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45 Cards in this Set
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Differentiate between the diagnostic criteria for Anorexia Nervosa and Bulimia; two types of bulimia
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anorexia is the restriction of food intake relative to requirements, and a fear or aversion of food. Bulimia is recurrent episodes of binge eating followed by compensatory behaviour to prevent weight gain. For both, self evaluation is unduly influenced by body shape. two types: restriction type and bung-purge.The main difference between bulimia and anorexia is weight!
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Discuss mortality and comorbidity with eating disorders
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- anorexia is the DSM5 disorder with the HIGHEST mortality rate
- people often die from suicide or from the trauma of in and out hospital visits accompanied by gain and huge loss when they get out - Comorbidity- high correlation with sub abuse disorders with bulimia - think about reward systems in brain! |
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Contributors to prevalence in eating disorders (3)
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- we don’t see any strong genetic, chemical or molecular correlated in eating disorders, and prevalence rates aren’t uniform in world- so its not biological but cultural, cognitive and behavioural processes
- self-esteem plays a main role- self esteem is the value placed on the persons self concept- what cognitive associations to you have with ‘you’ and how do you see this as worthless or valuable - peer groups also affect eating disorders |
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what is the cognitive model of eating disorders? (3)
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- there are negative beliefs about the self and this impacts emotions and beliefs about image and this impacts whether you binge or purge or restrict. Binges lead to negative views of food which leads to purging
- there is an underlying deregulation in the brain of thoughts and behaviours - perfectionism= cognitive style that says i have to be perfect or its not good- if i didn’t get 100% might as well not have done it. this is hugely exaggerated in anorexia. affects how you evaluate yourself and goals |
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the genetic component vs environment for Eating disorders...
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40% genetic, 50% environment
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discuss treatments for eating disorders.(what works for anorexia, bulimia, what is CBT, Dialectical?) what is the aim of the treatment?
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1) antidepressants and antipsychotics are ineffective for anorexia, although antidepressants do help a little after they've gotten out of hospital
2) for anorexia, the more support is for family based psychodynamic therapy and CBT 3) for Bumila anti-depressants work but not as well as CBT, especially for binge eating 4) in CBT they have phase 1= educate, keep daily records, phase 2= reduction of dietary restraint 5) dialectical Behaviour therapy is good for bulimia/binge eating as well as self injury- First they:- target life-threatening behaviour, then treatment interfering behaviour, and then emotional-regulation and quality of life interfering behaviour Aim of treatment is to keep them from loosing weight again. we needed to adapt behavioural therapy to be intensive and brief |
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what % of pop is obese? what disorder is becoming increasingly linked to obesity? Why should it maybe be diagnosed as an addiction?
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25%; many, but especially bipolar; like SAD, we see tolerance, negative consequences, they spend a lot of time doing it. certain foods hijack the drug channel and act like a drug as well as food and this messes with bodies ability to regulate weight
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Brain areas involved in obesity? How do they interact to result in over consumption of food?
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VTA, dorsal striatum, nucleus accumbens, lateral hypothalamus, insula
- lateral hypothalamus triggers food-seeking behaviour, accumbens creates motivation to go be causes it signals that the food will give reward, and insula deals with how valuable the goal is to us. |
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what are we doing in CBT for obese people?
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- in CBT we are strengthening the prefrontal cortex so it can inhibit the path of nucleus accumbens, insula, hypothalamus, and reconstructing the release of dopamine at the striatum
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treatment for obesity?
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- weight loss medications and surgery- not very long lasting
- DBT useful for binge eating, obesity from binging but after 3 years even the DBT and CBT results go away - new behaviour therapy treatment is more promising |
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random facts he gave on attractiveness
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- mothers give more attention to attractive babies
- teachers favour attractive students, judge them smarter - attractive adults get paid more - have more success in dating - juries less likely to find attractive people guilty n get lighter sentences |
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Females take ___% of the psychotropic drugs, make up___ of surgeries and are___ more likely to be hospitalized. At birth, there are ___ males to every___ females yet...
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70%, 2/3rds, 30%. 125 males born per 100 females but more female babies make it through the first year of life. WE LIVE LONGER. - 5 women reach 100 for every one man
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Why do women live longer? (theories)
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- estrogen? it is proactive for heart disease, the femalebody repairs itself quicker than male body unless you remove the ovaries
- differences in lifestyle? men more likely to have homocide, suicide, and are at increased risk for diseases BUT women smoke a lot - Testosterone? prob more likely to have a effect than estrogen- High levels of testosterone decrease age. If you neuter dogs and cats, they tend to live longer. Castrated people lived longer, even those with mental disabilities! |
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Does the growing workload for women make them more stressed? (3)
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- No! women who are unemployed are more unhappy and are at more risk for mental problems.
