Final Exam Study Guide Chapter 11 Eating Disorders 3 types of eating disorders o Anorexia nervosa pursuit of thinness that leads to self starvation Typically underweight Restrict behaviors that promote healthy weight Intense fear of gaining weight Distorted body image sense of body weight Persistent restriction of energy intake leads to very low body weight Either an intense fear of gaining weight or getting fat or persistent behavior that interferes with weight gain Subtypes Restricting last 3 months Binge eating severely limit food intake no binge eating purging during the regularly binge purge the last 3 months Onset early to middle teen years and women are 10x as likely to develop it The earlier the onset the more likely to recover50 70 actually recover Comorbid with substance dependence mood disorders schizophrenia High suicide rates Physical changes low blood pressure decrease in heart rate Kidney and gastrointestinal problems Lanugo soft downy body hair cycle of bingeing followed by extreme behaviors to prevent weight gain o Bulimia nervosa such as purging Typically at or above normal weight Recurrent binge eating compensatory behaviors like vomiting Binge eating characterized by eating more than anyone usually would in a discrete period of time 2 hour period plus lack of control over eating during the episode Compensatory recurrent in order to prevent weight gain such as vomiting laxatives Frequency at least once a week for three months Onset late adolescence or early adulthood Comorbid with depression PD s anxiety substance abuse conduct disorder o Binge eating disorder regular bingeing but not purging Typically overweight Recurrent episodes of binge eating at least once a week for three months Includes eating more rapidly eat until uncomfortably full or not hungry Risks include increased chance for type 2 diabetes cardiovascular disease breathing problems Most common eating disorder Lasts the longest lasts about 14 years on average Anorexia Subtypes o Subtypes Restricting months Binge eating severely limit food intake no binge eating purging during the last 3 regularly binge purge the last 3 months Risk factors for developing eating disorders o First degree relatives of individuals with both disorders more likely to have disorder o Higher MZ concordance rates for both anorexia and bulimia o Body dissatisfaction desire for thinness binge eating weight preoccupation are all inheritable o Environmental factors o Low levels of endogenous opioids substances that reduce pain enhance mood and suppress appetite Released during starvation therefore may reinforce restricted eating in anorexia Low levels in bulimia promote cravings therefore reinforcing bingeing Treatments for eating disorders o Antidepressants that increase serotonin serotonin is related to feelings of satiety feeling full effective for bulimia but not anorexia o Clinical management for anorexia focus on three primary issues Restroring weight Modifying distorted eating behavior Often outpatient with intensive day treatment Addressing the psychological and family issues Treatments include nutritional rehabilitation psychotherapy and medication o Anorexia immediate goal is to increase weight second goal is long term maintenance of weight gain o CBT reductions in symptoms through 1 year o Family based therapy anorexia is viewed as interpersonal rather than individual issue so they have family lunch sessions etc Describe each theoretical conceptualization of eating disorders for o Cognitive Behavioral through 1 year o Psychodynamic o Genetic more effective than medication Shows reduction in symptoms For binge eating disorders teaches restrained eating through self monitoring self control and problem solving skills family and twin studies support genetic link Body dissatisfaction desire for thinness binge eating etc is all heritable low levels of endogenous opioids aka substances that reduce pain enhance o Biological mood and suppress appetite Chapter 9 Schizophrenia 3 phases of schizophrenia o Prodromal not doing hw etc symptoms o Acute o Residual initial mild symptoms leading up to it Peculiar thinking start skipping classes severe symptoms Severely ill and very schizophrenic mild remaining symptoms They are getting better but they have remaining o Symptoms last for about 6 months a year or so Schizophrenia major disturbances in thought emotion and behavior o Disordered thinking ideas not logically related faulty perception and attention o Lack of emotional expressiveness inappropriate or flat emotions o Disturbances in movement or behavior disheveled appearance o Onset typically late adolescence o Two or more symptoms lasting for at least 1 month at least one should be 1 2 or 3 Delusions Hallucinations Disorganized speech Negative symptoms blunted affect avolition asociality Symptoms can be positive negative or disorganized Abnormal psychomotor behavior catatonia Schizophrenia vs Schizophreniform o Schizophrenia symptoms are 6 months year o Shizophreniform symptoms greater than 1 month but less than 6 months Positive symptoms of schizophrenia o Delusions o Hallucinations Negative symptoms of schizophrenia o Avolition lack of interest apathy o Alogia reduction in speech o Anhedonia inability to experience pleasure o Blunted affect exhibits little or no affect in face or voice o Asociality inability to form close personal relationships o Can be grouped into 2 domains experience domain motivation emotional experience sociality or expression domain outward expression of emotion vocalization Alogia negative symptom of schizophrenia that is the reduction of speech o Poverty of speech o Poverty of content of speech o Blocking o Increased latency of response Poverty of speech aka alogia negative symptoms that is minimal verbal communication that lacks the additional unprompted content characteristic of normal speech o Ex a depressed man will not just talk regularly he will only answer questions directed specifically at him and only say one or two words Anhedonia negative symptom that the person experiences loss of interest and pleasure Avolition lack of interest apathy Catatonia motor abnormalities o Repetitive complex gestures usually of the fingers or hands o Excitable wild flailing of limbs Thought insertion when the person cannot distinguish between their own thoughts and the experience of the thoughts that people are putting in their head Thought broadcasting delusional belief that others can hear or are aware of an
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