Eating and Sleep Disorders

What is a core feature of fEeding And Eating Disorders according to the DSM 5TR?

A persistent disturbance of eating or eating-related behavior that impairs physical health or psychosocial functioning

What defines the disorder Pica?

The persistent eating of non-nutritive, non-food substances for at least one month

For a diagnosis of Pica, the eating of non-nutritive substances must be ___

Inappropriate for the person’s developmental level

What is the primary and diagnostic requirement for Anorexia Nervosa regarding energy intake and body weight?

A restriction of energy intake that causes a significant low body weight for the person‘s age, sex, and physical health

What two psychological criteria must be met for a diagnosis of Anorexia Nervosa, besides low body weight?

1. An intense fear of gaining weight

2. A disturbance in how one experiences their weight or shape

The severity of Anorexia Nervosa is determined by the person’s current ___

Body mass index (BMI)

What type of mental disorder often precedes the onset of Anorexia Nervosa?

An anxiety disorder

What are the initial treatment goals for Anorexia Nervosa?

To restore the person to a healthy weight and address physical complications

What is enhanced cognitive behavior therapy (CBT-E) for eating disorders?

A transdiagnostic treatment which proposes that eating disorders share the core psychopathology of giving excessive value to physical appearance and weight

In family based treatment (FBT) for Anorexia Nervosa, what happens during phase 1?

Parents take charge of the adolescent’s nutritional rehabilitation and weight restoration with the therapist’s help

What happens in phase 2 of family based treatment (FBT) for Anorexia Nervosa?

Control over eating is gradually returned to the adolescent

What is the focus of phase 3 in family based treatment (FBT) for Anorexia Nervosa?

Addressing adolescent developmental issues, such as establishing age-appropriate independence

What are the three diagnostic criteria for Bulimia Nervosa?

1. Recurring episodes of binge eating

2. Inappropriate compensatory behaviors

3. Self-evaluation excessively influenced by body shape and weight

For a Bulimia Nervosa diagnosis, binge eating and compensatory behaviors must occur at least once a week for how long?

Three months or more

How is the severity of Bulimia Nervosa determined?

By the average number of episodes of inappropriate compensatory behavior per week

What is a common medical complication of purging in Bulimia Nervosa that can lead to heart arrhythmias and death?

Dehydration, causing an electrolyte imbalance

Compared to CBT, interpersonal therapy (IPT) for Bulimia Nervosa has comparable long-term effects, but is generally less preferred for what reason?

IPT takes longer to produce its effects

How does family based treatment (FBT) for bulimia differ from FBT for anorexia in its initial phase?

The focus is on disrupting the binge-purge cycle and establishing healthy eating, rather than just weight restoration

Which class of medication, particularly fluoxetine, has been found effective for treating Bulimia Nervosa?

Antidepressants or SSRIs

What two criteria define a binge eating episode in Binge Eating Disorder (BED)?

1. Eating a larger than normal amount of food in a discrete period

2. A sense of lack of control over eating

For a Binge-Eating Disorder diagnosis, a person must exhibit at least three of five characteristic symptoms, such as

Eating until uncomfortably full or feeling disgusted, depressed, or very guilty about one’s binge eating

How does Binge Eating Disorder differ from bulimia nervosa regarding post-binge behavior?

Individuals with BED do not engage in recurrent inappropriate compensatory behaviors

How does the onset of dieting typically differ between Binge Eating Disorder and Bulimia Nervosa?

In BED, dieting often follows the onset of binge eating, whereas in Bulimia Nervosa, dysfunctional dieting often precedes it

What is the recommended treatment approach for individuals with BED who are also overweight or obese?

To focus on the binge eating behaviors before or concurrently with weight loss efforts

What is enuresis?

The repeated voiding of urine into the bed or clothing in individuals at least five years old

For a diagnosis of enuresis, urination must occur at at least twice a week for three consecutive months or cause ___

Significant distress or impaired functioning

What is the most common treatment for nocturnal enuresis?

The moisture alarm, also known as the bell and pad

What is a major drawback of using the antidiuretic hormone desmopressin to treat nocturnal enuresis?

There is a high risk of relapse when the medication is discontinued

What is the core feature of Sleep-Wake Disorders according to the DSM 5TR?

Dissatisfaction regarding the quality, timing, and amount of sleep, resulting in daytime distress and impairment

What are the three symptom types associated with Insomnia Disorder?

1. Difficulty initiating sleep

2. Difficulty maintaining sleep

3. Early-morning awakening with inability to return to sleep

For a diagnosis of Insomnia Disorder, the sleep disturbance must occur at least ___

Three nights per week for a duration of at least three months

Types of insomnia: sleep maintenance or middle insomnia

Characterized by frequent or extended awakening during the night

How to subjective reports of sleep from people with insomnia typically compare compared to objective measures?

They usually overestimate time awake and underestimate total sleep time

What is the first line treatment for chronic insomnia?

Cognitive behavior therapy for insomnia (CBT-I)

In CBT-I, what is the goal of stimulus control?

To strengthen the association between the bed or bedroom and sleep

What is the purpose of sleep restriction in CBT-I?

To improve sleep efficiency by limiting time in bed to the actual amount of time spent sleeping

What is the primary focus of cognitive therapy for insomnia (CT-I)?

Reverse counterproductive cognitive processes that occur during both day and night, such as worry and selective attention to sleep related threats

In CT-I, what are sleep related safety behaviors?

Counterproductive coping strategies that worsen insomnia by preventing the disconfirmation of unhelpful beliefs about sleep

What is narcolepsy?

A disorder involving an irrepressible need to sleep, causing sleep attacks or daytime naps at least three times a week for three months

A diagnosis of narcolepsy requires at least one of three specific findings. What are they?

1. Episodes of cataplexy

2. Hypocretin deficiency

3. A specific REM latency finding on a polysomnography test

What is cataplexy?

A sudden loss of muscle tone, often triggered by a strong motion

Vivid hallucinations that occur just before falling asleep are known as what?

Hypnogogic hallucinations

What is the primary medication used to treat cataplexy in individuals with narcolepsy?

An antidepressant, such as venlafaxine or fluoxetine

Non-rapid eye movement sleep arousal disorders, such as sleepwalking and sleep terrors, typically occur during which stage of sleep?

Stage three or four sleep, in the first third of a major sleep period

What categories is an episode of sleep terror?

An abrupt arousal from sleep, often starting with a panicky scream, accompanied by intense fear and autonomic arousal

What is the typical memory recall for an individual after an episode of sleepwalking or sleep terror?

They have little or no memory of dream imagery, and cannot recall the episode

What is nightmare disorder?

A disorder involving repeated occurrences of extended, extremely dysphoric, and well remembered dreams

During which part of the sleep cycle do nightmares typically occur?

During rapid eye movement or REM sleep, usually in the second half of a major sleep period

How does a person state of arousal typically differ upon waking from a nightmare versus a sleep terror?

After a nightmare, the person is usually oriented and alert, whereas after a sleep terror, they are unresponsive and confused