- Animal studies showed that the higher your social rank, the better your immune -marital conflict can triple risk of second heart attack for women, whereas work stress had no effect |
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Describe stress (3)
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- represented by an inverted U shape
- Hans Salié was guy fro Mcgill who named stress first! - stress is idiosyncratic (individualistic) |
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Stress innoculation and its importance
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train people to tolerate stress. study- took monkeys and stressed them when they were young and then a year later and measured things like food consumption, objects they explored. Turns out- you need to be stressed to stress inoculate! those that weren’t stress inoculated didn’t explore they were introverted
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How do you measure stress? (2)
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- holmes and ray life stress scale- over a year period, you add up the number of events in life you had that were stressful. if you have 350 points you have a 50% chance of having a severe illness
- problems with these scales: - the nature of events doesn’t apply to everybody, doesn’t say how you reacted to it or how the events impact health, and focuses only on change but boredom is also stressful - Uplifts and Hassles scale- have to make up different hassles/ uplifts for different people. uplifts for women are as as negative as hassles. |
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Talk about social mediators of stress with some studies. (heart attacks, relationships, social support
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- in men, after heart attack half die with in a year if living alone vs 1/5 if living together
- in women, alone 40% develop depression, in a confiding relationship, 4% develop depression -monkey study- measured immune- problems with immune were more likely in unstable environments with monkeys who weren’t good at affiliation. (friendly) -study measured depression in adults- stressed everybody in same way but some perceived it as high some low. if you perceived it as high and had low social support, they were more likely to have depression - study done on death- looked at degree of emotional support and the degree of trauma. People with low social support were dramatically more likely to die as the number of traumas increased |
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What is how you cope with stress made up of? what are some studies on coping? (hypertension, wood, bambons)
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self efficacy what you think of yourself, your belief in ability to cope, positive reprisal and problem focused coping.....
- if you put a piece of wood, some mice will attack it and those who did something about it were les likely to get ulcers - if baboons increases social rank, they released less stress hormone- winners and losers in a fight don’t have same stress response - human study- measured hypertension to a painful noise (blood pressure increases) however you can prevent this by giving people a button to press to stop it. they didn’t have to push it, they just had to know that they had the option of control and then they didn’t develop hypertension |
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What are some environmental mediators/causes of stress? (3)
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- sever undernutrition (1/4 of the children in world) there is a syndrome that occurs when you starve called semistarvation neurosis- apathy, depression, irritable, emotionally instable, Pellagra - indistinguishable from schiz due to lack of bit
- Reduced environmental stimulation- when you put people in these conditions (lack of change of stimuli) - you get anxiety, delusions, thinking impairments, depersonalization, hallucination - seen in lone sailors, deafness - situations that threaten survival- disasters- short term effects are anxiety, GI upsets. Long term- depression, apathy, premature aging. Burabura , PTSD |
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How does DSMV define PTSD? (5)
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- exposure to actual or threatened violence or death by direct experience, witnessing, learning about a close ones repeated exposure
- intrusive symptoms (flashbacks) - persistence avoidance - negative alterations in cognitions and mood - alterations in arousal (sleep disturbance, angry outbursts) |
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Why is PTSD so common?
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there are 79, 000 combinations of symptoms in the dsm 4 for pstd, DSMv saw an 8 fold increase to 636,000
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Describe Pihls study onDrug abusing women and PTSD
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most of them fit the pTSD categories- intrusions (nitemares, thoughts), avoidance, loss of interest, detachment, hyper vigilance
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what are the different levels of reaction to a traumatic event? What brain regions are more active in PTSD patients?
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some have resilience, some recovery, some delayed reaction, and some chronic reaction
- in PTSD we have more amygdala activation and less in prefrontal areas |
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What are some predictors of PTSD? treatment?
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nothing is very predictive- correlations: prior trauma is .17, post trauma social support is -.28, the highest is dissociation (pretending during the event that it isn't happening to you) at .35
treatment- exposure- exposed to trauma until it desensitized- works the best, but they are looking to develop drugs which manipulate memories so that memories will not consolidate in experience |
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Psychosomatic disorders
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you have physical problems and at least part of the problem is psychological stress. Surgeon General said “mind and body are inseparable” nowadays we can talk about most illnesses in a psychosomatic way, even cancer
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what determines which disorder we will develop from stress? (3)
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1) genetics- salt-sensitive rats, —predisposition
2) environment- guy wit typoid got over it but now when stressed shows typoid symptoms 3) learning: a) expectancy- premenstrual syndrome study - convinced one group that they were premestrual and others that they weren’t. the group she convinced they were showed significant water retention, changes in diet etc- EXPECTANCY b) conditioning- patient would have asthma attack when presented with plastic rose. study with guinnea pigs, increased their histamine levels with a syrup and flavoured this with a smell. anytime they smelt it their histamine would decrease! |
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How is the PNS related to ulcers? what treatments are effective?
