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EXAM 4 STUDY GUIDE ABNORMAL PSYCHOLOGY Based off of Learning Objectives and Slide Shows CLASS CLP 4143 EATING DISORDERS Know the three eating disorder diagnoses according to the DSM IV TR Anorexia Nervosa Bulimia Nervosa Eating Disorder NOS Know the diagnostic criteria and subtypes for Anorexia Nervosa AN Key Features Diagnostic Criteria 1 Refusal to maintain normal weight Less than 15 of that expected for age and height BMI 18 5 Medical complications due to malnutrition 2 Intense fear of weight gain Engagement in extreme weight loss behaviors Persistent fear despite being underweight Makes treatment very difficult Symptom often becomes more intense as individual loses more weight 3 Disturbance in evaluating shape and weight Distortions in perception of one s body weight and shape Deny seriousness of current low weight Undue influence of shape weight on self evaluation Frequently overestimate size of various body parts Often see fears as justified 4 Amenorrhea missed periods Loss of 3 consecutive menstrual periods Criterion to be dropped in DSM 5 Attia Roberto 2009 5 Less than 18 5 bmi BMI Body Mass Index kg m2 Subtypes 1 Restricting Restricting 2 Binge Purging Binge Purge Perfectionistic Rigid OCPD traits Impulsivity Self harm behavior High cross over rate 62 Eddy et al 2002 Only 12 of women with AN did NOT report regular binge purge behavior at some point Understand the medical complications associated with AN High rates of suicide among those with AN Standardized mortality ratio SMR for suicide 31 Major Depression SMR 17 25 Bipolar Disorder SMR 10 Symptoms of starvation Lanugo Constipation Cold intolerance Major Organ Failures Cardiovascular complications E g Bradycardia arrhythmia heart failure Kidney Failure Osteoporosis related bone fractures Impaired immune functioning Know the prevalence course and sex ethnic differences for AN 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 Know what a diagnosis of EDNOS means and understand why it is diagnosed so frequently EDNOS is for disorders of eating that do not meet the criteria for AN or BN Examples All criteria for AN met except regular menses All criteria for AN met except significant weight loss weight is in the appropriate range All of the criteria for BN met except frequency duration Regular use of inappropriate compensatory behavior by individuals of normal body weight after eating small amounts of food Repeatedly chewing and spitting out but not swallowing large amounts of food Understand the key differences between AN BN and BED Symptom Body Weight Body Image AN Restricting Type Underweigh t by more than 15 Severely disturbed Binges Purges Sense of lack of control over eating Amenorrhea in Females No No No Yes AN Binge Purge Type BN Purging Type BN Non Purging Type Binge Eating Disorder Underweight by more than 15 Severely disturbed Over Normal or slightly overweight concerned with weight Yes Yes Yes Normal or slightly overweight Over concerned with weight Yes No Yes Significantly overweight Often disgusted with overweight Yes No Yes Yes Yes During Binges Yes Not Usually Not Usually No AN is always underweight by 15 AN always has Amenorrhea in Females AN Binges are not considered real binges just binges in patient s mind BN often normal weight BED usually significantly overweight Binge Eating Disorder does NOTHING to compensate for binges Know the prevalence course sex ethnic differences for each eating disorder Anorexia Nervosa o 1 2 lifetime prevalence o 90 of individuals diagnosed with AN are women o Caucasian African American women o Usually begins in adolescence ages 15 19 o Often very chronic hard to treat o Relapse rate up to 50 o Death rate is 5 8 SUBSTANCE ABUSE List of Substances o CNS Depressants alcohol barbituates benzos etc o CNS Stimulants cocaine amphetamines nicotine coffee o Opioids heroin morphine o Hallucinogens Phecyclidine PCP o Cannabis pot Understand the statistics on illicit drug use o 18 25 age group Which drugs are most prevalent o Marijuana and Alcohol When were they most prevalent o Marijuana 1980 o Alcohol Now Who uses them the most now o 18 25 year olds o Native American Understand substance intoxication and withdrawal INTOXICATION o Behavioral psychological changes that occur as a direct result of the physiological effects of a substance on the central nervous system o Reversible substance specific o Specific symptoms also depend on How much Tolerance Acute vs Chronic ingestion Expectations Environment WITHDRAWAL o Physical and behavioral symptoms that result when people who have been using substances heavily for prolonged periods of time stop or reduce Know the criteria for substance abuse dependence o ABUSE 1 of during 1 year period leads to impairment of distress Failure to fulfill important obligations at work home or school because of substance use Repeated use of substance in situations in which it is physically dangerous to do so Repeated legal problems because of substance use Continued use of the substance despite repeated social or legal problems because of use o DEPENDENCE 3 of Tolerance Larger amounts more time than planned Withdrawal Desire or unsuccessful efforts to quit Continued use despite problems Time spent obtaining using recovering Social occupational or recreational activities reduced Know the DSM diagnoses that can be given for alcohol caffeine cigarettes table 14 2 Substance Alcohol Caffeine Nicotine Intoxication Withdrawal Abuse Dependence X X X X X X X What age group have used the most illicit drugs in the past year o 18 25 year olds What are the specifiers for remission o Remission Specifiers applied only after no abuse have been met for 1 month criteria for dependence or full 1 month but 12 no criteria 1 month but 12 1 criteria for Early full remission Early partial remission dependence or abuse none of criteria met for 12 months Sustained full remission Sustained partial remission longer but 1 criteria have been met full criteria not met for 12 months or Depressants What are CNS depressants how do they affect the body Alcohol benzodiazepines barbituates inhalants ALCOHOL Depressants slow the activity of the central nervous system Moderate doses o Make people relaxed somewhat sleepy reduce concentration and impair thinking motor skills o Heavy doses o Induce stupor or even death LONG TERM


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FSU CLP 4143 - EATING DISORDERS

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Test 1

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Anxiety

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Suicide

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Suicide

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