Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Unit 10 > Week 1: eating disorder psychology > Flashcards

Week 1: eating disorder psychology Flashcards

1
Q

What are the key eating disorder recongised on the ICD11?

A

Anorexia Nervosa
Bulimia NErvosa
Binge eating disorder
Pica
ARFID
OSFED

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How might OSFED by further subdivided?

A

Atypical anorexia nervosa - BMI >18.5
Bulima/Binge Eating disorder of low frequency/duration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Whata re the ICD diagnositic criteria for anorexia nervosa?

A

BMI 18.5 or less
Persistent patterns of behaviour to prevent normal resotarion of weight
Body image distortion
Low body weight/shape is important to persons self evaluation
Intense fear of gaining weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the ICD-11 subtypes of anorexia nervosa?

A

Significantly low body weight - BMI 14-18.5
Dangerously low body weight - BMI below 14
Restricting pattern - exercise or restricted diet
Binge-purge pattern - binge and/or purging alongside restriction
Anorexia Nervosa - in recovery with normal body weight n normally given when behaviours have stopped for >1yr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the ICD diagnostic criteria for Bulima Nervosa?

A

Not significantly underweight
Preoccupation with weight/shape influences self evaluation
Episodes of binge eating with recurrent compensatory behaviour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the diagnositic criteria for a binge episode?

A

Discrete period of time
Subjective loss of control
More than usual - typically over 1000s calories

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the ICD diagnositic criteria for Binge Eating Disorder?

A

Frequenct bindges
Feel distressed and other negative emotions (guilt/disgust)
Not associated with compensatory behaviour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the ICD diagnostic criteria for ARFID?

A

Abnormal eating/feeding resulting in insufficent variety of quantity of food
May have significant weight loss or failure to grow
Impaired health and functioning as a result
Not due to concerns around body shape or weight
Isnt caused by underlying health condition, effects of meds or lack of food availability.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the ICD-10 main subtypes of ARFID?

A

Specific phobia - e.g choking, allergy
‘Picky eating’ - taste, texture, colour, brand
Lack of appetite/interest or somatic anxiety symptoms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the key features of anorexia nervosa specif in children?

A

Do not use BMI rather is BMI for age is under the fifth percentile
Prepubertal onset can lead to delayed pubertal events or arrested puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the key characertistics of anorexia nervosa in men specifically?

A

Loss of sexual interest or potency
Differences in idealised body shape - muscular or lean desire, starvation changes focus to law weight.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is bigorexia?

A

Believes they are small and skinny
Whilst in reality they are normally or greater than normal muscular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is drunkorexia?

A

When a person restricits intake in order to save calories for alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is orthorexia?

A

Obsessed with a healthy or clean diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Type 1 diabetes eating disorder?

A

Omitting insulin - aka diabulimia - in order to loose weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How common are eating disorders in HIC?

A

15% of young women
5.5% of young men
Will suffer from an eating disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are some figures around the prevalence and life span of anorexia nervosa?

A

One of the most common chronic illnesses in adolscence - at least as high as T1DM
Peak diagnosis is between 15-25
Average illness duration is around 6 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What physical illnesses are often considered as differential diagnosis alongside eating disorders?

A

Gastrointestinal condition
Endocrine conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What mental disorders are often considered as differential diagnosis for eating disorders?

A

Depressive disorder
Anxiety disorder
Driven by personaltity disorder - use changing/controlling food behaviour to diminish symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What co-morbid mental health conditions are people with anorexia nervosa also often diagnosed with?

A

Depression
Anxiety
OCD
Personality disorders - avoidant or anankastic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What co-morbid mental health conditions are commin in Bulimia?

A

Depression
Substance missuse
Self harm/suicide attempts
Emotionally unstable personality disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What was the Minnesota Starvation study?

A

In 1944 to 1945 - 36 men monitored on their normal diet then slowly starved - monitored physical and psychological changes - restored the weight monitored how easy that was and any remaining physical or psychological changes remained.

23
Q

What were the key findings of the Minnesota Starvation Study?

A

Large changes in personality and behaviour changes
Adapted unusual eating habits (over use of condiments), obsession over food
Low mood - isolated themselves
Episodes of psychosis - self harmed.
In recovery - reported struggling to understand hunger signals, take up to 2 years to return to normality.
Physical - decreased energy, heart rate, temperature and strength

24
Q

What are some of the biological risks of eating disorders?

