PSYC 331 Lecture Notes - Eating Disorder Inventory, Amenorrhoea, Binge Eating

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Published on 5 Feb 2013
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CLINICAL DESCRIPTION
The diagnoses of these two disorders share several clinical feautures the most imp being an intense
fear of being overweight
Co-twins of patients diagnoses with A.N for ex are themselves more likely than average to have
B.N
Anorexia Nervosa
Ms. A had A.N. anorexia refers to loss of appetite and nervosa indicates that this is for emotional
reasons
Most patients with A.N actually do not lose their appetite or interest in food. They are preoccupied
with food
Ms. A met all the four features required for the diagnosis:
1) the person must refuse to maintain a normal body weight, that is usually taken to mean that the
person weights less than 85% of what is considered normal for that persons age and height.
Weight loss is typically achieved through dieting although purging (self induced vomiting, heavy
use of laxatives or diuretics) and excessive exercise can also be part of the picture
2) the person has an intense fear of gaining weight and the fear is not reduced by weight loss.
They can never be thin enough
3) Patients with AN have a distorted sense of their body shape. They maintain that even when
emaciated they are overweight or that certain parts of their bodies esp the stomach, butt and thighs
are too fat. To check on their body size they typically weight themselves frequently, measure the
size of diff parts of the body and gaze critically at their reflections in the mirror. Their self esteem
is closely linked to maintaining thinness. The tendency to link self esteem and self evaluation with
thinness is known as over evaluation of appearance
4) in females the extreme emaciation causes amenorrhoea the loss of the menstrual period. Of the
four diagnostic criteria amenorrhoea seems least imp to determining a diagnosis of anorexia.
Moreover amenorrhoea occurs in a significantly minority of women before any significant weight
lose and the symptoms can persist after weight gain
eating disorder inventory (EDI). Was developed in Canada and is one of the most widely used
measured to assess self reported aspects of eating disorders
patients with AN overestimate their own body size and choose a thing figure as their ideal
DSM-IV-TR distinguishes two types of AN. In the restrictive type, weight loss is achieved by
severely limiting food intake; in the binge eating purging type the person also regularly engages in
binge eating and purging
The binging purging subtype appears to be more psychopathological; patients exhibit more
personality dis, impulsive beh, stealing, alcohol and drug abuse, social withdrawal and suicide
attempts than do patients with the restricting type of anorexia
Binging purging patients tend to weight more in childhood, come from heavier families with
greater familial obesity and use more extreme weight control methods.
Canadian research suggests that the diff between the two subtypes are becoming less distinct
An increasing proportion of patients were diagnosed with AN, the binging purging subtype, during
each period. Over time, participants in both groups appeared to weigh more and were less likely to
report amenorrhoea. Patients from both groups reported higher frequencies of purging beh,
impulsive beh, and associated affective symptoms in the later time periods
AN typically begins in early to middle teenage years often after an episode of dieting and
exposure to life stress. It is about 3-10 x more frequent in women than in men with a lifetime
prevalence about 1% in women
When AN does occur in men, symptomatology and other characteristics, such as family conflict,
are generally similar to those reported by women with the disorder
Found that males had lower levels of drive for thinness and body dissatisfaction but there were
many more similarities than differences between the males and females
Patients with AN are diagnosed frequently with depression, OCD, phobias, panic disorder,
alcoholism, oppositional defiant disorder, and various personality disorders
Comborbidty is higher in clinical samples than community samples. A growing concern is the
high rate of occurring eating disorders and substance use disorders
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