psychopathology exam II

Fear

• Response to an immediate, real danger

• Activates fight or flight

• Serve adaptive functions, can become maladaptive

• Panic attack: occurs when fear arises in absence of real danger

Anxiety

• Diffuse apprehension about possible future threats

• Cognitive & anticipatory

• Serve adaptive functions, can become maladaptive

Maladaptive

• Anxiety enhances learning & performance when mild

• Prepares individuals to anticipate & manage future threats

• Chronic or excessive anxiety becomes _____ & may lead to anxiety disorders

Social Anxiety Disorder (SAD)

Marked fear of social situations due to concern of negative evaluation (29%)

Social anxiety disorder

Core features of ______:

• Fear of scrutiny or judgement

• Avoidance of social situations

• Distress in everyday interactions

Causes of ….

• Cognitive bias

  • Negative interpretations of social cues

  • Memory recall biased toward negative evaluations

• Biological factors

  • Behavioral inhibition as a temperament trait

  • Amygdala hyperactivity in response to negative facial expressions

• Perceptions of uncontrollability

  • Childhood experiences of unpredictability

  • Leads to submissive & avoidant behaviors

Treatment of …

• Cognitive-behavioral therapy (CBT)

  • Exposure to feared social situations

  • Cognitive restructuring to correct negative self-perceptions

• Medication

  • SSRIs

  • Monoamine oxidase inhibitors

Panic disorder

Recurrent, unexpected panic attacks (4.7%)

Symptoms …

• Rapid heart beat

• Sweating

• Shortness of breath

• Fear of losing control/dying

Biological causes …

• Genetic contributions

  • Moderate heritability

  • Overlap with phobias & separation anxiety

• Neurobiology

  • Overactive fear network involving the amygdala & locus coeruleus

  • Decreased GABA activity, leading to heightened anxiety

• Neurotransmitters

  • Serotonin → regulate mood & anxiety

  • Norepinephrine → linked to panic attacks

Treatment of …

• Cognitive-behavioral therapy

  • Cognitive reconstruction to correct catastrophic thoughts

  • Exposure to feared bodily sensations

• Medication

  • SSRIs

  • Benzodiazepines (short term, risk for dependence)

One, month

Diagnosis of panic disorder: At least ____ attack followed by a ____ to worry about future attacks or behavior change

Agoraphobia

Fear & avoidance of situations where escape may be difficult (80-90%)

Triggers:

• Public transport

• Open spaces

• Crowded places

• Fear of experiencing a panic attack in public

Generalized anxiety disorder (GAD)

Chronic, excessive worry about various aspects of life

Causes of …

• Biological factors

  • Genetic predisposition

  • Neurotransmitter imbalance

  • Overactive corticotropin-releasing hormone system

• Psychological factors

  • Low tolerance for uncertainty

  • Perceptions of uncontrollability & unpredictability

  • Childhood trauma may increase risk

  • Reinforcing properties of worry

Treatment of …

• Cognitive-behavioral therapy

  • Focuses on identifying & reconstructing worry-related thoughts

  • Behavioral interventions → muscle relaxation & exposure therapy

• Medication

  • SSRIs

  • Benzodiazepines

  • Buspirone

GAD

Criteria for _____ …

• Occurs more days than not for at least 6 months

• Difficult to control worry

• At least 3 of the following:

  • Restless or feeling on edge

  • Being easily fatigued

  • Difficulty concentrating

  • Irritability

  • Muscle tension

  • Sleep disturbances

Body dysmorphic disorder (BDD)

Preoccupation with perceived physical defects not visible or minor to others; compulsive behaviors

Causes …

• Genetic & neurobiological factors

  • Moderate heritability

  • Overactivity in orbitofrontal cortex & caudate nucleus

• Cognitive factors

  • Biased attention towards appearance-related stimuli

  • Distorted perception of facial symmetry

  • Emotional abuse/neglect history increases risk

Treatment of …

• Cognitive-behavioral therapy

  • Exposure and response prevention (reducing mirror checking, avoidance)

  • Challenging distorted beliefs about appearance

• Medication

  • SSRIs (higher dose than OCD)

Compulsive behaviors

• Mirror-checking, excessive grooming, reassurance seeking

• Avoidance of social situations due to distress

• Severe causes:

  • Social isolation

  • Depression

  • Suicidal ideation

Obsessive-compulsive disorder (OCD)

Presence of obsessions (persistent, distressing intrusive thoughts), compulsions (repetitive behaviors or mental acts aimed at reducing distress), or both

