TOPIC VII Problems involving feeding and eating 1 What is anorexia nervosa Ch10 263 267 269 270 including DSM5 box on 270 a What are its symptoms and defining characteristics of this syndrome Extreme emaciation Refusal to maintain a minimally normal body weight Disturbance in evaluating weight or shape Some deny problems with weight others say weight is not a problem Distorted body image an inaccurate perception of body size and shape Fear of gaining weight Cessation of menstruation amenorrhea absence of at least 3 consecutive menstrual cycles People are hungry yet they starve themselves b What are medical complications associated with it Intolerance to cold Lethargy Skin becomes dry and cracked Lanugo a fine downy hair on the face and trunk of the body Constipation Abdominal pain Anemia Dental erosion Osteopenia bone loss Infertility Impaired kidney functioning Cardiovascular difficulties electrolyte imbalance disturbance in the levels of potassium sodium calcium etc leads to cardiac arrest kidney failure c What are comorbid psychological disorders associated with it Obsessive compulsive disorder Obsessive compulsive personality disorder Depression Sad mood Irritability Insomnia Social withdrawal Diminished interest in sex Obsessed with food and diet follow compulsive eating rituals d What subtypes are described in DSM 5 Restricting type people who rarely engage in binge eating or purging Binge eating purging type regular binge eating and purging during the course of the disorder 2 What is bulimia nervosa Ch10 263 265 267 269 270 271 including DSM5 box on 271 a What are its symptoms and defining characteristics of this syndrome Many people have a history of anorexia nervosa Repeated episodes of binge eating Inappropriate compensatory behaviors self induced vomiting misuse of laxatives excessive exercise The binge eating and inappropriate compensatory behaviors occur at least twice a week for 3 months Excessive emphasis on body shape and weight The disturbance does not occur exclusively during episodes of anorexia nervosa Trying to maintain a weight below the body s natural set point People with this have a normal appetite b What are medical complications associated with it Repeated vomiting can erode dental enamel produce a gag reflex that is triggered too easily Rumination the regurgitation and rechewing of food The enlargement of the salivary glands makes the sufferer s face appear puffy Rupture of the esophagus or stomach Electrolyte imbalances c What are comorbid psychological disorders associated with it Depression especially with those who self induce vomiting Anxiety disorders Personality disorders Substance abuse excessive use of alcohol and or stimulants 3 In what ways are anorexia and bulimia similar to one another In what ways do the differ Ch10 263 271 4 What other types of feeding and eating problems does DSM 5 include as disorders Ch10 269 270 Binge eating disorder Rumination disorder Avoidant restrictive food intake disorder 5 How common are the eating disorder syndromes Are some categories of people more affected than others for example are there gender age or ethnic cultural differences Ch 10 271 274 Both anorexia and bulimia begin in late adolescence or early adulthood Anorexia begins during early adolescence as girls approach puberty Adolescent onset of eating disorders has provoked speculation about their etiology hormonal changes autonomy struggles various sexual problems Eating disorders are far common among young women than young men More common among young women working in fields that emphasize weight and appearance models ballet dancers gymnasts Age Gender Ethnic cultural More prevalent in industrialized societies where thinness is the ideal than in nonindustrialized societies where a more rounded body type is preferred Higher among Arab and Asian women living or studying in Western countries than among women living in their native countries 6 A biopsychosocial perspective would look at factors from each of these levels of analysis to help us understand feeding and eating problems What specific social factors psychological factors and biological factors have been found to be related to these problems Describe how these factors help explain the development and or continued experience of the disorders or their specific symptoms Ch 10 274 277 Societal standards of beauty Troubled family relationships Bulimia conflict rejection Anorexia cohesive nonconflicted BUT maybe enmeshed or overly involved o o Social Factors Child sexual abuse Life Stressors Biological Factors Genetic factors Unstable or excessive neuro and endocrine responses to stress Evaluation in endogenous opioids Serotonin levels Diminished neuroendocrine and gastrointestinal functioning Psychological Factors Excessive focus on weight and appearance Struggle for control over own life o o o o o Perfectionism Excessive control of emotions Leads to lack of interceptive awareness Depression particularly in bulimia Low self esteem Negative mood can trigger binge episodes Negative body image 7 How might the specific factors both within and across levels interact to provide a more complete explanation than provided by any single factor or any single level of analysis Ch 10 277 This objective also requires you to put together information from across the biological psychological and social factors discussed in the previous objective 8 What types of treatments and preventative measures are used for these problems How successful are they and how good is the evidence of their effectiveness What is known about the course and outcome of these problems Ch 10 278 281 Treatment of Bulimia Nervosa Antidepressant medications Medication alone is not a good idea Cognitive Behavior Therapy Normalize eating patterns Dysfunctional beliefs about weight shape dieting and perfectionism Interpersonal psychotherapy Relapse prevention relapses Realistic expectations about eating weight binge eating coping with Treatment of Anorexia Nervosa Gain and maintain a safe normal body weight Address causes Family therapy Cognitive behavioral therapy Modified psychodynamic focus on interceptive awareness distorted body images Feminist therapies Prevention of Eating Disorders Focus on young women NOT directly focus on body image or disordered eating unhealthy eating Rather focus on promoting healthy behavior Direct training in health eating weight Dissonance intervention o Get them to help others figure out ways to help others
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