PSY 470 Ch. 8 Eating Disorders

Binge Eating

Eating excess amounts of food in a discrete period of time

• Eating is perceived as uncontrollable

• May be associated with guilt, shame, or regret

• May hide behavior from family members

• Foods consumed are often high in sugar, fat, or carbohydrates

Hallmark

Compensatory Behaviors - designed to make up for binge eating

• Most common: purging

• Excessive exercise

• Fasting or food restriction

Most common purging method

Self-induced vomiting

• May also include use of diuretics or laxatives

Bulimia Nervosa Consequences

• Dehydration

• Electrolyte Imbalances

• Heart problems

• Esophagus damage

• Tooth decay

• Vacay damage

• Malnutrition

• Pregnancy difficulties

• Anxiety,depression, self-harm, guilt, shame

• Suicide

Anorexia Nervosa

Extreme weight loss - hallmark of anorexia

• Restriction of calorie intake below energy requirements

• Intense fear of weight gain

• Often begins with dieting

Subtypes of Anorexia Nervosa

• Restricting: Diet to limit calorie intake

• Binge-Eating Purging: Purge to limit calorie intake

Anorexia Nervosa Consequences

• Amenorrhea (loss of periods in women)

• Dry skin

• Brittle hair and nails

• Sensitivity to cold temperatures

• Lanugo

• Cardiovascular problems

• Electrolyte imbalance

Most deadly mental disorder due to organ damage

Anorexia Nervosa

Causes of Eating Disorders

• Social Factors (Cultural)

• Bio Factors (Not clear - impulsivity)

• Psych Factors (Low sense of personal control and self-confidence)

• Perfectionist Attitudes

• Distorted Body image

• Preoccupation with food

• Mood intolerance

Treatments to Eating Disorders

• Drugs - primarily antidepressants (SSRIs)

• CBT & EMDR

Two major types of sleep disorders

• Dyssomnias (difficulties in amount, quality, or timing of sleep)

• Parasomnias (abnormal behavioral and physiological events during sleep)

Causes of Sleep Disorders

• Unregulated or dysregulated Suprachiasmatic Nucleus (SCN) - part of the hypothalamus in the forebrain , the brains circadian clock

• The Pons - part of the hindbrain

• Latin for bridge

• connects the cerebral cortex with the medulla oblongata

• involved in arousal and sleep

• Inhibits movement during sleep

Insomnia

Problems initiating/maintaining sleep

• Only diagnosed as a sleep disorder if it is not better explained by a different condition (Ex: GAD)

Causes of Insomnia

• Pain, physical discomfort

• Delayed temperature rhythm

• Light, noise, temperature

• Other sleep disorders cause secondary insomnia

• Stress and anxiety

Hypersomnolence Disorder

Sleeping too much/excessive sleep

• May manifest as long nights of sleep or frequent napping

Narcolepsy

Recurrent intense need for sleep, lapses into sleep, or napping

Also accompanied by at least one:

• Cataplexy: Sudden, brief loss of voluntary muscle tone

• Hypocretin Deficiency

• Going into REM sleep abnormally fast

• Onset during adolescence

• Can improve over time

Obstructive Sleep Apnea Hypopnea

Airflow stops, but respiratory system works

Central Sleep Apnea

Respiratory system stops for brief periods

Sleep related Hypoventilation

Decreased breathing during sleep

Circadian Rhythm Sleep-Wake Disorder

Disturbed sleep leading to distress and/or functional impairment

• Brain’s inability to synchronize day and night

• Affect suprachiasmatic nucleus, which stimulates melatonin and regulates sense of night and day

Insomnia treatment

Benzodiazepines and sleep medications for prolonged periods

• Best used as a short-term solution

Hypersomnia and Narcolepsy Treatment

• Stimulants (Ritalin)

• Cataplexy usually treated with antidepressants

Breathing-related sleep disorder treatments

• Medications

• Weight loss

• mechanical devices

Circadian Rhythm sleep-wake disorder treatments

• Phase delays (moving bedtime later)

• Phase Advances (moving bedtime earlier)

• Use of very bright light (tick the brains biological clock)

Two classes of parasomnias

• Those that occur during REM sleep

• Those that during non-REM sleep

Non-REM sleep Arousal Disorder

Recurrent episodes of either sleep terrors or sleepwalking

• Individual has no memory of the episodes

Sleep Walking Disorder

Somnambulism

• Usually during first 2 hours of deep sleep

• More common in children than adults

• Problem usually resolves without treatment

• Seems to run in families

• May be accompanied by nocturnal eating

Psychotic Disorders

Break from reality resulting in a spectrum of dysfunctions

• Affecting cognitive, emotional, and behavioral domains

• Positive symptoms: active changes in behavior, hallucinations

• Negative symptoms: Agitation, catatonia