Causes of …

• Neurobiological factors

  • Dysfunction in orbitofrontal cortex, anterior cingulate cortex, and caudate nucleus

  • Low serotonin levels

• Cognitive-behavioral factors

  • Attempts to suppress obsessions paradoxically increase their frequency

• Evolutionary perspective

  • Compulsions like checking and washing may be exaggerated survival behaviors

Treatment of …

• Medications

  • SSRIs (e.g., fluoxetine, fluvoxamine, sertraline) are the first-line treatment

  • Antipsychotics may be added for severe cases

• Behavioral & cognitive-behavioral treatments

  • Exposure and response prevention (ERP)

    • Repeated exposure to feared stimuli without performing compulsions

    • Anxiety naturally reduces over time (habituation)

    • 50-70% symptom reduction, long-lasting effects

  • Cognitive therapy

    • Targets catastrophic beliefs about obsessions

    • May enhance ERP effectiveness

Thought-action fusion

• Belief that having a thought is morally equivalent to acting on it or increases the likelihood of it happening

  • Example: A mother with intrusive thoughts about harming her infant believes thinking it makes it more likely to happen

  • Results in:

    • Inflated sense of responsibility

    • Increased compulsive behaviors to prevent harm

OCD

Diagnostic criteria for ____:

• Obsessions and, if present, compulsions cause significant distress or impairment

• Time-consuming (more than 1 hour per day)

• Not attributable to substance use or another mental disorder.

Hoarding disorder

Persistent difficulty discarding possessions, regardless of value

Results in …

• Extreme clutter

• Fire hazard

• Unsanitary conditions

Neurobiological distinctions …

• Different brain activation patterns than OCD

• Poorer response to standard OCD treatments

Trichotillomania

Recurrent pulling at hair resulting in hair loss

Mood disorders

Involve extreme alterations in emotion—ranging from deep depression to intense, unrealistic euphoria

[Normal mood states may occur between episodes, although sometimes mixed symptoms can be present within a single episode]

Unipolar depressive disorders

Only depressive episodes are experienced  

• Lifetime prevalence 17%

• 12-month prevalence 7%

• Women twice as likely as men to experience major depression

Bipolar disorders

Both depressive and manic (or hypomanic) episodes occur; normal mood states may occur between episodes, although sometimes mixed symptoms can be present within a single episode

• Lifetime prevalence 1%

• No specific gender differences

Depressive episode

Markedly depressed mood or loss of interest in once pleasurable activities for at least 2 weeks

Additional symptoms:

• Changes in sleep and appetite  

• Feelings of worthlessness or guilt  

• Difficulty concentrating  

• Recurrent thoughts of death or suicidal ideation

Most common form of mood disorder

Manic episode

Abnormally and persistently elevated, euphoric, or expansive mood lasting at least 1 week (or any duration if hospitalization is needed)

• Accompanied by three (or four if mood is only irritable) additional symptoms such as: 

  • Inflated self-esteem or grandiosity  

  • Decreased need for sleep  

  • More talkative or pressured speech  

  • Flight of ideas or racing thoughts  

  • Distractibility  

  • Increase in goal-directed activity or psychomotor agitation  

  • Excessive involvement in high-risk activities

Hypomanic episode

Similar symptoms to mania, but less severe, lasting at least 4 days, with no marked impairment or need for hospitalization

Major depressive disorder (MDD)

Presence of a major depressive episode without any history of mania or hypomanic episodes

• Key symptoms (at least 5 during a 2-week period) → symptoms must represent a change from previous functioning & cause significant distress or impairment:

  • Depressed mood most of the day  

  • Markedly diminished interest or pleasure  

  • Significant weight change or appetite disturbance  

  • Sleep disturbances (insomnia or hypersomnia)  

  • Psychomotor agitation or retardation  

  • Fatigue or loss of energy  

  • Feelings of worthlessness or excessive guilt  

  • Diminished ability to think or concentrate  

  • Recurrent thoughts of death or suicidal ideation

Melancholic, psychotic

• Specifiers for MDD:

  • _____ features: early morning awakening, depression worse in the morning, psychomotor changes, loss of appetite/weight, excessive guilt

  • ______ features: presence of delusions or hallucinations (usually mood-congruent

Delusions

Faulty fixed beliefs that contradict reality and have no truth

Hallucinations

Alterations in sensory perceptions without any external stimuli

Atypical features (of MDD)

Mood reactivity (mood brightens in response to positive events) plus two or more symptoms (e.g., weight gain, hypersomnia, leaden paralysis, sensitivity to rejection)

