lecture 10 - psychpathology

body dissatisfaction

most powerful contributor to dieting and development of eating disorders

anorexia nervosa definition

restriction of energy intake relative to requirements, leading to significant low body weight

intense fear of gaining weight, or repeatedly seeks to prevent weight gain despite significantly low body weight

restricting type (anorexia)

loss of weight is accomplished through dieting, fasting, and/or exercise

during past 3 months, no engagement in recurrent episodes of binging or purging

binge-eating/purging type

lose weight through binging or purging, such as vomiting after meals or by misusing laxatives or diuretics

may engage in eating binges

anorexia severity

severity ranges are dependent on current body max index

different levels of severity can be helpful w/ doing care/insurance

anorexia occurrence in pop

75% of reported cases of anorexia occur in women and girls

.6% of all people in western countries

anorexia onset

peak onset is typically between 14 and 20 years old

anorexia progression

typically begins when someone who is normal to slightly overweight follows diet

escalation towards anorexia (maybe bc stressor)

most recovery but 6% don’t

20% individuals continue to display severe eating pathology for decades

anorexia clinical picture

key goal is to become thin, driving motivation is fear, preoccupation with food

thinking is distorted, overestimation of body size

potential psychological problems (anorexia)

depression, anxiety, low self-esteem, sleep disturbances,

substance abuse

obsessive-complusive patterns and perfectionism

medical problems (anorexia)

amenorrhea (absence of period)

lowered body temperature, low blood pressure, metabolic and electrolyte imbalances, skin, nail, and hair problems

bulimia nervosa

repeated binge eating episodes

• eating an amount of food that is ‘definitely larger’ than what most other individuals would eat in a discrete period of time

• a sense of lack of control overeating during the episode

repeated performance of compensatory behaviors (forced vomiting, fasting, excessive exercise) to prevent weight gain

bulimia nervosa duration

symptoms take place at least weekly for a period of 3 months

binges

episodes of uncontrollable eating during which a person ingests a very large quantity of food

compensatory behaviors in bulimia

forced vomiting, fasting, excessive exercise to prevent weight gain

-compensatory behaviors effectiveness: some temporary positive effects or caloric bingeing effects not udone

bulimia incidence

1% of people develop bulimia in lifetime

83% reported cases reported are girls and women

bulimia progression

normal to slightly overweight individuals may be on intense diet,

begins in adolescence or young adulthood, last for years with periodic letups

weight fluctuates but often stays with normal range

binge eating episode characteristics

unusually fast eating

uncomfortable fullness

absence of hunger

secret eating due to sense of embarrassment

subsequent feelings of self-disgust, depression, or severe guilt

binge eating durations

episodes take place at least weekly over the course of 3 months

what makes binge eating disorder different from anorexia and bulimia

there is no compensatory behaviors

binge eating disorder prevalance

2.8% of population

67% are women

what most theorist believe cause eating disorders

multidimensional risk perspective

feelings of depression

ego deficiencies

psychodynamic theory

disturbed mother-child interactions = ego deficiencies

poor sense of independence and control

children of ineffective parents become confused adults who are unaware of their internal needs

cognitive behavioral factors leading to eating disorders

cognitive factors: improper labeling of internal sensations and needs

• limited control over life = excess control of body size

  • broad cognitive distortion - negative self-judgement based on body and weight.

biological factors leading to eating disorders

genes - relatives of people with eating disorders have 6X more likely to develop eating disorders

brain circuit dysfunction - interconnectivity problems

abnormal activity levels of serotonin, dopamine, and glutamate

hypothalamus and eating disorders

lateral hypothalamus: produces hunger

ventromedial hypothalamus: reduces hunger

could be correlated who fucking knows

weight thermostat

a weight set point is established by genetic inheritance and early eating practices

-when weight falls below a certain threshold, hunger is produced and metabolic rate decreases (not going to digest as fast)

-when weight falls higher than threshold, attempt to move excess weight by reducing hunger and increasing metabolic rate (digest faster)

sociocultural factors in developing eating disorders

western standards for attractiveness

socially accepted prejudice against overweight people

social networking/internet activity/ and television browsing

family structures affect of eating disorders

families may impact/maintain eating disorders

history of thinness, appearance or dieting

dieting and perfectionist mothers

enmeshed family patterns (overinvolvement; overconcern)

racial and ethnic differences in developing eating disorders

young women of color in US are even more likely to engage in disordered eating (particularly binge)

may actually have a higher prevalence of eating disorders

gender differences in developing eating disorders

men are as likely as women to eat in unhealthy ways but account for 25% of all people with reported anorexia and bulimia

-double standard for attractiveness/different ways of weight loss

causes for men of developing eating disorder

link to requirements and pressures of job or sport

body image

different patterns of dysfunctional eating

transgender and non-binary and eating disorders

greater risk to develop than cisgender

9% of transgender/non-binary display eating disorder in past year

associated with heightened bullying and victimization

eating disorder treatment goals

correct dangerous eating patterns

address broader psychological situational factors that have led to problem and maintenances of problem

treatments for anorexia

regain lost weight

recover from malnourishment

create well-being food relationship

restoring weight and eating methods (anorexia)

nutritional rehabilitation

intravenous feedings

behavioral weight-restoration approaches

combination of supportive nursing care, nutritional counseling, and high-calorie diet

motivational interviewing

achieving lasting changes for eating disorder

cognitive-behavioral therapy:

• identification of core pathology and alternative stress& problem solving strategies

• monitoring ties between feelings, hunger levels and food intake

  • changing attitudes about weight and eating

what is long-term success linked to in treating eating disorders

overcoming underlying psychological problems

• education, psychotherapy, family therapy, psychotropic drugs

  • most effective with anorexia and most effective when continued beyond 1 year

treatment aftermath (anorexia)

weight can be quickly restored and continued improvement is evident for most clients

medical improvement = fewer death

what is the percentage of people who experience continued difficulties after therapy (anorexia)

20%

treatments for bulimia

eating disorder clinics ~43% receive treatment

eliminate binge-purge patterns and establish good eating habits

eliminate the underlying cause of bulimic patterns

behavioral therapy for bulimia

behavioral techniques tailored to unique features of bulimia

• diaries

• exposure and response prevention

Cognitive therapy for bulimia

help clients recognize and change maladaptive attitudes towards food and eating weight and shape

teach individuals to identify and challenge negative thoughts that precede the urge to binge

treatment aftermath (bulimia)

untreated bulimia can last years

treatment provides immediate, significant improvement in about 40%, 40% show moderate response

after 10 years of treatment what percentage of people fully/partially recover from bulimia

75%

treatments for binge-eating disorder

eliminate patterns of bingeing and underlying causes

what % of people recover from binge-eating disorder

60%