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44 Cards in this Set
- Front
- Back
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AN
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Restriction of energy intake relative to requirements leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health – DSM 5 - Intense fears of becoming overweight - Distorted view of weight and shape |
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Restricting type |
Lose weight by cutting out sweets and fattening snacks, eventually eliminating nearly all food - Almost no variability in diet |
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Binge eating/purging type
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- Lose weight by self-inducing vomit after meals or by abusing laxatives or diuretics - Like those with bulimia nervosa, people with this subtype may engage in eating binges |
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Amenorrhea |
the absence of a menstrual cycle
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Medical consequences of AN:
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Dry skin Brittle hair and nails Low body temperature Irregular heart rate, low blood pressure, and weakened heart muscle Electrolyte imbalance Extreme tiredness Reduced bone density Lanugo- fine silky hair growth Relatively high mortality rate (2-6%) |
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BN:
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Binges Repeated bouts of uncontrolled overeating during a limited period of time Sense of lack of control over eating Inappropriate compensatory behaviors, including forced vomiting, misusing laxatives, diuretics, or enemas, fasting, or exercising excessively Base self-evaluation on weight/shape Symptoms occur ~1x/wk for 3 months *Most are generally within 10% of normal weight *Often guilt and secrecy |
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BN:
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tension/powerless--> binge-->relief-->shame-->compensatory behavior |
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compensatory behaviors
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Purging Vomiting, laxatives, or diuretics Nonpurging Exercise and/or fasting |
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medical consequences of BN: |
Effects of vomiting- Erosion of tooth enamel Dehydration Lower potassium Swollen parotid glands Effect of binge eating- Stomach rupture Gastrointestinal disturbances- Inflammation of esophagus Gastric and rectal irritation |
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Similarities between AN and BN:
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-Preoccupation with food, weight, appearance/Fear of becoming obese/Drive to become thin -Distorted body perception - Feelings of anxiety, depression, obsessiveness, perfectionism -Substance abuse (diet pills) -Risk for suicide attempts |
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Differences BN/AN |
Anorexia - Low body weight; almost all have amenorrhea Bulimia - More concerned about pleasing and being attractive to other people, more active, impulsive; mood swings (borderline personality), poor coping, damage from purging; normal-ish weight, teeth issues, intestinal disorders, kidney disease, heart failure. |
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onset of AN
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Onset 14-18 years 90%–95% females ~0.5% - 3.5% of females in Western countries Many more display at least some symptoms Rates increasing in North America, Europe, and Japan |
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onset of BN
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Onset 15-21 years 90%–95% females Up to ~5% in Western countries ~25-50% have symptoms Higher rates in college students |
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Comorbidities AN:
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Depression (~70%) Anxiety Low self-esteem Insomnia or other sleep disturbances Substance abuse Obsessive-compulsive patterns Perfectionism |
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Comorbidities BN:
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Anxiety (80.6%) Mood disorders (50- 70%) Substance abuse (36.8%) Personality disorder (~1/3) |
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Biological for eating disorders:
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Genetics MZ twin concordance especially high for anorexia (~70% MZ) Hypothalamus Lateral hypothalamus - produces hunger Ventromedial hypothalamus - reduces hunger Low levels of serotonin May cause bodies to crave and binge on carbs Weight set-point theory A predisposition to maintain a certain weight level, in part by the hypothalamus- May shut down inner thermostat in anorexia May spiral into binge-purge pattern in bulimia |
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Psychodynamic (eating disorder) |
Ego deficiencies, ineffective parenting - disturbed mother/daughter interations- effective vs ineffective parenting- cannot rely on internal signals- not being in control of their behavior, needs, impulses |
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Cognitive (ed) |
Distorted perceptions of bodies and internal sensations- little control over their lives, excessive control of size, shape weight, etc. - CBT THERAPY widely used |
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Behavioral (ed) |
-Positive reinforcement of weight loss (early stages) -Negative reinforcement of tension (binges) |
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Sociocultural (ed) |
Societal pressures to be thin (Western) Celebrities, media, websites Family environment Emphasis on thinness, appearance, and dieting- mother more likely to diet- families are dysfunctional- Enmeshed family patterns: overinvolved in each other's affairs and over concerned with details, “sick” role - teenagers push for independence makes the parents push a sick role onto the teen- develop an eating disorder or some other illness- enables appearance of harmony and togetherness. Racial/ethnic differences in standard of beauty In the U.S., the differences are disappearing (more into white culture- stats are the same) Gender Different standards for women- thinness, being attractive more aimed at women. Methods of weight loss - exercise (men) vs. dieting (women) Men - only 5-10% reverse anorexia; muscle dysmorphobia (shame about their bodies, experience depression) : still see themselves as scrawny and small although they have muscles, -excessive weightlifting, abuse of steroids- |
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treatment (ed) goals
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Two main goals 1. Correct dangerous eating patterns 2. Address broader psychological and situational factors that have led to, and are maintaining, the eating problem |
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treatment (anorexia)
