PSY-3304 Test 3 Overview

PSY-3304 Test 3 Overview

I. Eating Disorders

A. Major Types

• Anorexia Nervosa:  A person who purposely consumes too little nourishment, resulting in body weight that is very low and lower than other people who are of similar age and gender.

  • Individual is fearful of gaining weight, repeatedly seeks to prevent weight gain despite low body weight.

  • Individual has a distorted body perception, places inappropriate
    
    

Bulimia Nervosa: Recurrent episodes of binge eating followed by compensatory behaviors like vomiting to prevent weight gain.

• Examples of compensatory behaviors include:

  • Vomiting

  • Laxative use

  • Fasting

  • Excessive exercise

• Weight is typically normal or slightly above/below average

• Symptoms occur at least weekly for a duration of three months.

• Self-evaluation is excessively influenced by body weight and shape.

• Associated emotional states include distress and low self-esteem

B. Subgroups of Anorexia

1. Restricting Type

   • Weight loss achieved exclusively through dieting, fasting, or excessive exercise

2. Binge-Eating/Purging Type: Uncontrollable eating episodes where large quantities of food (ranging from 2,000 to 3,400 calories) are consumed, often in secret, primarily consisting of sweet, high-calorie foods.

   • Prior to binges, individuals experience significant tension that is relieved by eating, leading to feelings of guilt, shame, and concern over weight gain.

   • Incidence:

     • Affects about 2.8% of the population, with at least 67% being female.

     • Onset typically occurs in the 20s, with many later becoming overweight or obese.

     • Associated health risks include hypertension, heart disease, high cholesterol, and increased stroke risk.
       
       

   • Involves binge eating or purging behaviors (e.g., vomiting, laxatives) while still underweight

C. Co-Occurring Disorders

Obsessive-Compulsive Disorder (OCD):

• Definition: A mental health disorder characterized by unwanted, intrusive thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that a person feels driven to perform to reduce distress or prevent a feared event.

• Example: A person may repeatedly wash their hands (compulsion) to reduce anxiety about germs (obsession).

Co-occurrence with Eating Disorders:

• OCD frequently co-occurs with anorexia nervosa.

  • Individuals with both conditions often display rigid thinking patterns, compulsive behaviors, and an intense need for control.

Common Trait Shared Between OCD and Anorexia:

• Perfectionism:

  • Definition: A personality trait involving striving for flawlessness, setting extremely high standards, and being overly critical of one’s performance.

  • Example: A person with anorexia may feel compelled to maintain an exact calorie count each day or weigh themselves multiple times to ensure “perfection” in body image.

D. Compensatory Behaviors:

• Definition: Actions taken to “compensate” for or undo the perceived effects of binge eating, often seen in eating disorders such as bulimia nervosa.
  These behaviors aim to prevent weight gain or relieve guilt after eating.

Examples of Compensatory Behaviors:

1. Self-Induced Vomiting

   • Definition: Forcing oneself to vomit after eating to get rid of consumed food.

   • Example: A person binge eats, then immediately goes to the bathroom to vomit in an effort to avoid weight gain.

2. Misuse of Laxatives or Diuretics

   • Definition: Taking medication to artificially speed up bowel movements (laxatives) or increase urine output (diuretics) to eliminate calories or water weight.

   • Example: Using laxatives after a large meal to “cleanse” the body.

3. Fasting

   • Definition: Intentionally abstaining from eating for extended periods to offset calories consumed earlier.

   • Example: Skipping all meals the day after a binge episode.

4. Excessive Exercise

   • Definition: Engaging in extreme or compulsive physical activity to “burn off” calories or relieve guilt about eating.

   • Example: Exercising for hours daily, even when injured or exhausted, after eating a perceived “bad” food.