Catatonic features (of MDD)

Motoric immobility, including mutism and rigidity

Seasonal pattern (of MDD)

Recurrent depressive episodes occurring at the same time each year with full remission in other seasons

Persistent depressive disorder (PDD)

Depressed mood most of the day, on most days, for at least 2 years (1 year for children/adolescents) 

• Additional symptoms (at least two of the following) 

  • Poor appetite/overeating

  • Insomnia/hypersomnia

  • Low energy

  • Low self-esteem

  • Poor concentration

  • Feelings of hopelessness

• Key characteristic: intermittent periods of normal mood (lasting a few days to a few weeks, but never more than 2 months)

Double depression

Co-occurrence of persistent depressive disorder and intermittent major depressive episodes

Premenstrual dysphoric disorder

Symptoms appear in the final week before menses and improve soon after onset; key symptoms include affective lability, irritability/anger, depressed mood, or marked anxiety

Post-partum blues

Common in new mothers (and occasionally fathers), with symptoms like mood lability, crying, sadness, and irritability occurring in up to 50-70% within 10 days of childbirth and typically subsiding on their own

Hypoothalamic-pituitary-adrenal axis

Regulates cortisol release in response to stress

• Elevated cortisol is observed in 20-40% of outpatients and 60-80% of hospitalized patients with depression 

• In about 45% of patients with serious depression, dexamethasone fails to suppress cortisol levels (the “dexamethasone nonsuppressor” phenomenon)

• Prolonged cortisol elevations can lead to memory impairments, cognitive difficulties, and cell death in the hippocampus

Circadian rhythms

Regulate sleep & appetite

• Abnormalities in these rhythms are commonly observed in depression

Seasonal affective disorder (SAD)

Linked to the total quantity of available light; most patients become depressed in the fall/winter and normalize in spring/summer

• Light therapy may help reestablish normal biological rhythms in affected individuals

Sleep disturbances

______ _____ in depression

• Normal sleep involves five stages (Stages 1-4 of non-REM and REM sleep)

• Depressed patients frequently experience:  

  • Difficulty falling asleep and maintaining sleep   

  • Early morning awakening  

  • A shortened latency to the first REM period (often 15-20 minutes sooner than normal)  

  • Increased amounts of REM sleep in early cycles and reduced deep sleep

• Such sleep changes are particularly pronounced in patients with melancholic features

Severe stressful events

E.g., loss of a loved one, major economic or health crises often precipitate a major depressive episode

• Distinction between independent life events (e.g., natural disasters) and dependent life events (those partly generated by the person’s behavior). 

• Research indicates dependent life events may play a stronger role in triggering depression

Chronic stress

Ongoing for several months (e.g., poverty, marital discord), is associated with increased risk for the onset, maintenance, and recurrence of depression

Cognitive, biological

Psychological factors:

• Stressful life events, personality traits (e.g., neuroticism), and negative cognitive styles all contribute to depression

• _______ vulnerabilities (such as dysfunctional beliefs) may be activated by stressful events, triggering depressive symptoms

• These psychological factors may also be mediated by underlying ______ changes (e.g., hormonal imbalances)

Freud and Abraham

Psychodynamic theory

• “Mourning and Melancholia” (1917) noted similarities between depression and the symptoms of mourning

• Proposed that depression involves the regression to an earlier developmental stage and the introjection of the lost object, leading to anger turned inward

• Emphasis on both real losses and symbolic losses (e.g., failure in school or relationships) as triggers for depression

Aaron Beck

Cognitive theory

Argued that negative automatic thoughts often precede mood symptoms

• Central to his model are dysfunctional beliefs or depressogenic schemas

  • The model highlights the “negative cognitive triad”: 

    • Negative views about the self (“I’m worthless”) 

    • Negative views about the world (“No one loves me”) 

    • Negative views about the future (“It’s hopeless because things will always be this way”) 

  • Cognitive biases (e.g., all-or-none thinking, selective abstraction, arbitrary inference) serve to maintain these negative thoughts

Learned helplessness model

Cognitive theory

Originated from animal studies showing that uncontrollable shocks lead to passivity and depressive symptoms

• In humans, exposure to uncontrollable negative events may lead to a sense of helplessness that parallels these findings

• The reformulated helplessness theory emphasizes that the attributions people make about negative events (internal, stable, global) determine their vulnerability to depression

