine perceptions and opinions
69
inequality
unequal access to opportunities
70
equality
evenly distributed tools and assistance
71
equity
custom tools that identify and address inequality
72
justice
fixing the system to offer equal access to both tools and opportunities
73
Challenges in Vaccination
- Demand has tapered off
- Mixed messages from public health authorities, news, and doctors leading to hesitancy
- Barriers– transportation, clinic hours, scarcity in rural areas
- Trust in public health as a field and the local health department
74
five vaccine personas (+ key barriers/targeted solution examples)
1. the enthusiasts
- key barrier: Appointment availability
- targeted solution examples: Make it easy for them to get the vaccine
2. the watchful
- key barrier: Community norms, vaccine safety
- targeted solution examples: Make it visible that others are vaccinated or intend to be
3. the cost-anxious
- key barrier: Financial cost, time, vaccine safety
- targeted solution examples: Bring vaccines to people., offer paid time off
4. the system distrusters
- key barrier: Trust, access and inequity, vaccine safety
- targeted solution examples: Listen and learn. Partner with trusted community organizations
5. the COVID skeptics
- key barrier: Deeply-held beliefs around COVID-19, vaccine safety
- targeted solution examples: Don’t try to debunk. Enlist trusted figures to persuade
75
tuberculosis
a highly infectious disease that primarily targets the lungs/respiratory systems
76
major symptoms of TB
Coughing and shortness of breath
- Lasts three or more weeks
- Blood may be found in cough
Chest pain or pain with breathing or coughing
Weakness and fatigue
Chills, fever, night sweats
Unintentional loss of weight
- Loss of appetite
77
Tuberculosis can be spread via:
- Droplet transmission (coughs or sneezes from infected individuals)
- “Sit and wait” → TB can survive on surfaces for months
78
Mycobacterium tuberculosis
Tuberculosis is caused by Mycobacterium tuberculosis (bacteria)
- M. tuberculosis targets macrophages of the host immune system
- The pathogen may also stay “dormant” in the host
79
Active TB
have symptoms, contagious
- Only 5-10% of those with the pathogen will develop active TB
80
latent TB
asymptomatic, not contagious
- Most people with TB will stay in the dormant stage
81
TB targets the most vulnerable members of a society
- Individuals at a lower socioeconomic status
- Individuals with co-infections with immune-compromising conditions (e.g. HIV)
- Individuals facing extreme stress (e.g. refugees, migrants, etc)
- Individuals in prison
82
TB with hunters/gatherers
- Small hunting/gathering groups → risky for a deadly pathogen
- TB would stay in a dormant stage for decades
- Old age or periods of famine → the tuberculosis pathogen would activate and spread to new hosts
83
TB and agriculture
- Human TB did not come from cattle
- Increased stress from agriculture
- Poor nutrition
- Overcrowding
- More susceptible hosts and competition from other pathogens → TB evolves to be more virulent
84
Tuberculosis: Pre-antibiotics
Waves of TB swept throughout India, China, Greece, Rome, etc., for thousands of years
Classic “Period” of Tuberculosis:
- Massive numbers of deaths from 1600s-1800s
- “White plague” or consumption
Renovations to sanitation and improved nutrition led to a sharp decline in tuberculosis deaths
- 1900s: development of skin tests for detecting TB
- Sanitoriums → specialized hospitals, emphasis on “resting” and fresh air
85
“Curing” Tuberculosis
- Antibiotics first appeared around 1943
Treating TB requires multiple rounds of antibiotic “cocktails”:
- 6 months of daily first-line drugs
- Additional months of extra drugs
First-line drugs are harsh antibiotics and have severe side effects
- Expensive: $20,000+ per person
- Though many countries offer free treatment, there are still additional costs
86
Multidrug-resistant TB
does not respond to the first-line drugs and must be treated with harsher, more expensive drugs
- Antibiotic resistance may occur when 6+ month treatment course isn’t completed
stats:
- WHO: upwards of 500,000 drug-resistant cases of TB per year
- WHO: only ¼ to ⅓ of those with MDR-TB have access to proper antibiotics
MDR-TB is extremely expensive
$500,000 - $800,000 per case
It also takes much longer to “cure”
87
factors that might contribute to active TB
1. iron deficiency and anemia
- intestinal parasites consume blood, leads to iron deficiency and anemia
- poor iron status weakens host
- (intestinal parasites)
2. immune dysregulation
- intestinal parasites spark a competing immune reaction
- the strain on the immune system keeps the body from fighting off M. tuberculosis
- (intestinal parasites)
3. alternative biocultural factors
- poor socioeconomic status increases stress and limits resources (i.e. medical care, nutrition, adequate housing)
- not receiving proper nutrition weakens host
- poor SES can also increase risk for intestinal parasites
88
measles transmission
spread through direct contact, droplet transmission, and can live on surfaces for up to 2 hours
89
measles symptoms
High fever (10-12 days after exposure), runny nose, cough, watery eyes, small white spots on the inside cheeks (Koplik spots), and rash
90
measles: morbidity and mortality
- Complications include blindness, encephalitis, severe diarrhea, ear infections, and pneumonia
- Young children and those who are malnourished are most at risk
91
New York State Immunization Laws for School Settings
Schools and Child Care Programs
- Every student entering or attending public, private or parochial school in New York State (NYS) is required by law to be immune to diphtheria, tetanus, pertussis, measles, mumps, rubella, poliomyelitis, hepatitis B, varicella and meningococcal.