Time Criteria for Diagnosing Eating Disorders

Binge-Eating Disorder (BED)

• Frequency: Binge episodes occur at least once per week

• Duration: Persist for at least 3 months

• Definition: Eating a large amount of food in a short period (e.g., within 2 hours) with a sense of loss of control and no compensatory behaviors

Bulimia Nervosa

• Frequency: Binge eating and compensatory behaviors (vomiting, laxatives, fasting, or excessive exercise) occur at least once per week

• Duration: Persist for at least 3 months

Anorexia Nervosa

• No specific frequency/duration criteria

• Focus is on persistent restriction of energy intake, intense fear of gaining weight, and distorted body image

Cognitive-Behavioral Therapy (CBT) for Eating Disorders

General Goal

• Modify the thoughts and behaviors that maintain disordered eating

• Normalize eating patterns and address overvaluation of weight and shape

Specific CBT Approaches

CBT-E (Enhanced Cognitive-Behavioral Therapy)

• A transdiagnostic model (used for all eating disorders)

• Structured, time-limited, and focused on current maintaining factors

Core Strategies:

1. Psychoeducation & Self-Monitoring

   • Educate about how dieting, bingeing, and purging interact

   • Track eating patterns, emotions, and triggers

2. Establish Regular Eating

   • Create consistent eating schedule (3 meals + 2–3 snacks/day)

   • Prevent extreme hunger and reduce binge triggers

3. Cognitive Restructuring

   • Identify and challenge distorted beliefs about food, shape, and weight

4. Behavioral Experiments

   • Gradual exposure to feared foods

   • Reduce avoidance or body-checking behaviors

5. Relapse Prevention

   • Recognize early warning signs and develop coping strategies

Disorder-Specific Focus

Key Neurotransmitters

🧠 1. Serotonin (5-HT)

• Main role: Regulates mood, appetite, and impulse control

• Involved in:

  • Anorexia nervosa: Elevated serotonin activity → anxiety, obsessionality, and appetite suppression

  • Bulimia nervosa & binge-eating disorder: Low serotonin function → impulsivity, bingeing, and mood instability

• Treatment connection: SSRIs (Selective Serotonin Reuptake Inhibitors) often help reduce binge–purge behaviors

⚡ 2. Dopamine

• Main role: Associated with reward, motivation, and pleasure

• Involved in:

  • Dysregulated dopamine systems affect how food and reward are experienced

  • Anorexia nervosa: Reduced dopamine response → less pleasure from food/reward

  • Bulimia nervosa/BED: Overactivation of reward pathways → heightened drive to binge eat

💥 3. Norepinephrine

• Main role: Involved in arousal, stress response, and alertness

• Involved in:

  • Anorexia nervosa: Reduced norepinephrine → low blood pressure, bradycardia, decreased metabolism, and lethargy

  • Bulimia nervosa: Fluctuations in norepinephrine may affect stress and impulsivity during binge episodes

⚠ Important Note

• These three neurotransmitters — serotonin, dopamine, and norepinephrine — are all associated with eating disorders.

• If asked which neurotransmitter is NOT associated, the correct answer would be any neurotransmitter outsidethese three (for example, GABA, acetylcholine, or glutamate, depending on the options given).

II. Substance-Related Disorders

A. Key Definitions

1. Substance Intoxication

   • Temporary behavioral or psychological changes due to recent substance use

2. Substance Use Disorder (SUD)

   • A problematic pattern of substance use leading to impairment or distress

3. Tolerance

   • Refers to the need for increased amounts of the substance to achieve the same effect

4. Withdrawal

   • Physical or psychological symptoms experienced when reducing or stopping substance use

B. Specific Drugs & Terms

• Marijuana

  • A psychoactive drug affecting perception, coordination, and memory

• Ecstasy (MDMA)

  • A drug that functions as both a stimulant and a hallucinogen, causing effects such as:

    • Increased energy

    • Emotional warmth

    • Distorted sensory and time perception

C. Paraphilic Disorders

Paraphilic Disorders — Study Guide

Definition:
Paraphilic disorders involve intense and persistent sexual interests other than sexual interest in genital stimulation or preparatory fondling with physically mature, consenting human partners.
They become disorders when they cause distress, impairment, or harm (or risk of harm) to others.

1. Exhibitionistic Disorder

• Definition: Recurrent and intense sexual arousal from exposing one’s genitals to an unsuspecting person.

• Key features:

  • Usually involves surprise or shock of the victim.

  • The individual has acted on these urges with a nonconsenting person or the urges cause distress or impairment.