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- noticed individuals overreacted to stress and the overcompensation by the PSN is where they got ulcers
- treatments with ant-acids are 10% effective - later on discovered anti-bacterial drug 80% effective |
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describe 2 experiments in ulcer production (monkies, human)
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1) executive monkey studies
- had two monkeys side by side with feet getting shocked. only one of them had the lever to stop the shock - they shocked every 20 min unless the lever was pressed - after twenty days the monkey with the lever died from an ulcer - implicates control in being important - contradicts self-efficacy studies 2) stomach acid production experiments - had women swallow 3 tubes, a PH meter, a bicarbonate sodium neutralizer, an water to wash PH meter - they paid them for every time their stomach acidity went up, and then they reversed it by paying them when it went down - some of them didn’t even know what they were doing but they controlled stomach acid! |
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heart disease is...
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- build up of plaque from cholesterol which plugs the artery and produces heart attack
- number one killer of men and women - has decreased though in the last 40 years- medicine, interventions, drugs, habits etc |
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risk factors for heart disease (5) these account for what % of variance?
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hypertension, high serum cholesterol, lack of exercise, weight, smoking- 25% only, what else is involved? stress?
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on the job strain(_______) accounts for __% of heart attacks; ____ were more likely to show decreased oxygen levels to heart when stressed
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(situation where person is in a job stressful but they have very little control over the job) accounted for about 4%; heart attack survivors
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Coronary Prone Behaviour (3)
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Type A behaviour .
- extreme competitiveness, strive to achieve, aggressive, impatience, hyper-alert, negative emotions - type A doesn’t predict heart disease- however, some aspects have turned out to be important like hostility ad anger- not the hurry up personality but the ****** off one - there are correlations between type A and cholesterol |
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the rosetto effect- culture and heart disease study, other study...
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- study don’t in late 1950s, looked at two cities. one made up of italian immigrants, defined gender roles, society supportive. other was more modern, less traditional.
- the diet in the italian one was 40% fat so you would think they’d be in trouble but actually, the death rate from heart disease was much higher in the second more american town - other study compared japanese people in US - the more they adapted to US lifestyle the mor likely they were to get coronary heart disease, controlling for diet |
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dean ornish study with heart disease
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put people on a low fat diet with exercise etc. ad measured size of arteries. those who followed his diet etc had the greatest change in arteries functioning!
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chronic stress leads to..
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excessive inflammation which effects depression and cardiac- link between anxiety, depression and heart disease
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Psychoneuroimmunology process
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psychological state--- CNS intervention, hormones, behavioural change---immune change----diesase susceptibility
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Parts of immune system: Antigen, Lymphocytes
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antigen is antibody generator - skin, membranes, stomach acid. If these systems are breached, immune system attacks with lymphocytes (white blood cells) located in blood, spleen, thymus and lymph nodes
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types of lymphocytes (6)
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helper T-cells- turn on system
magrophages- trap antigen and show it to lymph B-lymphocytes- produces antibodies which attack Cytotoxic T-lymphocytes- destroys antigens Natural Killer Cells- attacks foreign cells Suppressor T-Cells- turns off system |
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how does family upbringing affect immune?
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- greatest inflammatory response were in individuals who had the greatest amount of family harshness
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How do stress and immunity relate biochemically?
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immune cells have receptors for cortisol and epinephrine and norepinephrine !
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describe the 3 mile island study; Mono study
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- had a radiation leak which resulted in an increase in illnesses of people but wasn’t dues to radiation- hypertension and upper reps. infections. they found that the immune system of these people was affected, fewer t cells t helper, b cells, suppressor. This was directly correlate with increase in epi, norepi and cortisol; Military study- found that those with full syndrome had certain personality characteristics- fathers over achievers, highly motivated in military career, poor academic performance
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stress and cancer (4)
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- stress is not a direct carcinogen
- stress is however related to the development, progression and prognosis - natural killer cells suppress tumour growth and stress reducers their function - greater risk of faster rate of cancer growth if you are stressed, fatigued, can’t express negative emotions, loss of significant relationship |
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How is depression related to immunity? what are the two explanations for this?
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- related to reduced response of lymphocytes to mitogens, reduced natural killer cell activity, altered white blood cell populations
two explanations: -activation of hypothalamus-pitiuary-adrenal axis and the sympathetic nervous system - association with specific behaviours like less sleep, less exercise, poor diets, sub abuse which also impact immune system |
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Describe the study with mice on conditioning immune response
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paired saccharine with immunosuppressive drug which lead to GI upset. When he presented saccharine alone, the mice had disruption of immune more likely to die. Did the opposite too- paired odour with killer cell enhancer and odour alone enhanced immune
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