- Every child in daycare, Head Start, nursery school or prekindergarten must be immune to diphtheria, tetanus, pertussis, measles, mumps, rubella, poliomyelitis, hepatitis B, varicella, Haemophilus influenzae type b (Hib), and pneumococcal disease
Colleges, Universities, and other Post-Secondary Institutions
- Students attending post-secondary institutions, who were born on or after January 1, 1957 and registered for 6 or more credit hours, must demonstrate proof of immunity against measles, mumps, and rubella. (SUNY also requires COVID-19).
92
immune response to allergens
- Th2 cells regulate the production of the antibody IgE
- IgE binds to mast cells which release histamine; Coughing/sneezing/wheezing/vomiting/diarrhea
93
Absolute poverty
based on subsistence, minimum standard needed to live
- Rowntree (1901): identified “poverty line” on the basis of minimum needs
94
Relative poverty
based on a comparison of poor people with others in society
-Townsend (1962): “Poverty is a dynamic, not a static concept… Our general theory then, should be that individuals and families whose resources over time fall seriously short of the resources commanded by the average individual or family in the community in which the community in which they live… are in poverty”
- Orshannsy (1969): “poverty, like beauty, lies in the eyes of the beholder”
95
Socioeconomic status (SES)
A composite measure that includes income, occupation, education, and housing conditions
96
“SES gradient”
every step downward in SES correlated with poorer health
- Risk of some diseases vary 10-fold from highest vs. lowest SES category
97
Poverty
measured as the share of the population on living than $3.10 international dollars per day
98
Health → SES causal pathway
Maybe chronic illness → missed educational and employment opportunities → lowered SES
99
SES → Health causal pathway
has most evidence
- Postmortem studies on adrenal glands
- Blood pressure studies in “low stress” groups
100
how does lower SES increase risk factors and decreases protective factors
- More smoking, drinking, obesity
- More likely to live in violent/polluted neighborhoods
- Less access to clean water, healthy foods, health clubs, adequate heating/cooling
101
Whitehall studies
Whitehall Studies show that low-ranked British civil servants (office messengers and other support staff) are almost twice as likely to die from heart disease as administrators of the same age.
Differences in risk factors– for example, higher smoking rates among the support staff- account for less than half the gap in mortality rates
102
stressor
Anything that disrupts physiological balance and activates stress response
103
homeostasis
“Same” “steady”; the tendency of the body to maintain a constant internal environment in response to environmental changes
104
allostasis
“Maintaining stability through change”; the physiological processes that allow organisms to adapt to stressors
- Long term disruption of homeostasis by stressors → allostatic load and negative health consequences
105
autonomic nervous system stress response
Immediate stress response
- Mobilizes energy resources to muscle cells
- Increases heart rate, bp, respiration and mental acuity
Sympathetic
Parasympathetic
106
hormonal stress response
Delayed stress response
- Replenishes energy stores through synthesis of glycogen (stored glucose) and fat deposition
Hypothalamic-pituitary adrenal (HPA) axis
107
Fight or Flight: The Stress Response is Adaptive in an Emergency
Energy needed
- Storage inhibited
- Stored energy mobilized
Muscles need oxygen
- Breathing rate increases
- Heart rate rises
- Vasoconstriction → BP increases
- Water retained to increase blood volume
No energy wasted on superfluous functions
- Digestion inhibited, blood flow to digestive tract decreased
- Reproductive physiology, behavior inhibited
- Growth, tissue repair inhibited
- Pain perception suppressed
- Changes in immune function
108
Autonomic Nervous System (parasympathetic & sympathetic)
Parasympathetic nervous system: “Rest-and-digest” or “feed and breed”
Sympathetic nervous system: “flight-or-flight”
- Norepinephrine (noradrenaline)
- Epinephrine (adrenaline)
109
Hormonal Stress Response
Hypothalamic-pituitary-adrenal axis (HPA axis)
- Corticotropin-releasing hormone (CRH)
- Adrenocorticotropic hormone (ACTH)
- Cortisol
110
cortisol
- Increases glucose availability in bloodstream and for the brain
- Increases bp and cardiac output