Relationships, social

Interpersonal effects

• Lack of close, supportive _____ increases vulnerability to depression

• _____ isolation and deficits in interpersonal skills are risk factors

Criticism

Interpersonal effects

Studies show that ______ (e.g., maternal criticism) elicits different neural responses in recovered depressed individuals

• Less activation in the prefrontal cortex

• Heightened amygdala response

Parental, marital

Interpersonal effects

• _____ depression raises risk for children

• _____ distress can precipitate relapse in depression

Interpersonal cascade

Depressive behaviors can evoke negative reactions from others (e.g., rejection, hostility)

Persisting reassurance seeking

Effect of depression on others that may lead to strained relationships and further isolation

Marital and family contexts

Unsupportive or critical environments contribute to worse outcomes and relapse

Bipolar spectrum

Includes bipolar I, bipolar II, & cyclothymic Disorder

Bipolar I disorder

Characterized by full-blown manic episodes (often with depression)

• Presence of full-blown mania; depressive episodes may be present even if subthreshold

Bipolar II disorder

Involves hypomanic episodes (less severe) and major depressive episodes

• Presence of hypomania (milder, no hospitalization required) plus major depressive episodes

Cyclothymic disorder

Chronic, fluctuating mood disturbances (hypomanic and depressive symptoms over ≥2 years)

High heritability, family risk, shared genetics, polygenic

Genetic Factors in Bipolar Disorders

• ____ __________: twin studies show ~60% concordance for monozygotic twins vs. ~12% for dizygotic twins

• _____ ______: first-degree relatives have a markedly increased risk

• _____ ______: some genetic polymorphisms overlap with schizophrenia and unipolar depression

• _____ nature: multiple genes contribute to liability for bipolar disorder

Monoamine hypotheses

Neurochemical & hormonal influences in bipolar disorders

• Imbalances in norepinephrine, serotonin, and dopamine

• Increased norepinephrine activity during mania; low serotonin in both phases

Hormonal dysregulation

Neurochemical & hormonal influences in bipolar disorders

• HPA axis abnormalities (e.g., elevated cortisol in depression)

• Thyroid function: abnormalities can affect mood; thyroid hormone may enhance antidepressant efficacy but also precipitate mania

Lithium therapy

• Widely used for both depressive and manic episodes

• Effective in reducing recurrence (especially in bipolar disorder)

• Considerations:

  • Side effects - lethargy, weight gain, cognitive slowing, possible kidney issues

  • Alternative anticonvulsants (e.g., carbamazepine, divalproex) are used when lithium is not tolerated

Women, men, low, increases

Epidemiology of Suicide 

• Global impact:

  • Suicide is the 15th leading cause of death worldwide (≈1.4% of deaths)

• Gender differences:

  • _____ are more likely to attempt suicide

  • _____ are about four times more likely to die by suicide due to use of more lethal methods

• Age trends:

  • ____ in childhood

  • ____ from adolescence through young adulthood, with a middle-age peak

• Pharmacological interventions:

  • Antidepressants may reduce suicidal ideation in adults, although concerns remain

  • Lithium shows strong anti-suicide effects in long-term management

Key warning signs

Nearly 90-95% of suicide victims have a history of at least one psychiatric disorder

Risk increases dramatically with comorbidity

• _____ ______ (immediate action needed):

  • Threats to self-harm or suicidal statements

  • Seeking access to lethal means (pills, weapons)

  • Talking or writing about death or suicide

  • Additional concerns → hopelessness, agitation, withdrawal, increased substance use, and dramatic mood changes

Somatoform

• Excessive thoughts, feelings, & behaviors about a bodily sensation

• Disproportionate & persistent thoughts about the seriousness of symptom(s)

• Excessive time & energy devoted to symptom(s)

• Most tentative spectrum

• Emotional dysfunction superspectrum

• Difficult to derive due to less existing evidence

Somatoform

• Assessment symptoms of … : MMPI or MSPQ

  • There seems to be a fullness in my head

  • I have numbness in my skin

  • I have a lump in my throat often

  • I do not notice my ears ringing (reversed)

  • Desire to pass water

  • Mouth becoming dry

  • Butterflies in stomach

  • Muscles twitching or jumping

Pain

Physical suffering

Somatoform with pain

• Disproportionate & persistent thoughts about the seriousness of pain symptoms

• Disproportionately excessive time & energy devoted to pain symptoms

• Ex. Patient w/ fibromyalgia whose symptoms aren’t responding to/managed by typical intervention

Somatic symptom disorder

• One or more x symptoms that are distressing or result in significant disruption of daily life 

