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55 Cards in this Set
- Front
- Back
Anorexia Nervosa
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Fear of fatness, distorted body images, reduce food intake. Ritualistic eating behaviours.
- Excessive exercise, restlessness - Social withdrawal, irritable, depression. Symptoms of disorder or starvation? |
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Bulimia Nervosa
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Periods of food restriction alternate with periods of binge eating resulting in inappropriate compensatory behaviours.
- Within normal weight range, objective binge eating. Impairs renal functioning and cardio problems. |
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Purging
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Behaviours to achieve or maintain weight loss. Self induced vomiting, laxatives, enemas or diuretics. Weight loss due to dehydration.
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Objective Binge
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Eat large amount of food in specific time period.
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Subjective Binge
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Eat small amounts or normal amounts of food during these episodes.
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Escape from Self Awareness Model
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Heatherton and Baumeister
- Episodes of binge eating occur to escape high levels of self-awareness. Brine eating as a shift in attention (attention narrowed to good feelings food brings and away from bas feelings of failure. |
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Anorexia vs. Bulimia (Similarities and Differences)
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Similarities: Weight and shape important, low self esteem, both may binge/purge
Differences: All bulimia binge eat and purge, not all anorexia binge and purge. Bulimia is normal weight, anorexia is underweight. |
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Anorexia vs. Bulimia
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Anorexia: deny family problems, emotionally over-controlled, less sex experience, less prone to obesity, introverted,mistrust, OCPD
Bulimic: Exaggerate family problems, emotionally impulsive, more ex experience, more prone to obesity, extraverted, too trusting, BPD and histrionic. |
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Prevalence of Anorexia
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>90% females, 0.5-1% young females.
- 10x as common in females |
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Mortality Rate
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Highest of all psychological disorders: 5-8%
- Mostly because of starvation and nutritional complications |
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Body Mass Index
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Weight in kg divided by heigh in metres squared.
- If 17.5 or less - or if 85% of expected weight - Don't use to diagnose anymore |
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Shape and Weight Based Self-Esteem Inventory (SAWBS)
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Measures importance of weight and shape to self-esteem.
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Weight-Influenced Self-Esteem Questionnaire
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Influence of weight on how individuals with eating disorders feel about themselves.
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Amenorrhea
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Absence of 3 consecutive menstrual cycles. Also if periods only occur when she take bc pill.
- Don't use to diagnose anymore |
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Restricting Type
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Attain low weight through strict dieting and sometimes excessive exercise.
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Binge Eating/Purging Type
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Strict dieting, possibly excessive exercise and also engage in binge eating and/or purging
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Compensatory Behaviours in Bulimia
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Must occur at least twice a week for three months.
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Purging Type
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Self induced vomiting or misuse of laxatives, diuretics, enemas or other medications.
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Non-Purging Type
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Other compensatory behaviours such as fasting or excessive exercise.
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Eating Disorder Not Otherwise Specified
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More common than anorexia and bulimia
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Binge Eating Disorder
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Recurrent episodes of binge eating but not inappropriate compensatory behaviours.
- Distinct eating disorder in DSM-5 |
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Pica
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Eating non-food
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Rumination
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Repeated regurgitation
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Avoidant/Restrictive
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Not anorexia because no disturbance in body image.
- "Picky Eater" |
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Atypical Anorexia
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All criteria for anorexia except weight may be at or above normal range.
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Subthreshold Bulimia
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Binge eating for limited duration
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Night Eating Syndrome
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Repeated nocturnal eating
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Is it possible to have more than one eating disorder?
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No
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Progression of Eating Disorders
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Tend to change in systematic way over the lifespan
- Mid teens looks like anorexia - Late teens looks like bulimia - Restricting type a "phase" |
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Lower BMI and waist/hip ratio
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If bulimic with history of anorexia.
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Eating Disorder Examination
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Structured clinical interview, high reliability and validity. Numerical ratings, frequency and degree of symptoms and normative data.
- Explores interpersonal function and potential history of traumatic events. |
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Eating Disorders Inventory
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Assess eating disorder attitudes and behaviours.
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Physical Complications of Anorexia
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Osteoporosis, cardio problems, low fertility, lethargy, dry skin and hair, hair loss, high sensitivity to cold and lanugo.
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Lanugo
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Downy hair on body to maintain body warmth.
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Physical Complications of Bulimia & Binge/Purge Type
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Dental problems, russell's sign, electrolyte imbalance, cardio and renal function.
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Russell's Sign
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Scrapes/calluses on backs of hands/knuckles.
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Most likely Commorbid of Eating Disorders
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Substance Abuse
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Neurotransmitters in Anorexia
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High serotonin activity
- Reduced density of serotonin transporters |
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Socio-Cultural
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Pressure from media
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Family Factors
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Cultural transmission of pathological values, critical family.
- Anorexia: mothers don't care about them |
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Personality
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Traits that seem to characterize people with eating disorders.
- Perfectionism and obsessiveness (anorexia) - Impulsive (bulimia) |
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Maturational
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High sex differences, eating disorders most often appear at puberty.
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Adverse Events
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Childhood abuse, also adult abuse. Trauma history more frequently in bulimic patients.
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Precipitating Factors
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Events that trigger eating disorder
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Perpetuating Facotrs
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Physical and psychological symptoms that maintain the disorder.
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Medical Treatment for Bulimia
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Tricyclic antidepressants and SSRI's
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CBT vs. Meds and CBT
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CBT better than meds + CBT
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Cognitive Behaviour Therapy
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1. Control over eating, psycho-education, teach to use behavioural strategies. Self monitoring.
2. Focus on normalized eating, eliminate dieting, problem-solving skills, id and modify dysfunctional thoughts and beliefs. 3. Maintain Change and prevent relapse. * Not as effective for anorexia as bulimia |
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Transdiagnostic Theory
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Similar CBT interventions, acknowledge underlying issues. Perfectionism, low self esteem, mood intolerance and interpersonal difficulties interact with core mechanisms.
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Interpersonal Therapy
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Focus on maladaptive personal relationships
- Equivalent effects to CBT but CBT decreases symptoms relatively quickly. |
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Meal Support
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During or after meals, normalize eating behaviour.
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Family Therapy
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Family engage in managing weight gain and eating. Then return control of eating to disordered person.
- Works better in teenage and anorexic |
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Reasons for Self Help
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1. Provide accessible information to people who might not otherwise get it
2. Conjunction with guidance from non-specialist (family doctor or nurse) 3. As first step in treatment 4. For people on waiting list for intensive treatment 5. Facilitate therapist CBT |
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Lateral Hypothalamus
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Activation increases eating, destroy and get starvation
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Anmeshment
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Family issues, high involvement in each others lives, interdependent, overprotective, avoid conflict, restricted, want control, use food.
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