- Suppresses nonessential activities (digestion, reproduction)
- Chronic elevated cortisol can suppress immune response and lead to type 2 diabetes and CVD
111
Stress-Related Illness
Stress response not designed for long-term or frequent activation
Poor health:
- Stress on cardiovascular system
- Immunosuppression
112
Stress Hormones and Cardiovascular Disease
Chronic release of epinephrine → increase in blood pressure
- leads to heart attacks and strokes
Chronic release of cortisol:
Increase in insulin to take up excess circulating glucose mobilized by epinephrine
- deposition of glucose in visceral (abdominal) fat cells
- Risk factor for CVD and Type 2 Diabetes
Increase in insulin resistance
- Risk factor for Type 2 diabetes
113
Cortisol reactivity
higher during negative life events
114
Social Moderators of the Stress Response
Social cohesion/social capital
- Group well-being
-Connections and shared values that enable individuals and groups to trust each other and to work together
Social support/social integration
- Improved recovery
- Decreased distress
- Lower mortality due to illness
115
GDP and Average Life Expectancy
Average life expectancy is higher when the GDP per capita is higher
116
Social Support and Morbidity
% of colds (infection and illness) are highest in groups with low social network diversity, and the percentage is lowest in groups with the highest social network diversity
117
Scientific Racism
the use of scientific evidence of techniques to support or justify the belief in racial inferiority or superiority
118
Cline
character gradient over geographic space
- Ecological gradients
- Gene flow between populations
119
Pregnancy-related death
the death of a woman while pregnant or within 1 year of the end of a pregnancy
- Regardless of the outcome, duration or site or the pregnancy
- From any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes
120
Safety net providers
supply healthcare and other needed services to uninsured, Medicaid and other vulnerable/marginalized patients
121
Person-centered care
integrated health care services delivered in a setting and manner that is responsive to the individual and their goals, values, and preferences, in a system that empowers patients and providers to make effective care plans together
122
Trillium Health Research Enterprise (mission)
to improve health care for all through diverse and inclusive clinical studies focused on Trillium’s areas of expertise, including HIV treatment and prevention, LGBTQ+ health, sexual health, DEI, health equity, and infectious diseases, that advance our understanding of the patients we serve and the models of care that best suit them
123
Early Hominid Social Structure
Data suggests that australopithecines lived in multi-male, multi-female groups
- Genus Homo: similar group size and structure, less dimorphic
- Move towards sedentism: larger, permanent groups (~150 people)
124
Evolving Social Hierarchies
Primates:
- Single alpha male
- Linear dominance hierarchy
Hunter-gatherers
- Relatively egalitarian
- Single chief
- Relatively simple social structure
Post-hunter-gatherers:
- Multiple hierarchies
- Highest rank = most valued
125
Diagnostic and Statistical Manual of Mental Disorders (DSM)
Produced by American Psychiatric Association to provide consensus diagnostic information for all types of mental illness
126
I am illnesses
Chronic conditions that people do not simply have but become
- E.g. hemophilia, diabetes, schizophrenia, bipolar disorder
Difficult to separate the disease from the self-identity of the sufferer
- Movement towards separating sufferers from their illnesses
127
Anorexia nervosa
BMI of 17 is mild, below 15 is severe; afraid of gaining weight, disturbed body perception
- Self esteem, distorted perception of self-control linked to weight gain/loss
128
Bulimia nervosa
Binge eating followed by vomiting, misuse of laxatives, fasting, excessive exercise
- Misperceptions of body weight and shape
129
Measuring attitudes towards ideal body shape in American college students – 1980s (Fallon and Rozin)
Males saw themselves as close to:
- Their own ideal
- What females would find most attractive
Females saw themselves as heavier than:
- Their own ideal
- The size they thought males would find most attractive
- The size males identified as ideal for females
Women thought that men preferred a thinner body type than they actually did;
- Women’s own ideal body type was even thinner than what they thought men would like
