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Abnormal PsychologyExam 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 Nervosa2. Bulimia Nervosa3. Eating Disorder, NOSKnow the diagnostic criteria and subtypes for Anorexia Nervosa (AN)Anorexia Nervosa (AN): 1. Refusal to maintain normal weighta. Less than 15% of that expected for age and height (BMI < 18.5)b. Medical complications due to malnutrition2. Intense fear of weight gaina. Engagement in extreme weight loss behaviorsb. Persistent fear despite being underweightc. Makes treatment difficultd. Symptom often becomes more intense as individual loses more weight3. Disturbance in evaluating shape and weighta. Distortions in perception of one’s body weight and shapeb. Deny seriousness of current low weightc. Undue influence of shape/weight on self-evaluationd. Frequently overestimate size of various body partse. Often see fears as justified4. Amenorrheaa. Loss of 3 consecutive menstrual periodsb. *criterion to be dropped in DSM-5!!Subtypes of Anorexia Nervosa:1. Restrictinga. Perfectionistic/Rigidb. OCPD traits2. Binge/Purgea. Impulsivityb. Self-harm behavior*High cross-over rate ~62% - only 12% of women with AN did NOT report regular binge/purge behavior at some pointAN: Clinical Features- Fidgety/restless- Cold  baggy clothes- Food rituals/strict rules around eatingo Cutting food, eat food in certain order- High comorbidity with depression, anxietyo Comorbidity is the norm (~56%)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- 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 ~ 31o Major Depression ~ SMR 17.25o Bipolar Disorder ~ SMR 10Understand the medical complications associated with ANMedical Complications:- Symptoms of Starvationo Lanugoo Constipationo Cold intolerance- Major Organ Failureso Cardiovascular complications (i.e. bradycardia, arrhythmia, heart failure)o Kidney failure- Osteoporosis and related bone fractures- Impaired immune functioningBulimia Nervosa (BN):Binge:- 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 episodeKnow the diagnostic criteria and the subtypes of BN.DSM-IV-TR criteria for diagnosis:1. Recurrent episodes of binge eating2. Recurrent inappropriate compensatory behavior in order to prevent weight gain3. Bing eating and inappropriate compensatory behaviors both occur, on average, at least twice per week for 3 months4. Self-evaluation is unduly influenced by body shape and weight5. The disturbance does not occur exclusively during episodes of anorexia nervosaSpecify 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 vomitingKnow the prevalence, course, & sex/ethnic differences BNPrevalence 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 AmericansUnderstand the medical consequences of BNPhysical Problems:Significant medical complications (due to purging)- Electrolyte imbalance- Erosion of dental enamel- Hypersensitive gag reflex- Regurgitation/rechewing of food- Enlarged salivary glandso Results in puffy appearance of face- Ruptured esophagus- Ruptured stomachBinge-Eating Disorder:-recurrent episodes of binge eating in the absence of regular use of inappropriate compensatory behaviors characteristic of BNKnow 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 hoursb. Sense of lack of controlB. Episodes associated with 3+ of the following:a. Eating more rapidly than normalb. Eating until feeling uncomfortably fullc. Eating when not feeling hungryd. Eating alone because of embarrassmente. Feeling disgusted, depressed, or guilty about over eating.Know the prevalence, course, & sex/ethnic differences for BEDPrevalence 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+ yearsUnderstand the key differences between AN, BN, and BEDPartial-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 twentiesKnow what a diagnosis of EDNOS means, and understand why it is diagnosed so frequentlyEating Disorder, NOSEDNOS: 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 disordersSociocultural 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:o Immediate Effects: 3 mins of exposure to fashion magazines vs. magazines without models Fashion magazines increased depression, shame, guilt, stress, insecurity, and body dissatisfactiono Chronic Exposure: 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- “Contagious Dissatisfaction” Studyo Thin


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FSU CLP 4143 - Exam IV study guide

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