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Flashcards in PSY280 - Exam 3 Deck (20):
1

Anorexia Nervosa

A. Restriction of energy intake, significantly low body weight - children who have sudden change in growth trajectory.
B. Intense fear of gaining weight or becoming fat even though significantly low weight.
C. Disturbance in way sees body weight/shape.
Specify:
-Restricting type: no binge eating/purging
-Binge-Eating/Purging type: recurrent binge eating or purging
-In partial remission (B or C still present)
-In full remission
Crude mortality rate = 5% per decade
Suicide = 12 per 100,000 per year

2

Bulimia Nervosa

A. Recurrent binge episodes (includes dissociation)
B. Compensatory behavior to prevent weight gain.
C. At least once a week for 3+ months
D. Self-esteem based on body weight/shape.
E. Behaviors not restricted to episodes
Check for Anorexia diagnosis if low weight.
Crude mortality rate = 2% per decade (often suicide).

3

Anorexia and Bulimia

BN almost 3x as likely.
Two peaks at 14/18
AN earlier, BN later
Adolescence through 25, not usually after 40.
Chronic w/out treatment.
30% of bulimics still presented 10 years after began
22% of anorexics after 5-6 years.

4

Binge-eating Disorder

A: Recurrent binge episodes
B: 3+: large ants food when not hungry, physically uncomfortable, eating alone, depressed/guilty/disgusted after.
C: Distress
D. At least once a week for 3+ months.
E. No recurrent compensatory behavior, not exclusively during bulimia or anorexia.
--1-3x, 4-7x, 8-13x, 14+ times a week for severity.
Triggers: stressors, dietary restraint, negative feelings about weight/shape/food, boredom.
Greater functional impairment, lower quality of life, more subjective distress, and psychiatric comorbidity.
Women 2x as likely as men, found across all ethnic/racial groups. Higher relapse than BN/AN.
Cognitive-behavioral Therapy, antidepressants and some stimulants (ADHD meds).
Comorbid w/ depression/anxiety.

5

Cultural Factors

Almost 2/3 of playboy centerfolds/Miss America contestants meet the weight criterion for anorexia.
Attractiveness: bilateral symmetry, muscular development in men, appropriate waist to hip ratio in women universally always attractive.
Women rate body shape as heavier than ideal and what they think is attractive.
Men rate body shape close to both ideal and what they think is attractive.

6

Obesity

National epidemis: 61% Americans overweight, 26% obese, 1/3 children are overweight, 90% of dieters fail to keep pounds off.
BMI = body weight (kilograms) / height squared (meters) - not a good indicator of health.
Causes: caloric intake exceeds energy output, genetic/metabolic/lifestyle/psychological factors, fat cells.
Ethnic and Socioeconomic Differences: obesity more prevalent among poor people of color (esp women), immigrants of 2nd/3rd generation eat poorly, distance to grocery story, price of fruits/veggies, chronic stress elevates certain hormones too much for too long, metabolisms vary.
Solutions: increased access to health education/treatment/healthful foods/recreational opportunities, decrease in stigma/shame.

7

Sleep-wake Disorders

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8

Dyssomia

Disturbances in amount, quality or timing of sleep.

9

Insomnia

A. Dissatisfaction with sleep quantity or quality w/ 1+: difficulty initiating sleep, remaining asleep, waking up early.
B. Occurs 3+ nights/week for 3+ months.
C. Occurs despite adequate opportunity for sleep.
D. Not explained by another sleep-wake disorder/psych/medical condition or effects of a substance.
Specify: w/ non-sleep disorder mental comorbidity, other medical comorbidity, other sleep disorder.
1/3 adults experience chronic/persistent insomnia any year - most common sleep disturbance, 10-15% have daytime disturbance.
More common among women.
40-50% have comorbid psych disorder, often depression/anxiety which are worsened by insomnia.
Lasts a few days - a few weeks often associated with changes in sleep schedules. May remit or eventually qualify for Insomnia Disorder.

