Eating Disorder in men EXAM 3 NOTES o 10 million males will suffer from an eating disorder o Few with anorexia some with bulimia but majority is with binge eating o Wrestlers and horse riders and body builders are most prevalent with eating disorders gaining losing or unhealthy ways to get to a certain weight o Men are less likely to get help when suffering from an eating disorder o Homosexuals have a higher rate of eating disorders than heterosexuals Binge Eating Disorder o Engage in food binges without compensatory behaviors o Eating is perceived as uncontrollable o A lot like substance abuse o Uncontrollably large amounts of eating o Associated Features Many people with this disorder are obese or above weight Concerns about shape and weight Often older than bulimics and anorexics Anorexia is most common at age of 13 14 early Bulimia is most common at age of 16 19 late adolescence adolescence Most psychopathology vs non binging obese people o Prevalence Women Men 1 6 0 8 o Some cases of eating disorders are similar to substance use disorders Craving Compulsive behavior A food addict does not get satisfied by a normal amount of eating and continues to eat o Neurobiological Theories Reward pathway Dopamine and opioids Other NTs Serotonin o Decreases control over cravings o Increase craving for sweets Glutamine o Increase food intake o Food Addiction Psychological theories Learning theory of addiction o Positive reinforcement and negative reinforcement Withdrawal symptoms from sugar but not from fat o People crave sugar more than fat Impulsivity self control o Stress coping o When getting stressed the HPA is overactivated which is producing norepinephrine and cortisol o Decrease in these chemicals makes you need more of these chemicals and you try to replenish with poor nutrient food Self medication Treatment of binge eating disorder Medical Treatment o Subutramine meridia Psychological Treatment o CBT Appears efficaous Similar to theat used for bulimia Interpersonal techniques Dissociative Disorders o Why would someone dissociate o What disorders have dissociative features o Overview Involve severe alterations or detachments Affect identity memory or consciousness Depersonalization Experiencing unreality or detachment from one s mind Experiencing unreality or detachment from one s self or body Derealization surrounding Symptoms Positive e g depersonalization derealization Negative e g amnesia losing a memory catatonia DSM 5 Depersonalization derealization disorder Dissociative identity disorder Dissociative amnesia o With dissociative fugue Overview and defining features Treatment o Little is known Dissociative Amnesia Depersonalization Derealization o Severe and frightening feelings of unreality and o Feeling dominate and interfere with life detachment functioning o Primary problem involves depersonalization and o High comorbidity with anexiety and mood derealization Facts and Statistics disorder o 0 of population o found typically around 16 Causes o Cognitive deficits in attention short term memory spatial reasoning o Deficits related to tunnel vision and mind emptiness o Such persons are easily distracted Includes several forms of psychogenic memory loss o Two types of amnesia Retrograde Past memories Interograde Dissociative Fugue Ability to make memories o Fugue flight o Related to dissociative amnesia DSM 5 Subtype of dissociative amnesia o Take off and find themselves in a new place o Unable to remember the past o Unable to remember how they arrives at new location o Often assume a new identity Statistics Causes o Usually begin in adulthood o Show rapid onset and dissipation o Little is known o Trauma and stress can serve as triggers o How do you prove that someone is in a fugue state You really cant tell Treatment o Most get better without treatment o Most remember what they have forgotten Dissociative Identify Disorder formerly multiple personality disorder Clinical Depression o Defining feature is dissociation of personality o Adoption of several new identities as many as 100 average is 15 o Loss of self control o Identities display unique behaviors voice and postures Unique aspect of DID o Alters o Host o Switch together another Sybil Statistics Different identities or personalities The identity that keeps others identities Quick transition from one personality to o Psychiatrist wrote about a person she o Average number of identities is close to 15 o Ratio of females to males is high 9 1 o Onset is almost always in childhood o High comorbidity rates lifelong chronic course o More common that previously thought 3 to 6 o Misdiagnosed a lot Is it real What are the evidence for and against Difficulty to scientifically observe Reports remain Causes Trauma explanations o Histories of horrible unspeakable child abuse o Closely related to PTSD Socio cultural influences o Increase in cases after movies and books about DID o Some selected psychologists report high number of cases o DID symptoms behaviors can be simulated o Social role enacted due to the influence of culturally determined rules for expressing multiple selves Causes Treatment o Suggestibility o Biological vulnerability o Focus is on reintegration of identities o Identify and neutralize cues triggers that provoke memories of trauma dissociation o Patient must relive and confront the early trauma Hypnosis 11 19 Schizophrenia and Other Psychotic Disorders o Schizophrenia vs psychosis Psychosis Broad term e g hallucinations delusions and negative symptoms catatonia or restricted emotional range Schizophrenia A type of psychosis o Psychosis and schizophrenia are heterogenous Disturbed thought emotion behavior Can exist on a spectrum o Historical Background Emil Kraepelin Used the term dementia praecox around 1900 o Subtypes of schizophrenia catatonia hebephrenia disorganized thinking and paranoia Eugen Bleuler o Introduced the term schizophrenia splitting of the mind o DSM 5 Schizophrenia spectrum and other psychotic disorders Schizotypal personality disorder Delusional disorder Brief psychotic disorder Catatonia Schizophrenuform disorder Schizophrenia Schizoaffective disorder o Abnormalities in one or more of the following five domains Delusions Hallucinations Disorganized thinking speech Grossly disorganized or abnormal behavior including o Depressants are the choice of drug for schizophrenic is depressants to catatonia Negative symptoms decrease dopamine o Positive Symptom Cluster Active manifestations of