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23 Cards in this Set
- Front
- Back
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___ of adolescents and college students have a severe ED
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3-10%
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Typical Characteristics of a Person with an ED
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Weak Sense of Self
Holds Neg. Beliefs/Cognitive Distortions Self-Critical/Cannot Accept Flaws Strives for Perfection/Demands High Achievement of Self Needs to be in control/O/C tendencies Dissatisfied with Body Unsatisfying Social Relationships People Pleasing/Overly Sensitive to Rejection/Criticism Difficulty Tolerating Emotions/Doesn’t Cope Well w/ Disappointment or Failure Feels Powerless Experiences Dep. Or Anxiety Intense Narcissistic Qualities/Needs Fears Growing Up (AN) Becomes Impulsive (BN) |
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Risk Factors for ED
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Age 13-18
Female (although # of males increasing) Obesity Avoidance/Fear of Gaining Weight Early Puberty and Maturation Restrained Eating Unhealthy Weight Control Measures Difficulty Identifying and Expressing Emotions History of Depression Need for Perfection Low Self-Esteem Lack of Adequate Coping Skills Alcohol/Substance Abuse Sexual or Physical Abuse History Early Dating/Confusion about Appropriate Behavior Ill Health or Early Pregnancy |
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Sociocultural Factors in development of an ED
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Standard of Beauty
Media/Advertising Diet Industry/Fast Food Industry Sports Peers |
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Familial Factors in development of an ED
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Family Environment
Trauma |
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Family Environment Factors in development of ED
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Expectation of Success/Achievement Orientation
Push to be Perfect in Attitude and Appearance Chronically Criticize Children and/or Each Other Many Conflicts with Inability to Resolve Them Expression of Painful or “Negative” Emotions Discouraged Disconnected from one or both parents Overinvolvement/ Underinvolvement Parents who are Controlling Emphasis on Weight and Thinness Family History of ED Food Used to Soothe Feelings Physical/Emotional/Sexual Abuse |
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Family Environment Factors in AN
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Limited Ability to Tolerate Psychological Tension or Disharmony
Emphasis on Propriety and Rule-Mindedness Overdirection of Child/Discouragement of Autonomy Poor Conflict Resolution Skills |
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Family Environment Factors in BN
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Substance Abuse (Parents use to deal with problems)
Obesity and/or Migraines Affective Disorders (Depression etc.) |
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Trauma etiological factors in ED
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Includes Family, Authority Figures, Peers, Strangers
Psychological Growth Delay Sexual Abuse and Body-Hate Emotional Abuse Most Clearly Influences Eating Behaviors/Pathology (Kent et al., 1999) |
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Biogenetic Factors in AN
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Increased Risk of AN in 1rst Biological Degree Relatives
May Have Increased Levels of Serotonin and May Diet in an Attempt to Decrease Anxiety, Obsessiveness and Perfectionism Starving enduces Endorphins/Cortisol |
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Biogenetic Factors in BN
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Higher Frequency of BN, mood disorders and substance abuse in 1rst degree relatives of those with BN
43% of sisters/26% mothers of women with BN had an ED Diagnosis Lowered Serotonin Levels |
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Inheritable Genetic Traits
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Depression
Anxiety Obsessiveness Compulsiveness Inhibitedness/Shyness Asocial Behavior/Schizoid Lability/Emotional Disregulation Narcissism Pessimism Worrying Perfectionism Low Frustration Tolerance Sociopathy |
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Intrapsychic Factors in AN
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Childhood Anxiety Disorder
Perfectionism (Over Compliance, O/C, Exacting, Self-Controlled) Harm Avoidance (Worrier, Pessimistic, Shy) Easily Fatigued Low Level of Novelty Seeking Negative Affect |
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Intrapsychic Factors in BN
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Childhood Anxiety Disorder
High Level of Novelty Seeking Negative Affect Affective Instability Low Self-Esteem/Interpersonal Sensitivity |
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3 Layers of an Eating Disorder
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1) deficits in self concept
2) body image disturbances 3) eating and biologic symptoms/disturbances |
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Common Presenting Complaints and Medical Conditions of AN
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Hair Loss
Dry Skin/Facial Hair Growth Pain Around Heart/Down Left Arm Heart Palpitations Low Blood Pressure Loss of Menstrual Cycle Catches Colds/Infections Easily Anemia Osteopenia/Osteoporosis Gets Chills/ Can’t Warm Up Stomach Aches after Eating Food Sits in Stomach Fainting Alternating Energy Level btwn High Energy and Extreme Fatigue Attn./Concentration/Retention Difficulties |
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what AD is contraindicated in AN
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fluoxitine (appitite depressant)
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What AD is contraindicated with BN
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buprophin (wellbutrin)
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Common Presenting Complaints and Medical Conditions of BN
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Dental Erosion
Blisters in Mouth Blood in Vomit Pain around Heart/Down Left Arm Heart Palpitations Low Blood Pressure Fatigue Irregular Menstrual Cycles Esophageal Burning Constipation/Diarrhea Hypoglycemia Kidney Problems Dehydration Diminished Cognitive Function Dizziness |
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Inpatient Hospitalization indicated if:
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AN and/or BN symptoms so severe and entrenched that meeting 1 to 2 times per week would have no impact
Weight is 25-30% below healthy body weight at start and little gain is likely to be achieved in outpatient Health is medically compromised Debilitating anxiety/depression/suicidality Symptoms worsen during therapy and remain worse for over one month No improvement over a 3 to 4 month period |
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Intensive Outpatient Programs indicated if:
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patient will need more than traditional outpatient treatment but would benefit from continuing with work, school etc. and are able to do so without regressing into eating disordered behaviors or experience refeeding syndrome.
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Overall Aims of Treatment for AN
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Weight gain of .5 to 2lbs per week
Restoration of normal weight Restoration of normal menstruation |
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Overall Aims of Treatment for BN
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For BN:
Eliminate binge and purging For Binge Eating: Eliminate bingeing Natural weight loss created by healthy eating |