• Typical onset: Late adolescence or early adulthood.

2. Fetishistic Disorder

• Definition: Recurrent and intense sexual arousal from nonliving objects or highly specific non-genital body parts (e.g., feet, shoes, leather).

• Diagnostic note:

  • The fetish objects are required for arousal or cause clinically significant distress or impairment.

  • Does not include arousal to cross-dressing or use of sex toys.

3. Pedophilic Disorder

• Definition: Recurrent and intense sexual arousal involving prepubescent children (generally age 13 or younger).

• Criteria:

  • The person has acted on these urges or they cause marked distress/interpersonal difficulty.

  • The individual is at least 16 years old and at least 5 years older than the child.

• Subtypes: Exclusive (only children) vs. Nonexclusive (also adults); attraction to males, females, or both.

4. Voyeuristic Disorder

• Definition: Recurrent and intense sexual arousal from observing an unsuspecting person who is naked, disrobing, or engaging in sexual activity.

• Criteria:

  • Person has acted on these urges with a nonconsenting individual or experiences distress/impairment.

  • Must be at least 18 years old for diagnosis.

• Motivation: Excitement from the secrecy and risk of being caught.

D. Body Parts Directly Affected by Substances (Notably Alcohol)

1. Liver

• Primary site of alcohol metabolism (via enzymes like alcohol dehydrogenase).

• Effects:

  • Fatty liver → Hepatitis → Cirrhosis (long-term damage).

  • Reduced ability to detoxify the body.

2. Brain

• Most sensitive organ to alcohol and drugs.

• Effects on Neurotransmitters:

  • GABA: Alcohol enhances GABA → sedation and slowed reflexes.

  • Glutamate: Alcohol inhibits glutamate → impaired learning/memory.

  • Dopamine: Increases dopamine → pleasure and reinforcement of drinking behavior.

• Cognitive Impacts:

  • Impaired judgment, coordination, decision-making, and memory.

  • Long-term use → cognitive decline and brain shrinkage.

3. Heart

• Short-term: Increased heart rate, blood pressure changes.

• Long-term:

  • Cardiomyopathy (weakened heart muscle)

  • Arrhythmias

  • Increased risk of stroke and hypertension

4. Nervous System

• Alcohol depresses the central nervous system (CNS) → slowed reaction time and poor motor control.

• Chronic use → peripheral neuropathy (nerve damage causing tingling, numbness, weakness).

II. Legal Guidelines — Alabama DUI Laws

Blood Alcohol Concentration (BAC) Limits

• Standard limit: 0.08% BAC for drivers 21 and older

• Under 21 (Zero Tolerance Law): 0.02% BAC

• Commercial drivers: 0.04% BAC

Determination of Impairment

• A driver is considered legally impaired if:

  • BAC ≥ 0.08%, or

  • They show observable impairment (e.g., inability to operate a vehicle safely), even if BAC < 0.08%.

• Law enforcement uses field sobriety tests and chemical tests (breath, blood, urine).

Penalties (General Overview)

• First offense: Fines, license suspension (90 days), possible jail time.

• Repeated offenses: Longer suspensions, higher fines, ignition interlock device.

III. Order of Neural Transmission (Neurotransmission Steps)

🧠 Understanding how substances affect brain communication

1. Neurotransmitter Release

   • Electrical signal (action potential) reaches the axon terminal.

   • Neurotransmitters (e.g., dopamine, serotonin) are released into the synaptic cleft.

2. Receptor Binding

   • Neurotransmitters cross the synapse and bind to receptors on the postsynaptic neuron.

   • This binding triggers the next signal or response in that neuron.

3. Reuptake (or Breakdown)

   • Neurotransmitters are reabsorbed by the presynaptic neuron (reuptake) or broken down by enzymes.

   • This ends the signal and resets the synapse for the next transmission.

How Substances Affect This Process

• Stimulants (e.g., cocaine, amphetamines): Block reuptake of dopamine → prolonged pleasure signal.

• Alcohol: Alters release and receptor activity (increasing GABA, reducing glutamate).

• Antidepressants (SSRIs): Block serotonin reuptake → more serotonin available at synapse.

✅ Quick Summary Table