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27 Cards in this Set
- Front
- Back
what are the 3 broad categories of eating disorders?
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1. anorexia nervosa (AN)
2. Bulimia Nervosa (BN) 3. Eating disorder not otherwise specified (EDNOS) |
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how are eating disorders often described in OT?
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biologically based serious mental illness that restricts participation in life activities
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what are some factors impacting the cause of eating disorders?
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-compulsive behaviors
-loss of control over one's behaviors -repetitive dysfunctional behavior despite adverse consequences or obvious negative physical impact -no single factor but a combo of biological, behavioral, psychological, emotional, interpersonal, and social factors |
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what are common behavioral patterns and thinking?
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Inflexible thinking often with cognitive distortions (black and white thinking) (use CBT to reframe dysfunctional thinking)
Low self esteem (calibrate self image) Feelings of inadequacy Sometimes depression and anxiety Perfectionistic attitude Limited self efficacy May have a history of difficult family relationships May have a history of physical or sexual abuse Unrealistic or diminished self image and self concept |
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what has one of the highest mortality rates of any mental illness?
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anorexia
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what percent of people with anorexia die as a result?
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10%
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what % of people with anorexia have other psychiatric diagnosis?
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54-94%
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what are the physical signs of weakness?
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Heart- feel weak, electrolyte shortage orthostatic pressure changes, weak pulse
Digestion-GI tract slows, constipation, bloating Hormones-disrupts sex hormone production; delays puberty, infertility; periods may stop Brain-cognitive damage with possible changes in serotonin levels due to obsessive thinking; low concentration Hair-thin, dry, brittle from protein deficiencies Skin- dry, easily bruised, fine layer of hair may grow as insulation (lanugo) Bones-risk for fractures, growth arrested Muscles-atrophy, boney appearance Kidneys-can lead to organ failure Endocrine metabolic- hypothermia, feel cold, tired Nails-turn brittle Hemotologic- bruise easily Obvious signs of malnutrition Liver dysfunction |
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what do the later signs of anorexia look like?
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-brain shuts down at brain stem level and patient refuses or has difficulty swallowing, shallow breathing, organs shutting down
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what types of BN are there?
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purging and non purging type
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what does the criteria for diagnosis of bulimia include?
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-recurrent periods of eating an abnormally large amount of food in a discrete period and feeling unable to stop or control the amount eated
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what does the purging type of BN focus on?
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inappropriate reoccuring behavior to prevent gaining weight and may include:
-self induced vomitting -laxative abuse -diuretics -enemas -medications -binge-purge cycles |
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what are health consequences of BN?
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-electrolyte imbalance
-gastric rupture -esophageal inflammation -severe tooth decay -chronic irregular BM -peptic ulcers -pancreatitis |
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where do laxatives work?
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end of the bowel where diarrhea affects loss of water and electrolytes
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what are symptoms of laxative withdrawl?
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-constipation
-fluid retention -bloating -temorary weight gain -these symptoms usually diminish after 3-4 days with regular exercise and hydration, however, for persons with an eating disorder this is often misinterpreted as permanently feeling fat |
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what are GI tract cosequences from BN?
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damage from continual vomiting destroys the esophagus, teeth, ect
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what are skin cosequences from BN?
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loses elasticity
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what are reproductive cosequences from BN?
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scanty periods
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what are muscle cosequences from BN?
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muscle weakness
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what are psychological cosequences from BN?
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eating behavior not connected to hunger but more to compulsivity, low self esteem, negative body image, cognitive distortions about self and others
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what is OT's role in eating disorders?
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occupational profile of patters of eating and how this affects engagment in occupations
(how are routines and habits impacted) (use of time with the pre-occupation on restricting food and preventing weight gain) -eval of thought processes -assessing life style choices -providing psychoeducation about eating disorders -exploration of healthier coping skills |
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what are goals for OT?
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-recognize dysfunctional patterns of eating behaviors
-educate on health patters of eating -cognitvely reframe dysfunctional thinking -learn and use coping skills -promote healthy communication and interaction skills with others; allow for self expression and problem/solution identification -understand need for control and learn ways to deal with this issue |
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what are some issues to discuss regarding eating disorders?
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feminist perspective on body image; influences of the media on body image
-ethnic differences -eating habits of various socioeconomic classes and how weigh control is viewed |
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what are common problems of eating disorders?
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-Eating
maladaptive eating habits and impaired meal preparation -Communicating impaired communication and assertiveness skills -coping with emotions impaired stress management skills -participating in everyday activities maladaptive self care, productivity and leisure habits, and impaired independent living skills -impaired volition disabiling psychological factors influencing motvation to change and participate in occupations/roles --over-valuation of weigh/shape --mood intolerance --core low self-esteem --perfectionism --interpersonal problems |
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what are intervetion ideas?
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self-help and support groups
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what are general principles of intervention?
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-physical harm reduction
-cognitive reconstruction -psychosocial functional enablement |
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what are specific OT interventions?
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menu planning and meal prep
lifestyle redesign and independent living skills communication ans assertion training stress management projective art crafts relapse prevention body image improvement |