Comprehensive Guide to Eating, Trauma, Personality, and Psychotic Disorders

What is the core feature of Anorexia Nervosa (AN)?

Restriction driven by fear of weight gain or distorted body image, resulting in significantly low weight.

What distinguishes Atypical Anorexia Nervosa (AAN) from Anorexia Nervosa (AN)?

AAN has the same psychological features as AN but occurs without low body weight.

What defines Bulimia Nervosa (BN)?

Recurrent binge eating followed by compensatory behaviors such as purging, fasting, or excessive exercise.

What characterizes Binge Eating Disorder (BED)?

Recurrent binge eating without compensatory behaviors, marked by distress and a sense of loss of control.

What does ARFID stand for and what is its main characteristic?

Avoidant/Restrictive Food Intake Disorder; food avoidance driven by sensory sensitivity or fear of aversive consequences, not primarily by weight concerns.

What is a common stereotype about eating disorders?

That they are exclusively about appearance, which can delay or prevent accurate diagnosis.

Which demographic groups can be affected by eating disorders?

People of all genders, races, body sizes, ages, and socioeconomic backgrounds.

What role do genetics play in eating disorders?

Genetics have a moderate to high heritability estimate across all eating disorders.

What is learned industriousness in the context of Anorexia Nervosa?

When self-discipline and effort are rewarded, extreme restriction can feel like an achievement rather than a symptom.

What are some social and cultural risk factors for eating disorders?

Weight bias, appearance ideals, social media influence, trauma, discrimination, and gender norms.

What is the primary treatment for Anorexia Nervosa?

Psychotherapy, as no pharmacological treatment has demonstrated efficacy.

What is Family-Based Therapy (FBT) and who is it recommended for?

FBT is recommended for adolescents with eating disorders, involving parents in the refeeding process.

What is the difference between Acute Stress Disorder (ASD) and PTSD?

ASD symptoms begin within four weeks of the event and last less than one month; PTSD symptoms last more than one month.

What are the core symptom clusters of PTSD?

Re-experiencing, avoidance, negative alterations in cognition or mood, and alterations in arousal and reactivity.

What percentage of Americans develop PTSD after experiencing a traumatic event?

Only 6-8% develop PTSD despite 50-85% experiencing a traumatic event.

What factors contribute to the development of PTSD?

Biological vulnerabilities, childhood experiences, cognitive and psychological factors, social support, and the nature of the trauma.

What is Cognitive Processing Therapy (CPT)?

A therapy that targets 'stuck points' in thinking about trauma that impede recovery, involving writing and reading trauma accounts.

What is the DSM-5 definition of a traumatic event?

Exposure to actual or threatened death, serious injury, or sexual violence.

What is a limitation of the DSM-5 definition of trauma?

It may be too narrow, excluding events like discrimination and financial hardship that can cause PTSD-like symptoms.

What is the role of social support in PTSD recovery?

Lack of social support after trauma is a consistent risk factor for developing PTSD.

What is the impact of food insecurity on eating behaviors?

Scarcity can lead to eating as much as possible when food is available, potentially developing into disordered behaviors.

What is the significance of clinician bias in diagnosing eating disorders?

Clinician bias can prevent accurate diagnosis, particularly in men and individuals in larger bodies.

What is the FDA-approved medication for Bulimia Nervosa?

Fluoxetine (Prozac) is FDA-approved for the treatment of BN.

What are the two subtypes of Anorexia Nervosa?

Restricting and binge-purge subtypes.

What is the relationship between perfectionism and eating disorders?

Perfectionism can be adaptive in some contexts but also serves as a risk factor for developing eating disorders.

How can trauma severity influence PTSD risk?

Interpersonal violence and intentionally inflicted trauma carry a higher risk for developing PTSD than natural disasters.

What is the purpose of writing an impact statement in therapy?

To articulate the effects of trauma and facilitate processing in therapy.

What does Prolonged Exposure (PE) therapy involve?

Imaginal and in vivo exposure to trauma-related stimuli to reduce avoidance and fear.

Why does avoidance worsen PTSD over time?

Avoidance prevents the fear response from running its course, maintaining the trauma's impact.

What defines a personality disorder?

An enduring, rigid pattern of inner experience and outward behavior causing significant impairment.

What are the key DSM-5-TR criteria for diagnosing a personality disorder?

Long-term and pervasive patterns affecting cognition, emotion regulation, social functioning, and impulse control.

What is the difference between categorical and dimensional approaches to personality disorders?

Categorical approach classifies disorders as present or absent, while dimensional approach sees personality traits on a continuum.

What are the five traits in the dimensional model of personality disorders?

Negative Affectivity, Detachment, Antagonism, Disinhibition, and Psychoticism.

What distinguishes Paranoid Personality Disorder (PD)?

Pervasive distrust and suspicion of others without delusional intensity.

How does Schizoid PD differ from autism?

Schizoid PD involves a desire for connection, while autism involves difficulties in social interaction.

What are the core features of Borderline Personality Disorder (BPD)?

Difficulty regulating emotions, unstable relationships, impulsivity, and chronic feelings of emptiness.

What is the central distinction between Antisocial PD and Narcissistic PD?

ASPD involves disregard for others' rights, while NPD involves grandiosity and need for admiration.