• Excessive thoughts, feelings, or behaviors related to the x symptoms or associated health concerns as manifested by at least one of the following:

  • Disproportionate & persistent thoughts about the seriousness of one’s symptoms

  • Persistently high level of anxiety about health or symptoms

  • Excessive time & energy devoted to these symptoms or health concerns

Illness anxiety disorder

• Preoccupation with having or acquiring a serious illness

• Somatic symptoms are not present or, if present, only mild in intensity - if another medical condition is present or there is a high risk for developing a medical condition, the preoccupation excessive or disproportionate

• High level of anxiety about health, & individual easily alarmed about personal health status

• Individual performs excessive health-related behaviors or exhibits maladaptive avoidance

• Illness preoccupation present for at least 6 months, but specific illness that is feared may change over that period of time

• Illness-related preoccupation not better explained by another mental disorder

Care-seeking type

Medical care, including physician visits or undergoing tests and procedures is frequently used

Care-avoidant type

Medical care is rarely used

Functional neurological symptom disorder (conversion disorder)

A type of somatic disorder that is sometimes applied to patients who present neurological symptoms, such as numbness, blindness, paralysis, or fits, which are not consistent with a well-established organic cause, cause significant distress, and can be traced back to a psychological trigger

Functional neurological symptom disorder

______ ________ _______ ________ begins with some stressor, trauma, or psychological distress

• Common symptoms include:

  • Blindness

  • Partial or total paralysis

  • Inability to speak

  • Deafness

  • Numbness

  • Difficulty swallowing

  • Incontinence

  • Balance problems

  • Seizures

  • Tremors

  • Difficulty walking

Factitious disorder

A condition in which a person, without a malingering motive, acts as if they have an illness by deliberately producing, feigning, or exaggerating symptoms, purely to attain (for themselves or for another) a patient's role; people with a factitious disorder may produce symptoms by contaminating urine samples, taking hallucinogens, injecting fecal material to produce sickness, and similar behavior

Factitious disorder imposed on another (also called Munchausen syndrome by proxy)

A condition in which a person deliberately produces, feigns, or exaggerates the symptoms of someone in their care

Dissociative

Characteristics of _______ disorders

• Individuals becoming split off, or dissociated, from their core sense of self

• Memory & identity become disturbed; disturbances have a psychological rather than physical cause

Depersonalization

Characteristic of dissociative disorders:

A feeling of detachment or estrangement from one’s self; feeling as if you are an onlooker of your own body

• Qualitative study, conducted by by Ciaunica et al., 2023, reveals lived experienced of individuals struggling with depersonalization, and found three core themes: 

• Individuals with high levels of depersonalization reported:

  • Detachment from the world and one’s self – “I just feel like I’m watching myself over a distance and I don’t know who I am”

  • Embodiment, denoting unusual or changing experiences of the body – “whenever I feel intimidated, I tend to lose control of my body and can’t move properly”

  • Identity changes, a lack of congruence between one’s felt self and one’s words and action — “My thinking self and my speaking self feel different”

Derealization

Characteristic of dissociative disorders:

An alteration in the perception of one’s surroundings so that a sense of reality of the external world is lost; the world you are experiencing doesn’t feel real

• The sense that one is in a “fog”

• A see-through wall or veil is separating you from your surroundings

• The world appears lifeless, muted, or fake

• Objects or people look “wrong” – blurry,  unnaturally sharp, too big, or too small

• Sounds are distorted, too loud, or too soft

• Time seems to speed up or stand still

Dissociative amnesia

Characteristic of dissociative disorders:

When dissociation causes memory loss

• How memory works:

  • Encoding: the receival and interpretation of information

    • The act of getting info into our memory from either automatic and effortful processing

  • Storage: maintaining information over time

    • The retention of encoded information

  • Retrieval: the ability to access information when you need it

    • The act of getting information out of storage and into awareness through recall and recognition

Retrograde

When dissociative amnesia affects finding old memories

Anterograde

When dissociative amnesia blocks the formation or storage of new memories

Identity confusion

Characteristic of dissociative disorders:

Thoughts & feelings of uncertainty & conflict a person has related to their identity

• “I have a feeling that I am made up of two or more people”

• “It happens that I have the feeling that my mind is split up”

• “At times it seems as if someone else inside of me decides what I do”

• “It happens that I have the feeling that I am somebody else”

Identity alteration

Characteristic of dissociative disorders:

Manifestations of alters (or alternative identities) containing & expressing different opinions, perceptions, & senses of self

• Individuals may notice a shift in their sense of how old they are, their gender identity, their preferences, skills, and memories 

