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Lecture 9

Lecture 9

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Carleton University
PSYC 3604
Owen Kelly

th rd No class April 10  April 3 is the last class Eating Disorders • Becoming more and more understood from a neuropsychological framework. • Pro-ana: online communities of people who are committed to starvation and being excessively thin. Also seen with drug addictions as well (ways to get the most high etc). • Distortion of persons actual body  what they perceive their body to look like. It can also reach like a delusional level. They are renowned for their lack of insight: similar to Body Dysmorphic Disorder in that insight is very limited. • Treatment usually occurs after the individual is hospitalized. Typically seen in-patient program and then out-patient program. Often suffer from anxiety and depression. Usually only during times of stress when the eating habits come back • The damage to the body can be enduring even after treatment. Anorexia afflicts mostly young women • 10-15% tend to be male • Male Analog??? Men convinced that they need to be more muscular: obsessions about being more muscular. May be some kind of flipping; the opposite of anorexia • If you ask women to ideal male body looks like  middle build even though men think its the more muscular male. If you ask males ideal female it would also be the middle build whereas females think males prefer the skinnier one. Calibration problem • Shows up primarily 16-20 years. Can happen in kids as young as 10. Rarely happens past age 20 • Generally find many of the cognitions around the eating disorder are still there but have high control over the behavioural manifestation. DSM Criteria • Refusal to maintain body weight (determined through Body Mass Index) • Intense fear or gaining weight or becoming fat • Distortions in perception of one’s body weight • Loss of menstrual criteria  core characteristic. Cannot be formally diagnosed without that. However will be changing in the new DSM Types of Anorexia • Restricting type: some may go days without eating. Just enough calories to pretty much function. • Binge Type: self-induced vomiting, laxatives etc. They will still be 15% below a healthy body weight whereas people with Bulimia will be at a normal weight or just a bit over. Also missing their period. This tends to be the more severe presentation of anorexia. • These behaviours are safety behaviours  • Trigger = eating food/seeing food/thinking about being fat/smelling food/reading about food can make them want to engage in their compulsion (vomiting) • Thought = going to get fat • Emotion = sadness • Physical = fight/flight • Behaviour = release vomiting • Anorexia affects whole body • If your ions and electrolytes are off it can easily make your heart stop • If not eating/drinking; urine can get very concentrated and acidic  kidney stones • Just know that they are multi-factorial; many systems buy it and know the main systems that would be effected *EXAM* • Gastrointestinal complication  acid reflux, hard to re-start the systems slowly Bulimia • Eating a lot and lack of control over eating • Intake of calories can be pretty substantial  superhuman amounts of calories • At least twice a week for 3 months • Don’t see same profound delusional thinking in Bulimia. It can be there but its more like really unhealthy preoccupation. Can even be like an obsession but not delusional. • Animal species stop eating when they feel under threat or nervous  biological underpinnings perhaps of human eating disorders. Take mice: easily trained to eat cheerios, sweetened water etc. Train it to eat a favourite treat if you put the mouse in a new cage with that treat; they monitor the food firs, hang out in the cage in the corner, they don’t just automatically start eating. But if you give them an SSRI they will immediately approach the food. • Evolutionarily: our fear system is really stupid: cannot discriminate between what’s new and what’s dangerous. • Eating disorders often come out of chaotic upbringings and times of stress. Not always abuse but can be a feature of eating disorders when the person has endured abuse. • Ubiquatey Book Types of Bulimia • Non-purging type: excessive exercise variant  generally prescribe exercise for anxiety and depression. If they exercise compulsively it becomes a safety behaviour and often they don’t recognize it as so. But can sometimes re-train them to have a healthier relationship with it. • Routines that they come up with and hide from family is significant. Can become very ritualized. • Eating disorders are just anxiety disorders focused on body issues. Can also be used as a coping mechanism for trauma. Medical Complications • Laxative use: your body can become addicted –dependant on them. The stomach and the intestines (their own nervous system) and that nervous system can go to sleep Binge Eating Disorder • Resembles bulimia but doesn’t engage in purging, fasting or excessive exercise  so taking in 10,000 calories in one sitting and then not getting rid of it. • A lot of obesity that comes along here • Underlying anxiety, depression, trauma, often associated with Cluster B traits (BPD, histrionic personality disorder) and the binge = veiled self harm much in the way cutting is. Contributors to the Eating Disorder • Multi-factorial • Genetic predisposition  inherited in a practicable manor • An anxiety or mood related issue that occurs in the family (in mother GAD, daughter as an eating disorder) manifests in different ways in different people but overall pre disposition is there • Very apt to have really pessimistic negative thinking; very irritable, angry kind of depression • Predisposition to depression  avoidant coping style: that’s what gets depression up and running in the first place • Hypothalamus  primitive part of the brain in control of animalistic functions (sex, thermo regulation, eating, appetite). Maybe it’s sending or misreading signals from the body/brain • Serotonin imbalances (not specifically high or low) • Ghrelin and Leptin  could be some of these hormones could be dysregulated so they don’t feel satiated. Sociocultural and Psychological Factors • Pressure to be thin: there is evidence surfacing that tends to suggest anorexia may be more or as prevalent throughout the world not just in the western world. • Cultural norms (used to be ideal to be overweight and not
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