Module 8

Question 1

development habits in AN

Answer 1

Starvation starts as goal-directed: weight loss

Habits will develop + reinforced by weightloss and being in control.

Starvation also leads to stress which accelerates habit formation

Question 2

impaired cognitive functions in AN?

Answer 2

• Disturbed set shifting  more errors on WCST
• Perform poorly on iowa gambling task (decision making)
• Delay discounting is not worse for AN. AN patients often have a stronger focus on delayed gratification and long-term goals. It is steep for BED.
• No evidence for impaired response inhibition

Question 3

DSM AN

Answer 3

• Underweight
• Intense fear of gaining weight
• Disturbance in the way in which one’s body weight or shape is experienced

Question 4

DSM BN

Answer 4

• Binge eating episodes
• Inadequate compensatory behaviours
• Self-evaluation is influenced by body shape and weight

Question 5

DSM BED

Answer 5

• Recurrent episodes of binge eating
• At least 3 of: eating rapidly than normal, eating until very full, eating large amoutns of food when not feeling hungry, eating alone due to embarrassment, feeling disgusted, depressed or guilty after over eating
• Marked distress regarding binge eating
• No compensatory behaviours

Question 6

ARFID (avoidant / restrictive food intake disorder

Answer 6

• Weight loss
• Nutritional deficiency
• Tube feeding
• Interference with psychosocial functioning
• No body image disturbance / fear of weight gain
• Sensory based avoidance (taste or structure) / arousal or interest based avoidance (no interest in food or feel no hunger) / concern or fear based avoidance

Question 7

Prevalence

Answer 7

• AN least prevalent
• BED most prevalent specified eating disorder
• OSFED (other specified feeding and eating disorders) is most prevalent (50%)

Question 8

Controlling behaviours

Answer 8

• Body checking
• Excessive exercising
• Counting calories
• Rituals and rules

Question 9

First, positive consequences of ED

Answer 9

• Increased self-esteem
• Identity becomes related to eating behaviour
• Escape from negative emotions

Question 10

negative consequences ED

Answer 10

• Psychological: negative mood, stress, obsessive behaviours increasing, more rules, problems with concentration, emotional numbness, rigid thinking
• Social: social isolation, conflicts with parents, avoidance
• Physical: lanugo (donshaar), poor blood circulation, erythema abigne (huidvlekken), russell’s sign (consequence of vomiting), erosion teeth, swelling of jaw glands, low blood sugar, heart problems, lack of growth in children, osteoporosis (bone density), kidney problems

Question 11

Barriers to help seeking

Answer 11

• Lack of knowledge about illness / treatment
• Shame, fear, problems with disclosure
• 3 – 5 years on average between onset and help
• More than 50% with ED never receive treatment

Question 12

treatment An and BN

Answer 12

• outpatient CBT
• inpatient / day treatment
• multi family treatment in youth
• psychotropic medication only when resistance, avoid relapse or comorbid disorders

Question 13

treatment BED

Answer 13

• outpatient CBT
• antidepressants
• self help programs based on CBT

Question 14

Advantages e health

Answer 14

greater accessibility, lowers barriers, reduced stigma, cost-effective, more can be helped

Question 15

disadvantages e health

Answer 15

inconsistent clinical oversight and diagnostic challenges
no therapeutic relationship
no nonverbal information
no clinical intuition possible