• Even vocal pitch, body language, and physical reactivity to stress can change

Anorexia nervosa

• Not simply a “lack of appetite” but a relentless pursuit of thinness leading to a significantly low body weight

• DSM-5 criteria:

  • A - restriction of energy intake resulting in significantly low body weight

  • B - intense fear of gaining weight or becoming fat

  • C - disturbance in body weight/shape perception

• Subtypes:

  • Restricting type - extreme limitations of food intake

  • Binge-eating/purging type - binging/purging behaviors

Bulimia nervosa

• Characterized by recurrent binge eating followed by inappropriate compensatory behaviors

• DSM-5 criteria highlights:

  • Recurrent episodes of binge eating (eating an unusually large amount of food in a short time with a loss of control)

  • Inappropriate compensatory behaviors (self-induced vomiting, misuse of laxatives, fasting, or excessive exercise)

  • Occurs at least once a week over 3 months

• Clinical notes:

  • Typically, individuals are within a normal weight range or slightly overweight

  • Often accompanied by feelings of shame and guilt

Anorexia nervosa

• Weight: Markedly low

  • Atypical anorexia: extreme weight loss, but bmi remains in the “normal” range (could be due to starting at a higher weight)

• Behavior: Restrictive intake (or binge/purge in one subtype)

• Body Image: Distorted perception; intense fear of weight gain

Bulimia nervosa

• Weight: Normal or slightly overweight; no pronounced weight loss

• Behavior: Binge eating with compensatory behaviors

• Body Image: Overconcern with weight; feelings of shame

Binge-eating disorder

• Weight: Often overweight or obese; not a requirement

• Behavior: Binge eating without compensatory measures

• Body Image: Concerns present, though less rigid dietary restraint compared to other disorders

Risk factors and demographics

• Age of onset

  • Most eating disorders begin in adolescence

  • Binge-eating disorder often develops between ages 30-50

• Gender differences

  • Historically seen as predominantly affecting females; current ratio is about 3:1 (female:male)

  • Men’s body dissatisfaction may focus on muscularity

• High-risk groups

  • Individuals in professions emphasizing thinness (e.g., models, ballet dancers)

  • Athletes in sports with weight restrictions

  • Sociocultural pressures and media influence play significant roles

Anorexia nervosa

Medical complications:

• Heart arrhythmias and risk of cardiac arrest

• Electrolyte imbalances leading to kidney damage

• Osteoporosis due to low bone density

• Other signs: dry skin, brittle hair, lanugo (fine hair growth)

Bulimia nervosa

Medical complications:

• Dental erosion and mouth ulcers from repeated vomiting

• Swollen salivary glands

• Electrolyte disturbances impacting heart and muscle function

Biological

________ factors 

• Genetic predisposition

  • Family and twin studies indicate high heritability for anorexia and bulimia nervosa

  • Recent GWAS found a genetic locus on chromosome 12 linked to anorexia nervosa and metabolic factors

• Brain structure & neurotransmitter imbalances

  • Hypothalamus role - lateral hypothalamus stimulation promotes appetite

  • Serotonin - abnormalities (such as altered 5-HIAA levels) suggest disrupted serotonergic function

• Set points & reward sensitivity

  • The body’s “set point” resists significant weight changes

  • Differences in reward processing (e.g., response to food cues) may predispose to binge eating or restrictive behaviors

Sociocultural

________ influences 

• Media & cultural ideals

  • Exposure to Western media (TV, magazines) is linked to body dissatisfaction

  • Studies (e.g., in Fiji) show that media can shift local attitudes toward thinness

  • Icons like Twiggy and Kate Moss have influenced the “thin ideal”

• Internalization of the thin ideal

  • Believing that thinness equals beauty and success increases risk

  • Social comparisons and peer evaluation reinforce these beliefs

• Family influences

  • Families of patients often exhibit rigid attitudes, high expectations, and focus on dieting

  • Parental preoccupation with appearance may contribute to the development of eating disorders

Individual, perfectionism

_______ variables 

• Personality traits 

  • ________: an enduring trait linked to rigid dieting and excessive self-criticism; more pronounced in women; men with eating disorders tend to be less perfectionist

• Body dissatisfaction

  • A powerful predictor of eating disorder onset

  • Distorted self-perceptions lead to chronic dieting and negative self-evaluation

• Negative emotionality & dieting behaviors

  • Dieting is common and can trigger or worsen disordered eating

  • Negative moods and depression are predictive of binge eating and dietary restriction