What characterizes Avoidant Personality Disorder (PD)?

Discomfort in social situations, feelings of inadequacy, and extreme sensitivity to rejection.

What is the main feature of Obsessive-Compulsive Personality Disorder (OCPD)?

Rigid preoccupation with rules, order, and perfectionism, viewed as reasonable by the individual.

What is the primary treatment for Borderline Personality Disorder?

Dialectical Behavior Therapy (DBT), which combines mindfulness and emotion regulation strategies.

What is psychosis?

A state where a person loses contact with reality; it is a symptom, not a diagnosis.

What are the diagnostic criteria for schizophrenia?

Requires 6+ months of disturbance with at least 1 month of active symptoms, including delusions or hallucinations.

What are positive symptoms of schizophrenia?

Symptoms that add to experience, including delusions and hallucinations.

What are the '5 As' of negative symptoms in schizophrenia?

Avolition, Anhedonia, Asociality, Alogia, and blunted Affect.

What differentiates disorganized symptoms from other symptoms in schizophrenia?

Disorganized symptoms include disorganized speech and inappropriate affect, indicating a lack of coherent thought.

How does hallucination frequency impact its clinical significance?

Clinical significance depends on frequency, distress, content, and functional impact of the hallucinations.

What is the impact of cultural expectations on diagnosing personality disorders?

The DSM requires deviation from cultural expectations to avoid misdiagnosis and ensure accurate understanding of behavior.

What is a common misconception about hallucinations in the general population?

That they are not a meaningful diagnostic criterion for schizophrenia; frequency and context matter.

What challenges do therapists face when treating clients with personality disorders?

Limited insight in clients often reduces treatment motivation, complicating the therapeutic process.

What is the role of CBT in treating personality disorders?

Cognitive Behavioral Therapy (CBT) targets maladaptive schemas and cognitive distortions across several personality disorders.

What is the duration for a diagnosis of brief psychotic disorder?

Up to 1 month

What is the duration for a diagnosis of schizophreniform disorder?

1 to 6 months

What is the duration for a diagnosis of schizophrenia?

6+ months

What is schizoaffective disorder?

Schizophrenia symptoms with concurrent mood episodes

What does the diathesis-stress model propose?

Both a constitutional vulnerability and a significant stressor or environmental trigger are needed to cause schizophrenia.

What are the two 'hits' in the diathesis-stress model?

First hit: vulnerability (genetic factors, prenatal complications); Second hit: stress (chronic stress, life events)

What is the role of dopamine dysregulation in schizophrenia?

Striatal D2 receptors receive too much dopamine (positive symptoms), while prefrontal D1 receptors receive too little (negative and cognitive symptoms).

What factors are associated with a better prognosis in schizophrenia?

Good premorbid functioning, stress-triggered onset, abrupt onset, later onset, early treatment.

What is the impact of schizophrenia on life expectancy?

Schizophrenia is associated with a 10-20 years shorter life expectancy and elevated suicide risk.

What is the primary function of first-generation antipsychotics?

To reduce positive symptoms by blocking D2 receptors.

What are common side effects of first-generation antipsychotics?

Extrapyramidal side effects such as tardive dyskinesia, akathisia, and Parkinsonism.

What is the difference in side effects between first-generation and second-generation antipsychotics?

Second-generation antipsychotics have less effect on the motor cortex and a different side effect profile, including weight gain and blood sugar changes.

What is the purpose of psychotherapy in treating schizophrenia?

To be combined with medication, including CBT for psychosis, family psychoeducation, and social skills training.

What is deinstitutionalization in the context of mental health treatment?

The process of discharging patients from hospitals to community settings, motivated by social critique and the promise of antipsychotic medications.

What is separation anxiety disorder?

Extreme anxiety when separated from home or attachment figures, often resulting in school refusal.

What is selective mutism?

Failure to speak in certain social situations despite speaking normally in others, often beginning in preschool.

What is ADHD and its prevalence in children?

ADHD is a neurodevelopmental disorder affecting 3-8% of children, with symptoms present before age 12 across multiple settings.

What are the characteristics of autism spectrum disorder (ASD)?

Challenges in social communication and restricted, repetitive behaviors, with onset before age 3.

What defines intellectual developmental disorder?

Deficits in intellectual and adaptive functioning across conceptual, social, and practical domains.

What are specific learning disorders?

Below-expected academic skills that interfere with daily functioning, such as dyslexia.

What is conduct disorder (CD)?

Repetitive violation of others' rights or societal norms, with familial links to adult antisocial personality disorder.

What characterizes oppositional defiant disorder (ODD)?

A pattern of angry/irritable mood and argumentative/defiant behavior.

What is enuresis?

Repeated voiding of urine into clothing or bedding, classified as primary or secondary.

What is encopresis?

Repeated passage of feces in inappropriate places in someone over age 4, often linked to chronic constipation.

What mental health issues increased during COVID-19?

Depression (29%), anxiety (26%), PTSD (48%), and eating disorder ER visits up 66%.

What are the effects of bullying on mental health?

Includes depression, anxiety, low self-esteem, school problems, and suicidal ideation.

What is the importance of multi-setting symptoms for ADHD diagnosis?

Symptoms must be present across multiple settings to confirm the diagnosis.