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PSYC 316 Book Chapter 9 Notes

by: Sara Karikomi

PSYC 316 Book Chapter 9 Notes PSYC 316

Marketplace > Northern Illinois University > Psychlogy > PSYC 316 > PSYC 316 Book Chapter 9 Notes
Sara Karikomi
Simon Jencius

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Chapter 9 Notes with extra examples for further understanding.
Simon Jencius
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This 11 page Bundle was uploaded by Sara Karikomi on Friday October 23, 2015. The Bundle belongs to PSYC 316 at Northern Illinois University taught by Simon Jencius in Fall 2015. Since its upload, it has received 28 views. For similar materials see Intro-Psycpathology in Psychlogy at Northern Illinois University.


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Date Created: 10/23/15
Chapter 9 Eating Disorders Bulimia Nervosa individual will go on frequent eating binges consuming large quantities of food then force themselves to vomit or take other extreme measures to prevent weight gain Binge Eating Disorder individual will display frequent eating binges without forced vomiting 1 Anorexia Nervosa A Anorexia Nervosa individual is convinced they need to be extremely thin loses extreme amounts of weight in the pursuit of extreme thinness may starve themselves to death 1 RestrictingTvpe Anorexia Nervosa at least half of the people with anorexia nervosa restrict their food intake to lose weight After a while individuals with restrictingtype anorexia nervosa have almost no variability in diet BingeEating PurgingType Anorexia Nervosa individuals attempt to lose weight by vomiting after meals abusing laxatives or diuretics and even engage in eating binges Statistics a Approximately 9095 of all anorexia nervosa cases occur in women b The peak age of onset between 1418 years although it can develop at any age c Between 0535 of all women in Western countries develop this disorder at some point in their lives d Between 26 of individuals with the disorder become ill enough to the point of death usually from medical issues resulting from starvation or by suicide e Fortunately most victims recover m a Disorder appears to be on the rise in North America Europe and Japan b Typically sets in after a slightlyoverweight or normal weight individual has been on a diet c Disorder may develop after a stressful event separation of parents personal failure etc B The Clinical Picture 1 m provides motivation for the individual to be thin a Fear of becoming obese b Fear of giving in to the desire to eat c Fear of losing control over the size and shape of their body Preoccupation with Food a Lots of time is spent thinking and reading about food and planning limited meals b Many report that their dreams revolve around food c Preoccupation may be a result of food deprivation not its cause Starvation Studv 1940s a 36 normalweight individuals were put on a sixmonth semi starvation diet and became preoccupied with food just like individuals with anorexia nervosa Distorted Thinking a Individuals display low optimism for the shape of their body b Individuals consider themselves unattractive Laboratorv Tests a Participants looked at their own photograph through an adjustable lens and were asked to adjust the lens until the image matched their actual body size b One study showed that more than half of the participants with anorexia nervosa had overestimated their body sizes c Maladaptive Attitudes and Misperceptions Psvcholoqical Problems individuals with anorexia nervosa may display depression anxiety low selfesteem insomnia and other sleep disturbances a Many struggle with substance abuse and display obsessivecompulsive patterns many compulsively exercise and make it one of their highest priorities C Medical Problems starvation leads to other medical problems 1 2 Amenorrhea absence of menstrual cycles Affects on the Bodv a Internal 1 Lowered body temperature low blood pressure body swelling reduced bone mineral density and slowed heart rate 2 Metabolic and electrolyte imbalances may develop and lead to heart failure or circulatory collapse death b External 1 Poor Nutrition a skin becomes rough dry and cracked b nails become brittle c hands and feet get cold and turn blue d hair loss or the growth of lanugo ne silky hair that covers some newborns II Bulimia Nervosa A Bulimia Nervosa 1 Also known as BingePurge Syndrome disorder is marked by repeated and uncontrollable bingeing episodes a Compensatory Behaviors forcing themselves to vomit abuse laxatives diuretics or enemas fasting excessive exercise m 9095 of cases of this disorder typically occur in women Most cases the disorder typically begins between 1521 years of age Weight uctuates considerably within a normal range Some may become seriously underweight and may meet criteria for anorexia nervosa Studies a b C d Many teenagers and young adults experiment with bingeing vomiting or using laxatives after hearing about such things on the media 2550 of students report periodic binge eating or selfinduced vomiting Some surveys suggest that about 5 of women develop the full syndrome Rates among college students are expected to be higher B Binges Binge Episodes 1 a b C d Bulimia Nervosa sufferers may engage in 130 binge episodes in a week most are carried out secretly Usually eating sweet highcalorie soft foods rapid eating less chewing May consume up to 10000 calories in one episode Episodes typically precede stressful situations or those of great tension 1 Feelings of irritability unreal powerlessness and a desire to eat the foods they have forbidden themselves from eating C Compensatorv Behaviors After bingeing the individual attempts to compensate or undo the effects of the episode 1 3 Repeated Vomiting affects the individual s ability to feel satiated which leads to increased hunger and more frequent and extensive binge episodes b Abuse of Laxatives or Diuretics These compensatory behaviors can temporarily relieve the discomfort anxiety and selfdisgust that come from binge episodes a The individual eventually believes that purging allows more bingeing which then means they have to purge Cycle leads to feelings of powerlessness and disgust D Bulimia Nervosa Versus Anorexia Nervosa 1 Differences a Individuals with bulimia nervosa are more focused on their appearance to others and having intimate relationships 1 More sexually experienced and active 2 More likely to have a history of mood swings become easily frustrated or bored and have trouble coping effectively or controlling impulses and strong emotions 3 Over 13 of these individuals display characteristics of personality disorders borderline personality disorders 4 12 of women with bulimia nervosa are amenorrheic compared to almost all those with anorexia nervosa 5 Individuals with bulimia nervosa have dental problems from the hydrochloric acid from vomiting a Vomiting and continuous use of laxatives may lead to dangerous potassium de ciencies which may result in weakness intestinal disorders kidney disease or heart damage 111 Binge Eating Disorder individual engages in repeated binge episodes during which they feel they have no control over their eating absence of compensatory behavior A Statistics Result of their binge episodes 23 of individuals with binge eating disorder become overweight or 1 l obese 2 Between 27 of the population displays binge eating disorders B Similarities and Differences Similarities 3 b C d 6 Still includes preoccupation with food and sense of lack of control during binge episodes Improperly perceive their body size Extreme body dissatisfaction Experience depression anxiety perfectionism May have substance abuse issues Differences 3 Not as driven to be thin as individuals with anorexia nervosa and bulimia nervosa b Binge eating disorder does not always begin with extreme dieting C Not large gender differences in binge eating disorder prevalence IV What Causes Eating Disorders A Multidimensional Risk Perspective theory identi es risk factors that are thought to combine to contribute to the development of a disorder If more factors are present the risk for developing the disorder increases B Psychodynamic Factors Ego Deficiencies Hilde Bruch believed that disturbed motherchild interactions may lead to l a Ego Deficiencies including poor sense of independence and control and Perceptual Disturbances are believed to be caused by disturbed motherchild interactions b Effective Parenting parents attend to the biological and emotional needs of their children c Ineffective Parenting not attending to the child s needs parents decide when the children have needs and what the needs are without correctly interpreting the their actual conditions 1 Parents may feed the children at times of anxiety instead of when the child is hungry d Since they cannot rely on internal signals interpreting their own feelingsemotions the children turn to external guides their parents Sunnort for Bruch s Theorv a Parents of teens with anorexia or bulimia nervosa tend to de ne their children s needs instead of allowing the child to do so for themselves b Research has shown that when individuals with eating disorders were upset they mistakenly interpret that they are hungry and respond to their emotions as they would respond to their hunger l Alexithymic individual has great dif culties clearly identifying their feelings c Individuals with eating disorders are more likely than others to seek approval worry about how others view them to be conforming and to feel as if they have little to no control over their lives C Coenitive Factors 1 Bruch holds that due to ineffective parenting individuals who suffer from eating disorders tend to improperly label their internal sensations and needs feel little control over their lives therefore desiring excessive control over their body size and eating habits C02nitive Theorists a Individuals with anorexia and bulimia nervosa judge themselves based on their shape and weight and their ability to control them b Core Pathology is what sparks all of the other features of the disorder Studies have not determined that the de ciencies cause the eating disorder but many cognitive behavioral therapists work from this perspective and focus on correcting the patient s cognitive distortions and behaviors D Depression 1 Since many people with eating disorders show symptoms of depression some theorists believe that depressive disorders make people more prone to developing eating disorders a Those with eating disorders qualify for major depressive disorder diagnosis more so than the general population b Close relatives of an individual with an eating disorder show higher rates of depressive disorders than close relatives of individuals without such disorders c Many individuals with eating disorders have low serotonin activity d Individuals with eating disorders are often helped by the antidepressants that reduce depression E Biological Factors 1 Hypothalamus brain area that helps to regulate bodily functions such as eating and hunger a Two areas of the hypothalamus help control eating 2 Lateral Hypothalamus region of the brain that produces hunger a When the lateral hypothalamus is electrically stimulated in laboratory animals the animal eats even if it was fed recently 3 Ventromedial vaothalamus brain region that depresses hunger a When the ventromedial hypothalamus is electrically stimulated in laboratory animals they stop eating 4 Weight Set Point weight level that an individual is predisposed to maintain controlled partially by the hypothalamus a When an individual s weight falls below their set point brain areas including the lateral hypothalamus are activated and work to restore the lost weight by producing hunger and lowering the body s metabolic rate 1 Metabolic Rate the rate at which the posy expends energy b When an individual s weight rises above the set point brain areas including the ventromedial hypothalamus are activated and work to remove the gained weight by reducing hunger and increasing the body s metabolic rate 5 Weight Set Point Theorv debated in clinical eld but is still widely accepted by theorists and practitioners a When an individual diets and reaches a weight below their weight set point their brain activates brain areas hypothalamus and bodily changes to help restore the lost weight 1 The desire to eat rises and the individual becomes preoccupied with food and driven towards bingeing 2 This leads these individuals to RestrictingType Anorexia or toward a bingepurge or binge only pattern F Societal Pressures l Anorexia Nervosa and Bulimia Nervosa are most common in Western countries 2 Western Standards a Theorists believe that Western standards of beauty thinness are partially responsible for the development of these eating disorders b Models actors dancers and athletes are more likely to be concerned about their weight 1 These individuals are more prone than others to develop Anorexia Nervosa and Bulimia Nervosa 3 Statistics a Surveys of athletes at US colleges over 9 of female college athletes suffer from an eating disorder 1 Another 50 display eating behaviors that put them at risk for developing an eating disorder b 20 of surveyed gymnasts display signs of eating disorders 4 Economic Differences a Women in upper socioeconomic classes were more concerned about thinness and dieting than women of lower socioeconomic classes 1 Anorexia Nervosa and Bulimia Nervosa were more common among women in upper socioeconomic classes b Stigma 1 Western society highly values thinness and shames overweight individuals a Survey of 248 adolescent girls tied eating disorders and body dissatisfaction to social networking intemet activity and television b Respondents who spend more time on Facebook were more likely to display eating disorders have a negative body image eat in dysfunctional ways and are driven to dieting G Family Environment 1 Research a As many as half of the families of individuals with anoreXia or bulimia nervosa have histories of emphasizing thinness physical appearance and dieting 2 Enmeshed Familv Patterns family members are over involved with each other s activities and are overconcemed regarding each other s welfare a Salvador Minuchin believes that this family system can lead to eating disorders 1 Minuchin believes that adolescence desire independence and therefore threatens the family s pattern of closeness The family may subtly push the individual to develop an eating disorder or some other illness that allows the family to maintain its appearance of harmony H Multicultural Factors Racial and Ethnic Differences 1 Most studies show that eating behaviors values and goals of young African American women were significantly healthier than those of young white American women a 1995 study found that eating behaviors and attitudes of young African American women were more positive than those of young white American women 1 Nearly 90 of white American participants showed dissatisfaction for their weight and body shape compared to around 70 of African American teens b White American and African American adolescent girls have different standards of beauty 2 Body image concerns dysfunctional eating patterns and anoreXia and bulimia nervosa are rising in minority groups a Survev Results 1 65 of African American respondents reported dieting behavior 2 39 said that their lives were controlled by food 3 19 avoided eating when they were hungry 4 17 abused laxatives 5 4 vomited to lose weight 3 Other studies suggest that Hispanic American female adolescents and young adults engage in disordered eating behaviors and display body dissatisfaction rates at equal rates of white American Women I Multicultural Factors Gender Differences 1 2 Men account for only 510 of all anorexia and bulimia nervosa cases Double Standard a Thinness is aimed primarily at women This is believed to make women more inclined to dieting and more likely to develop eating disorders Weight Loss Methods a Men are more likely to exercise b Women are more likely to diet Men and Eating Disorders a Eating disorders have been linked to requirements or pressures of a job sport 1 37 of males with eating disorders had jobs or played sports that prioritized weight control compared to 13 of women with eating disorders b When men develop eating disorders body image is still a key factor c Reverse Anorexia Nervosa or Muscle Dvsmornhobia 1 muscular men still see themselves as scrawny and continue to strive for perfection by using extreme leasers a Excessive weight lifting b Steroid abuse V How Are Eating Disorders Treated A Treatments for Anorexia Nervosa main goal is for the individual to gain the lost weight recover from malnourishment and eat normally again 1 How Are Proper Weight and Normal Eating Restored a Tube and Intravenous Feeding method used on patients who refuse to eat 1 Approach of forcefeeding causes distrust b Behavioral WeightRestoration clinicians reward patient for eating properly or gaining weight no reward when patient does not eat properly or fail to gain weight c Combination Approaches supportive nursing care nutritional counseling highcalorie diet 1 Nurses educate patients track their progress provide encouragement and help the patient recognize that their weight gain is under control and will not result in obesity a Patients in nursingcare programs typically gain the necessary weight between 812 weeks How Are Lasting Changes Achieved in order to achieve lasting improvement the patient has to overcome their underlying psychological problems a CognitiveBehavioral Therapy clients are encouraged to appreciate and change behaviors and thought processes that maintain their restrictive eating 1 Behavioral clients monitor feelings hunger levels and food intake and how the variables relate to each other a Taught alternative ways to cope with stress and to solve problems 2 CognitiveBehavioral clients are lead to change attitudes about their eating habits and their weight a identify challenge and change maladaptive assumptions b For best results cognitivebehavioral techniques should be combined with other approaches b Changing Family Interactions dysfunctional family patterns are identi ed to help the family make changes 1 Individual with anorexia nervosa is encouraged to separate their feelings and needs from those of the rest of the family 3 What is the Aftermath of Anorexia Nervosa a Combined treatments have been helpful but recovery may be challenging 1 Positive a Weight is restored when treatment begins b improvements may continue for years c Up to 90 of patients show full or partial improvement for years d Most females with anorexia nervosa recover from amenorrhea when they regain their weight 2 Negative a Up to 25 of individuals with anorexia remain ill for a long time b When an individual recovers it is not always permanent c Anorexic behaviors return in at least 13 of recovered patients i triggered by stress marriage pregnancy major relocation d 12 of those who have suffered from anorexia still experience emotional problems after treatment depression obsessiveness social anxiety B Treatments for Bulimia Nervosa 1 CoqnitiveBehavioral Theranv many techniques are the same as treating anorexia nervosa but the techniques are modi ed to the speci c elements of bulimia and the associated thoughts a Behavioral Techniques 1 Clients may be requested to keep a diary of their eating behavior changes in feeling hunger fullness and their other emotions a Aids in helping the patient recognize their dieting patterns and the emotions and situations that create the desire to binge 2 Stu dies a Clients showed a signi cant decrease in binges purges other bulimia symptoms and feelings of depression after i being in an outpatient in a 12week cognitivebehavioral therapy 1 sending nightly texts reporting bingeing and purging drives and episodes to their therapists 2 receiving feedback with reinforcement and encouragement for their achieved goals b CognitiveBehavioral Techniques 1 Exposure and Response Prevention used to break the bingepurge cycle 2 Treating Bulimia Nervosa a Clients are required to eat certain types and amounts of food and then are prevented from purging to show them that eating can be harmless and does not need to be undone b Therapist will typically stay with the patient until the urge to purge passes c This treatment has been found to help reduce eatingrelated anxieties bingeing and purging c Cognitive Techniques 1 Therapists focus on helping bulimia nervosa patients recognize and change their maladaptive attitudes toward food eating their weight and shape a Recognize question and change their standards of perfection helplessness and poor selfconcept 2 Results a Around 65 of patients treated with cognitivebehavioral approaches have stopped bingeing and purging 2 Other Forms of Psvchotheranv a Interpersonal Psychotherapy approach is tried when the patient fails to respond to the cognitive behavioral therapy b Psychodynamic Therapy few studies have tested and supported its effectiveness c Many other forms of therapy are combined with family therapy 3 Antidepressant Medications a People with bulimia nervosa bene t considerably from antidepressant drugs while the same cannot be said about those with anoreXia nervosa l Antidepressants have helped up to 40 of patients Of this 40 a 67 show reduction in bingeing b 56 show reduction in purging 4 What is the Aftermath of Bulimia Nervosa a Without any treatment bulimia nervosa can last for years 1 For about 40 of clients treatment helps them to improve significantly and immediately 2 20 show less immediate improvement 3 After treatment followup studies show that as many as 75 of bulimia nervosa patients have recovered either slightly or completely b Relapse 1 triggered by life stressors 2 around 13 of recovered patients relapsed Within 2 years of treatment a more likely among those With a longer history of bulimia nevosa C Treatments for Binge Eating Disorders 1 Similar treatments to those for bulimia nervosa a Cognitivebehavioral therapy psychotherapy and sometimes antidepressants 2 Since binge eating disorder has been identi ed and being studied new information and treatment methods Will be developed


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