10

Hypersomnolence Disorder

A. Excessive sleepiness despite sleeping 7+ hours w/ 1+: multiple sleep periods/day, prolonged sleep (9+ hours) that is not restorative.
B. Occurs 3+ nights/week for 3+ months.
C. Not explained by another sleep disorder psych/medical condition or effects of a substance.
Become progressively more sleepy rather than a sudden sleep attack. 5-10% of those in sleep disorders clinics: equal across gender.

11

Narcolepsy

A. Sleep attacks (irrepressible need to sleep/falling asleep/napping without warning). 3+x/week, 3+ months.
B. 1+ of following: cataplexy (sudden loss of muscular control while conscious after laughing/joking, or w/in first 6 months experience grimaces or weird tongue thrusting), intrusions of REM sleep lasting <15 minutes, hypocretin deficiency.
Slightly more men, super rare, 20-60% will experience hypnogogic hallucinations.

12

Breathing-related Sleep Disorders

Repeated disruptions of sleep due to respiratory related problems - result in insomnia or excessive daytime sleepiness.

13

Obstructive Sleep Apnea

A. One or both: 5+ obstructive apneas or hypopneas per hour of sleep w/one or both (with nocturnal breathing disturbances and/or daytime sleepiness/fatigue/unrefreshing sleep.
B. Evidence of 15+ obstructive apneas or hypopneas per hour of sleep w/o other symptoms. Severity based on # of events per hour, oxygen desaturation (10% of sleep at <90%O), greater arousal, reduced deep sleep.
1-2% of children, 2-15% middle-aged, 20%+ older adults.
Men 2-4x more likely until older because menopausal women begin to have it more.
Strongly associated with obesity, can be life-threatening.
People with large neck at much higher risk.
Very loud snoring @ high risk.
Every episode is waking up a little - poor sleep quality.
Cause/worsen obesity.

14

Central Sleep Apnea

Brain fails to send message to body to breathe. May not be snoring.
A. 5+ obstructive apneas or hypopneas per hour of sleep.
B. Not explained by another sleep disorder.
Occurs among 30% of those taking opiates for chronic pain.

15

Circadian Rhythm Sleep-Wake Disorders

A. Recurrent sleep disruption from alterations in the circadian system or the sleep-wake schedule (result of environment/social/professional schedule).
B. Sleep disruption - excessive sleepiness or insomnia or both.
5 Subtypes: Delayed Sleep Phase, Advanced sleep pass, Irregular sleep-wake, non-24 hour sleep-wake (abnormal s;inch between 24-hour light-dark cycle and internal circadian rhythm), and shift work types.

16

Parasomnias

Abnormal behavior, experiential/physiological events taking place during sleep, specific sleep stages, or sleep-wake transitions.
-Non-rapid eye movement sleep arousal disorder (sleepwalking, sleep terrors)
-Nightmare disorder
-Rapid eye movement sleep behavior disorder
-Restless legs syndrome.

17

Non-rapid Eye Movement Sleep Arousal Disorders

A. Recurrent episodes of partial awakening, usually during 1st third of night, w/ sleep walking to sleep terrors.
B. No memory of dream.
C. Amnesia for episodes.
D. Episodes cause distress/impairment.
Specify: Sleepwalking Type with sleep-related eating, or with sleep-related sexual behavior (sexomnia). Sleep Terror Type.

18

Sleepwalking Type

Sleeper arises from bed and walks around while remaining fully asleep - several minutes to a half-hour.
Specify: with sleep-related eating or sleep-related sexual behavior.
More common in children than adults - 1-5% children, 1-7% adults. 10-30% report at least one episode in lifetime.
Associated with Personality/mood/anxiety disorders in adults. Not associated with MI in children.

19

Sleep Terror Type

Terror resulting in abrupt awakening that usually begins with a panicky scream. Fear and autonomic arousal (tachycardia, rapid breathing, sweating) during episode. Unresponsive to comfort. Confused/disoriented.
More common in children than adults, but true prevalence unknown. 1-6% children, <1% adults.

20

Nightmare Disorder

Extended, frightening and well-remembered dreams (nightmares)
Awaken sleeper, disrupt sleep, person awakes fully oriented/alert.
Based on threat of imminent danger in 2nd half of night's sleep when REM is more intense. Increased during stress or trauma. 1-4% children. Men twice as likely as women.