Abnormal Psychology Exam IV Study Guide Eating Disorders Eating disorders are defined as the disturbance of eating behaviors caused and influenced by intense fear of gaining weight and excessive emphasis on weight and shape Know the three eating disorder diagnoses according to the DSM IV TR 3 Eating Disorder Diagnoses 1 Anorexia Nervosa 2 Bulimia Nervosa 3 Eating Disorder NOS Know the diagnostic criteria and subtypes for Anorexia Nervosa AN Anorexia Nervosa AN 1 Refusal to maintain normal weight Less than 15 of that expected for age and height BMI 18 5 a b Medical complications due to malnutrition 2 Intense fear of weight gain a Engagement in extreme weight loss behaviors b Persistent fear despite being underweight c Makes treatment difficult d Symptom often becomes more intense as individual loses more weight 3 Disturbance in evaluating shape and weight a Distortions in perception of one s body weight and shape b Deny seriousness of current low weight c Undue influence of shape weight on self evaluation d Frequently overestimate size of various body parts e Often see fears as justified 4 Amenorrhea a b Loss of 3 consecutive menstrual periods criterion to be dropped in DSM 5 Subtypes of Anorexia Nervosa 1 Restricting a Perfectionistic Rigid b OCPD traits 2 Binge Purge a b High cross over rate 62 Impulsivity Self harm behavior AN Clinical Features Fidgety restless Cold baggy clothes Food rituals strict rules around eating o Cutting food eat food in certain order High comorbidity with depression anxiety Comorbidity is the norm 56 o Know the prevalence course and sex ethnic differences for AN Prevalence and Course 1 2 lifetime prevalence 90 of individuals diagnosed with AN are women only 12 of women with AN did NOT report regular binge purge behavior at some point Caucasian African American women Usually begins in adolescence ages 15 19 Often very chronic hard to treat Relapse rate up to 50 Death rate is 5 8 AN and Suicidality High rates of suicide among those with AN Standardized mortality ration SMR for suicide 31 o Major Depression SMR 17 25 o Bipolar Disorder SMR 10 Understand the medical complications associated with AN Medical Complications Symptoms of Starvation Lanugo Constipation Cold intolerance o o o Major Organ Failures o o Kidney failure Osteoporosis and related bone fractures Impaired immune functioning Bulimia Nervosa BN Binge Cardiovascular complications i e bradycardia arrhythmia heart failure Eating within a 2 hour period an amount of food that is definitely larger than most people would eat in similar conditions A sense of lack of control over eating during the episode Know the diagnostic criteria and the subtypes of BN DSM IV TR criteria for diagnosis 1 Recurrent episodes of binge eating 2 Recurrent inappropriate compensatory behavior in order to prevent weight gain 3 Bing eating and inappropriate compensatory behaviors both occur on average at least twice per week for 3 months 4 Self evaluation is unduly influenced by body shape and weight 5 The disturbance does not occur exclusively during episodes of anorexia nervosa Specify If Purging type self induced vomiting or misuse of laxatives diuretics or enemas Non purging type other inappropriate compensatory behaviors like fasting or excessive exercise but not self induced vomiting Know the prevalence course sex ethnic differences BN Prevalence and Course 0 5 3 lifetime prevalence for clinical diagnosis Onset between 15 and 29 More common in women than men More common in Caucasians that African Americans Understand the medical consequences of BN Physical Problems Significant medical complications due to purging Electrolyte imbalance Erosion of dental enamel Hypersensitive gag reflex Regurgitation rechewing of food Enlarged salivary glands o Results in puffy appearance of face Ruptured esophagus Ruptured stomach Binge Eating Disorder recurrent episodes of binge eating in the absence of regular use of inappropriate compensatory behaviors characteristic of BN Know the diagnostic criteria and the subtypes of BED Criteria A Recurrent episodes of binge eating characterized by both a Eating amount definitely larger than most people would eat in 2 hours b Sense of lack of control B Episodes associated with 3 of the following a Eating more rapidly than normal b Eating until feeling uncomfortably full c d Eating alone because of embarrassment e Eating when not feeling hungry Feeling disgusted depressed or guilty about over eating Know the prevalence course sex ethnic differences for BED Prevalence and Course 2 3 5 lifetime prevalence in general populations 30 of individuals in weight loss programs More common in women than in men No racial ethnic differences Course Chronic mean duration of the disorder is 8 years Understand the key differences between AN BN and BED Partial Syndrome Eating Disorder Lots of symptoms not enough Adolescents with partial syndrome eating disorders are just as likely to have anxiety disorders substance abuse depression and attempted suicide 90 had psychiatric disorders in their early twenties Know what a diagnosis of EDNOS means and understand why it is diagnosed so frequently Eating Disorder NOS EDNOS disorders of eating that do not meet the criteria for AN or BN for example one requirement may be missing Purging Disorder individual frequently purges but does not binge eat individuals who meet this requirement are diagnoses with EDNOS COMING SOON Likely to appear in DSM V or DSM V appendix Pam Keel of FSU is driving force behind the research Know the sociocultural psychological and biological factors that influence the development of eating disorders Sociocultural and Psychological Aesthetically obsessed Decisions that the human body should look a certain way Learned how the human body can be manipulated Influences of the Media Immediate Effects Chronic Exposure o o o Contagious Dissatisfaction Study Athletes 3 mins of exposure to fashion magazines vs magazines without models Fashion magazines increased depression shame guilt stress insecurity and body dissatisfaction Adolescent girls randomly get 15 month subscription to leading fashion magazine OR no subscription Girls who already felt pressure dissatisfaction become more depressed Girls without social support became more dissatisfied dieted more showed more bulimic symptoms Thin confederate either complains about her body or doesn t if she does participants became more dissatisfied with their own bodies Elite athletes are at higher risk for
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