PSYCH 333 1nd Edition Lecture 16 Outline of Last Lecture I. SchizophreniaII. Genetic CausesIII. Environmental CausesIV. Psychological/Social Factors Outline of Current Lecture II. Eating Disorder in the DSM-5III. Anorexia NervosaIV. Bulimia NervosaV. Binge-Eating DisorderVI. Biological FactorsVII. Cognitive-Behavioral FactorsCurrent Lecture- Eating Disorder in the DSM-5:o Anorexia nervosa.o Bulimia nervosa.o Binge-eating disorder.o Eating disorder (not otherwise specified).- Anorexia Nervosa:o Restrictive behaviors/weight loss.o Fear of gaining weight/being fat.o Distorted body image or sense of body shape. Perceiving that their body is much larger than what it actually is.o Extremely underweight, cannot be at a normal weight and have anorexia.o Subtypes: Restricting.- May consume only 400-500 calories a day. Binge-eating/purging.- May eat a large meal and then excessive behaviors to compensate.o Associated features: Much more common in women. Onset adolescence – usually middle or high school.These notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute. Comorbid with depression, OCD, panic, phobias, substance use, personality disorders. Differences between subtypes:- Binge/purge – more impulsivity; increased suicide risk, substance use, and personality disorder. Child-like mannerisms.- Age inappropriate behavior. Severe medical consequences.- Bulimia Nervosa:o Recurrent. Frequent bingeing. Sense of loss of control when bingeing.o Compensatory behaviors (purging).o Self-esteem/image unduly influenced by body shape/weight.o Associated features: Onset adolescence, early adulthood. Binges typically triggered by stress, emotional distress. Secrecy, feelings of shame/disgust. Comorbid with depression, personality disorder, anxiety disorders, substance use, conduct disorder, suicide. Medical consequences.- Mostly due to effects of purging. History of sexual abuse.- Binge-Eating Disorder:o Frequent, recurrent binges.o Absence of compensatory behaviors. Bingeing but no purging.o Associated features. Higher BMI and associated medical conditions. Slightly higher prevalence in women. Childhood obesity. Comorbid with insomnia, anxiety, depression, and IBS.- Biological Factors:o Genetics. AN and BN run in families; risk may be non-specific. Higher concordance rate in MZ vs. DZ twins. Some of the genetic variation may be due to personality.o Neurobiological. Hypothalamus – limited support. Endogenous opioids – released during starvation and many compensatorybehaviors. BN and BED – low serotonin and feelings of satiety. Dopamine – reward pathways.o Treatments. Medications.- Antidepressant (SSRIs).- Fluoxetine (Prozac) may help regulate mood, appetite.- Limited efficacy.- Relapse when discontinued. Medical treatment.- Treats effect of disordered eating.- Cognitive-Behavioral Factors:o Anorexia nervosa. Cognitions: fear of being fat; distorted body perception; drive for thinness, body dissatisfaction. Behavioral: reinforcement of weight loss, restricting behaviors.o Bulimia nervosa. Similar cognitions. Role of restrictive dieting and
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