A

AN: large gentic link 11.3x more likley if close relative has
BN: 5x more likely if a close relative
Gender 10:1 in F:M
Early puberty - early body changes in comparison to friends can increase dysmorphia
Type 1 diabetes - food focused treatment

25
Q

What are some of the suspected genes involved in Anorexia Nervosa?

A

Mutations in metabolism particulary regulating blood sugar levels and body fat
May allow patients to starve their body for longer.
May also be gentic effects on brain structure -personality etc.
Includes ESRRA, gherline, leptin and other appetite regulating genes

26
Q

What are some social risks for eating disorders?

A

Dieting industry
Profession - model, dance, competitive sport
Upbringing
Acculturation - change of body standards between different cultures
Social media - particularly instagram

27
Q

What are the risks of eating disorders for the patient and surrounding society?

A

AN highest mortality rate of any major psychiatric disorder
Burden of care on families is equal to that of depression or schrizopenia
Economic/social estimates suggest comparable burden as for anxiety or depression

28
Q

What are some of the risks of starvation?

A

Cardiac arrythmias
Postural hypotension
Hypothermia
Bone marrow suppression
Electrolyte imbalance
osteoporosis
Muscle wasting
Impaired fertility
Imparied cognitive function
Liver pathology
Kidney failure

29
Q

What are some of the negative effects of vomiting?

A

Enamel erosion
Swollen parotid gland -increased amylase/bicarbonate productino
gastric and Oesophageal trauma - Mallory Weiss tear
Electrolye imbalance - low K+ Na+ Cl-

30
Q

What are some of the complications of using laxatives as a compensatory behaviour in an eating disorder?

A

Loss of water and electrolytes
Rectal bleedings
Abdominal Cramps
rebound constipation (when stop taking laxatives - hence suggest gradual reduction rather than stopping)

31
Q

What are some of the complications of using exercise as a compensatory behaviour in an eating disorder?

A

Physical exhaustion
Muscle damage
Elevated creatine kinase
Cardiac/ECG abnormalities - bradycardia, heart block.
Rhabdomyolysis - release of protein from damaged muscle causes kidney damage

32
Q

What is falsifying weight and how might eating disorder patients do this?

A

Trying to weigh more on the scales that they actually are
Drinking lots of water before weighing
Hiding weights in hair/shoes

33
Q

What is the basic theory of refeeding syndrome?

A

Starved individual - low glucose, low insulin levels, low mineral and electrolytes
Refeed - spike in glucose levels, high insulin spike, glucose absorbed into cells - also absorb vitamins and minerals as part of the process
Particularly phosphate, magnesium, potassium, sodium and thimaine
Leads to dangerously and rapidly low plasma levels of these.

34
Q

What are some of the potential complications of re-feeding syndrome?

A

Wernicks/ korsakoff - brain and memory disorders
Odema and cardiac failure from Na+

35
Q

What in particular is at risk of re-feeding syndrome?

A

Very low BMI
Very little or no nutrition for the last 5 days
Co-morbid alcohol dependence
Co-morbid physical health condition such as cancer
Parental feeding > NG feeding > Oral feeding

36
Q

What risks (potentially dangerous situations) need to be considered/ screened for in eating disorder patients?

A

Risk to self - self harm or suicide
Safe to drive - typically no if BMI is under 16 - affect concentration
Able to work - no if BMI <16
Child care - concentration and judgement
Activities - horse riding
Universities guidance of if sit to attend (often no as concentration impaired and difficult to monitor exercise and intake)

37
Q

What assessments are always carried out to identify risk of complications in an eating disorder patient?

A

Weight, height - BMI and rate of weight loss
BP (postural), Pulse and temp
ECG
Sit up/sqaut test
FBC, U&E, Glucose, Bone marrow function and Mg levels

38
Q

What is the sit up squat test?

A
  1. sit up - patient lies down flat on the floor and sits up if possible without using their hands
  2. Squat-stand - rise without using hands

Scored sepeartly.
0 - unable
1 - able using hands
2- able with difficulty
3- able with no difficulty

39
Q

What are some red flags for a high risk to life in ED patients?