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*Restore healthy weight* Therapy strategies identify and modify thought process that maintain restriction, and challenge beliefs about worth of shape and weight - Monitor feelings, hunger levels, and food intake to recognize patterns- - Recognize need for independence and learn appropriate ways to be in control - Recognize and understand internal sensations (I must always be perfect) - Change family interaction patterns- family therapy and meeting with the family as a whole- separate feelings and needs from other members of the family. |
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treatment (bulimia)
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-Eliminate binge-purge patterns - Establish healthier eating habits - Address underlying cause of bulimic patterns - Strategies similar to those for AN: -Monitoring, recognizing patterns - Challenge maladaptive thoughts -Exposure and response prevention to break bingepurge cycle (eating certain foods and then prevent them from vomiting) to show that they haven't gained weight. -antidepressants more helpful than AN No long-term efficacy - combined with CBT |
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psychosis
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The ability to perceive and respond to the environment is significantly disturbed- cant function with friends, at home, at work. -Deterioration in functioning -Symptoms may include hallucinations (false sensory perceptions) and/or delusions (false beliefs) can be due to brain injury, schizo (persists for 6 months or more), or substance abuse |
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DSM 5 Diagnosis of schizo
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For at least 1 month, two or more of the following symptoms for a significant portion of time: Delusions Hallucinations Disorganized speech Negative symptoms E.g., alogia, restricted affect, avolition, withdrawal Grossly abnormal psychomotor or catatonic behavior Declining functioning in school, work, interpersonal relations, or self-care Signs of disturbance for at least 6 months |
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Pos symptoms schizo
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bizarre additions or excess
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delusions
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Delusions of persecution (e.g., paranoia) (most common) - believe they are being plotted on, spied ,threatened, attacked, people are trying to harm you. Delusions of reference (e.g., special messages) - meant just for them. Delusions of control (e.g., thought insertion) - feelings, thoughts, actions being controlled by others Delusions of grandeur (grandiose) - great inventors, religious saviors, powerful people |
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Disorganized thinking and speech Thought disorder |
- Loose associations (derailment) - most common- rapidly shifting from one topic to another, thinking they make sense. (insects to favorite number, to liking to dance) - Neologisms- made up words that have meaning only to that person - Perseveration- repeat words again and again - Clang- rhyme to think or express themselves "so hot you know it runs on a cot" |
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Hallucinations (delusions occur together) |
Sensory experiences in the absence of sensory stimulation: Auditory- most common- ** sounds or voices coming from outside their heads- talk directly to them or give commands. Voices commenting, arguing, “committee in my head” Visual |
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inappropriate affect (schizo)
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incongruent with the situation (smile when told bad news) mood swings - start yelling after a tender convo with spouse
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Negative symptoms schizo
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characteristics lacking in an individual
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alogia (neg)
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reduction in speech or speech content- think and say very little- others say a lot but convey little meaning |
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restricted affect (neg)
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(blunt (less ager, sadness, joy, other feelings than most people ) /flat (nothing )) Exhibits little or no emotional expression in face or voice -flat: no emotions at all anhedonia- general lack of pleasure and enjoyment. when persons with schizo watch an emotional clip, they do not produce as much facial expression- but just as much pos and neg emotion. |
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avoliton (loss of volition)
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apathy- feeling drained of energy- no drive- common in people who have suffered for many years as if they are worn down from it - ambivalent about most things |
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social withdrawal
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attend only to their ideas and fantasies. distancing themselves further from reality. |
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psychomotor
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awkward movements or repeated grimaces and odd gestures- catatonia- extreme forms posturing - bizarre positions for long periods of time. rigidity- rigid, upright position for hours and resist efforts to be moved stupor- stop responding- motionless and mute in bed for days excitement- wild waving arms |
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3 phases of schizo
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prodromal, active, residual |
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Prodromal
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active
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symptoms become apparent- perhaps from a trauma in life. meets diagnosis |
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residual |
back to prodromal- symptoms lessen but restricted emotions remain. Subthreshold symptoms of schizophrenia |
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Onset and outcome |
Onset typically late teens to mid-30s - May be precipitated by stress Earlier onset in males (men: 23, women: 28) Prodrome onset ~ ages 15-25 Recovery in ~¼ of cases; predictors of recovery: Good pre-morbid functioning When disorder triggered by stress, started suddenly, or developed during middle age |
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Prevalence |
Schizophrenia affects approximately 1% of the U.S. population (no gender difference) HOWEVER, those with Schizophrenia account for: 2.5% of all U.S. health care expenditures 10% of the permanently disabled 25% of the people who are homeless More prevalent in low income groups Cause? (stress) Effects? downward drift theory - the disorder causes its victims to fall from a higher to a lower socioeconomic level or to remain poor because they are unable to function effectively. |
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Twin concordance |
MZ 48% DZ 17% |
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Genetic factors - schizo |
following principles of diathesis stress model- some inherit a BIOLOGICAL PREDISPOSITION for schizo and then develop the disorder when they face extreme stress usually during late adolescence or early adulthood. |
