Eating Disorders PSYC 40111-002
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This 5 page Class Notes was uploaded by Amy Turk on Saturday April 16, 2016. The Class Notes belongs to PSYC 40111-002 at Kent State University taught by Dr. Fresco in Spring 2016. Since its upload, it has received 15 views. For similar materials see Abnormal Psychology in Psychlogy at Kent State University.
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Date Created: 04/16/16
EATING DISORDERS ● Three major types ○ Anorexia ○ Bulimia ○ Binge eating ● Severe disruptions in eating behavior ● Extreme fear and apprehension about gaining weight ● Other subtypes ○ Rumination disorder ○ Pica ○ Feeding disorder Anorexia Nervosa ● Refusal to maintain body weight at or above a minimally normal weight for age and height ● Intense fear of gaining weight and becoming fat, even though underweight ● Self-evaluation unduly influenced by body shape and weight ● Amenorrhea = absence of at least three consecutive menstrual cycles ● Subtypes ○ Restricting type ○ Binge eating purging type Bulimia Nervosa ● A sense of loss of control over eating during the episode ● Recurrent inappropriate behavior in order to prevent weight gain ○ Vomiting, laxatives ● Average two times a week for 3 months ● Self evaluation influenced by body shape and weight ● Disturbance does not occur during an episode of anorexia ● Subtypes ○ Purging ■ Vomiting ■ Laxatives ○ Non-purging ■ Fasting ■ Excessive exercise Rates of Eating Disorders ● Anorexia nervosa ○ Steady over time <1% ● Bulimia ○ Rising, currently 2% ○ Perhaps due to better recognition ○ Perhaps due to the contagion effect ● 90% of cases are female ● College women at highest risk ● Age of onset = 13 (Anorexia) ○ Bulimia = 16-19 ● Recovery rates ○ Better prognosis for BN with treatment ○ 10-20% suffer chronically with AN ● Co-occurring impulsive behaviors ● BN feels like a “failed” AN Anorexia Medical Complications ● Cardiovascular ● Metabolic ● Fluid & electrolyte ● Hematological ● Dental ● Endocrine ● Gastrointestinal Bulimia Medical Complications ● Renal ● Gastrointestinal ● Electrolyte ● Dental ● Laxative abuse Risk Factors for AN & BN ● Pre-morbid characteristics ○ Childhood obesity ■ Bulimia ○ Personality traits ○ Depression ○ Parental history ● Pre-morbid experiences ○ Criticism of weight and shape by parents ○ Teasing by peers ○ Participation in appearance focused activities ■ Ballet ■ Ice skating ■ Cheerleading ■ Acting Precipitating Events ● Major life changes ● Family problems ● Failure at school/work ● social/romantic problems ● Traumatic event Binge Eating Disorder ● Experimental diagnostic category in DSM-4 ● Brought in as disorder in DSM-5 ● Recurrent binges ○ Twice a week for 6 months ○ Lack of control during the binge episode ● Binge eating disorder does not involve weight loss or purging ● Rates ○ 1-2% ○ 15% Jenny Craig ○ 30% university weight loss clinics ○ 70% overeaters anonymous ○ 60% are female ○ Age of average client = 40 ● Share similar concerns as anorexics and bulimics regarding shape and weight ● Biological risk factors ○ Childhood obesity ○ Parental affective illness ○ Obesity and psychological distress Etiology of Eating Disorders ● Biological accounts ○ Genetics ○ Endogenous opioids play a role in bulimia ○ Serotonin may be deficient in bulimia ■ Bulimics have less serotonin metabolites ■ Bulimics are less responsive to serotonin agonists ■ Serotonergic drugs are often effective for bulimia ○ Dysregulation of hypothalamic Cultural Pressures on Eating Behavior ● The value of thinness in our society ● The myth of the infinitely malleable body ● The “ideal” is not real ● Ethnic differences Diet-Binge-Purge Cycle ● Rigid dieting ● Slip ● Abstinence violation effect ● Binge eating ● Guilt, remorse ● Purging ● (cycle starts over) Restraint Model 1. Emphasis on weight/shape in social network 2. Internalized social expectations about thinness and beauty 3. Body concern 4. Extreme dietary restraint 5. Binge eating Interpersonal Vulnerability Model 1. Disturbance in early child-caretaker relationship 2. Insecure attachment 3. Disturbance in self (social self, low self-esteem) 4. Affective dysregulation 5. Binge eating What To Make of Models ● They probably interact ● Biological, psychological, and environmental contributors Levels of Treatment ● Most intensive to least intensive ● Inpatient hospital programs ● Day treatment hospital programs ● Outpatient individual and group psychotherapy ● Family therapy ● Medication ● Nutritional counseling ● Self-help books and groups Medical Treatment ● Antidepressants can help reduce binging and purging behavior ● Antidepressants are not good in the long run ● Are none successful for anorexia Psychological Therapy ● First goal ○ Weight restoration (For AN) ○ Regulate eating patterns (for BN) ● Then change thought processes ● Treatment involves education, behavioral, and cognitive interventions Cognitive Behavioral Therapy ● Self monitoring ● Weekly weighing ● Prescribe regular meal pattern ● Examine eating style ● Prescribe exercise ● Pleasurable alternative activities ● Forbidden foods ● Weight and shape concerns ● Cognitive distortions ○ Identify problem thought ○ List objective evidence to support and dispute ○ Develop a reasoned conclusion ● Problem solving ○ Determine a course of action Interpersonal Theory ● Binge eating is used to “numb out” negative feelings from interpersonal difficulties ● Current interpersonal problems ● Experience and express positive and negative feelings directly ● Practice new ways of relating ● Time limited and focused Prevention of Eating Disorders ● College and university-based programs ● Community-based programs ● Government-based programs Where Are We Now? ● DSM criteria ● More effective treatments needed ● Designing prevention programs ● Muscle dysmorphia ● Obesity and its prevention
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