A

These risks indicate hospitalisation is needed
- lost more than 1kg per week for more than 2 weeks
- BMI below 13
- HR below 40
- standing BP below 90mmHg with postural drop
- abnormal biochemistry and bloods

Others include: severe dehydration, significant ECG abnormalities, reduced strength, postural drop above 20mmhg, exercising for more than 2 hours a day, moderate to high suidicde risk

40
Q

What are some amber flags for risk to life in an ED patient?

A

Loosing over 0.5kg per week for 2 weeks +
BMI between 13-14.9
HR between 40-50
Standing BP below 90mmHg with occasional postural drop
Moderate dehydration

41
Q

What signs should be looked for during a physical examination for an ED?

A

General appearance
Body temperature/ paleness
parotid glad swelling
Russel sign
Lanugo
Erythma ab igne
Sub-conjuctival haemorrohage

42
Q

Why is it important to intervene early in an eating disorder?

A

Brain changes are more malleable in the early stage - after recovery
Greater percentage of patient recover is recognised and treated within the first 2-3yrs
In later stages habits are more compulsive and entrenched

43
Q

What is the main goal of nutritional management of eating disorders?

A

Ran by dietitians and occupational therapists
regular eating and snacks
aiming for 0.5-1kg restoration per week
May take food shopping, or cooking food
Encourage eating in different social situations
Psychoeducation

44
Q

How can beig vegan/vegetarian complicate eating disorde recovery?

A

Difficult to distinguish is decision is part of eating disorder in order to decrease calorific intake
Can make it harder to gain weight as limited Vegan nutritional substitutes
May need to feed substances against their beliefs.

45
Q

What is the set point concept in Eating disorder treatment?

A

Everyone has an indivdual set point - range of weight that out body will try to maintain in order to have optimal biological functioning.
Body metabolism and function can adapt to variations in intake in order to maintain a body weight
Explains why different people have a different healthy weight

46
Q

What is part of the medical management of eating disorders?

A

Monitor physical parameters - BMI, bloods, vital signs
Monitor for signs of refeeding syndrome - important to start gradual but should not underfeed
No medication for anorexia itself but patient may be given
Olanzapine (anti-psychotic to reduce emotional turmoil) in low dose as an off-licenes

47
Q

How can bone density be managed in an eating disorder recovery?

A

DEXA scan - identify bone density
May have oteopenia or osteoporosis
May be given a calcium supplement or alendronic acid
The only way to restore bone density is to restore weight

48
Q

WHat are the different possible treatment setting for eating disorders?

A

GP monitoring/community centre/ day service
Medical ward (if high risk of physical abnormalities or refeeding syndrome)
Specialist Eating Disorder Unit

49
Q

What medical treatments might a person with an eating disorder be given?

A

Nasogastric feeding
Bed rest v chair rest
Frequency of monitoring bloods/investigation/obs

50
Q

What psychological treatment may be offered to those with anorexia nervosa?

A

CBT
MANTRA
Specialist Supportive Clinical Management
Eating disorder focused FPT

51
Q

How does risk and readiness to change alter the treatment plan in eating disorder patients?

A

Low risk wanting change - standard treatment
Low risk not ready to change - motivation work and discharge
High risk and wanting change - intensive treatment
High risk and not wanting change - consider the use of the mental health act.

52
Q

How does the mental health act apply to eating disorders?

A

Disorder thought to impair judgement and capcity therefore can be put under the mental health act
Main reason: risk of self neglect
Medical treatment given without consent if it treats a symptoms or manifestation this includes NG tubes and Blood tests
Patient may be out on a medical ward or a psychiatric ward.

53
Q

What makes treating a patient with an eating disorder difficult?

A

Behaviour can appear as aggressive or naughty - remember this is a manifestation of the disease and may not appear in other aspects of personality
Patients are often coherent and articulate
Patients know a lot about the disease - method to score higher on tests - eating well before a meal or falsifying weight or trying to appear as wanting to make change to avoid sanction
Confusion of capacity - severely ill often lack capacity, can fluctuate and can be hard to assess as appear high capacity in areas unrelated to food.

54
Q

What is the progression from abnormal to normal in an ED patient ECG?

A

Normal
Hypokalaemia onset
Low T wave
Low T wave with a high U wave
Low T wave, high U wave and low S_T segment

Unit 10 (37 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions