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York University
PSYC 3140
Joel Goldberg

ABNORMAL PSYCHOLOGY LECTURE: FEBRUARY 12TH, 2013 TOPIC: MOOD AND EATING DISORDERS ➔ Quiz 5 and 6 will be due Feb 25 and Midterm Feb 26 th ➔ Midterm ◦ Chapters 6, 7, 8, 9, 15 ◦ Lecture material ◦ 50 MC ◦ 1 hour ◦ Lecture after test ➔ Eating Disorders – Prevalence ◦ 3% of women will have an eating disorder in their lifetime ◦ Prevalence among female athletes is even higher. 15-62% will be affected. Other women at risk are models ➔ Current Picture – Eating Issues ◦ 70% → women on diet ◦ 80-90% women dislike body ◦ 50% of high school girls and 20% of high school boys → diet or want to lose weight ◦ 80% of 10 yr old on diet and 50% of 9 year old on diet ◦ Some girls report being more afraid of gaining weight than war or cancer, or losing their parents ➔ Body Mass Index (BMI) ◦ A score that is calculated based on a person's weight and height. It is used to estimate body fat ◦ Seriously underweight → BMI under 17.5 ◦ Underweight → BMI 17.5-18.5 ◦ Normal range → BMI 18.5-24.9 ◦ Overweight → BMI 24.9....... ➔ Anorexia Nervosa ◦ Anorexia – Physiological – decreased appetite ◦ Nervosa – Psychological – causation ◦ DSM-IV-TR criteria on p. 539 in textbook ▪ Refuse to maintain body weight ▪ Intense fear of gaining weight ▪ Disturbance in which one's weight or shape is experienced ▪ Under influence of weight/shape on self-evaluation or denial of seriousness of low body weight ▪ Absence of menstrual cycle for at least 3 cycles (this may be removed because it cannot apply to men and because it may be a secondary or consequence of physical complications) • You can die from this mental health problem → fatal ➔ Subtypes ◦ Restricting subtype → the person has not regularly engaged in binge-eating or purging behaviour ◦ Binge-eating/purging type → the person has regularly engaged in binge-eating or purging behaviour ▪ Eats a lot then tries to throw up or takes laxatives ➔ Bulimia Nervosa DSM-IV-TR criteria on p. 542 ◦ Recurrent episodes of binge eating ◦ Recurrent inappropriate compensatory behaviour in order to prevent weight gain ◦ The binge eating and compensatory behaviours both occur, on average, at least twice a week for 3 months ◦ Self -evaluation is unduly …... ➔ Eating Disorder – Not Otherwise Specified ◦ Meet all AN criteria, except have regular period ◦ Meet BN criteria, except frequency of binge or compensatory behaviours is less than twice per week or less than 3 month duration ➔ Binge Eating Disorder ◦ Typically overweight ◦ Have eating binges but not the inappropriate compensatory behaviour (do not use self- induced vomiting) ◦ Likely will be a disorder in DSM-5 (currently in appendix) ➔ REFER TO HANDOUT FOR PHYSICAL COMPLICATIONS OF EATING DISORDERS ➔ Eating Disorders – Causes and Risk factors ◦ Age – mid teens to young adulthood ◦ Sex – more women than men ◦ Adverse life events – abuse, trauma ◦ Weight concerns, dieing, body dissatisfaction ◦ Family dynamics ◦ Personality (perfectionism, impulsivity) ◦ Sociocultural ▪ Example: dancers are always told to dance perfectly ▪ Higher order eating disorders in Western culture ➔ Study ◦ Isolated place ◦ No television ◦ Sociologists studied the culture prior to television and when it was introduced ◦ Television effects on Native culture ◦ Results ▪ Virtual absence of eating disorders before TV ▪ After TV, striking increase in eating disorders ▪ Culture putting pressure on young women to be thin • Dove Beauty Soap → spoke against thinness as the bodily ideal • Video ◦ It is about setting an example for young girls because of all the millions of advertisements full of naked, thin, beautiful, perfect women everywhere ! What message are we sending our children? ▪ Message : talk to your daughter before the beauty companies do ➔ Sociocultural ◦ Higher prevalence of Eds in western cultures, where emphasis on thinness as an ideal ◦ Media plays an important role in communicating our cultural ideals ◦ Increased preoccupation with dissatisfaction with body and increased purging behaviour → the study ➔ Functional significance of Eating Disorders ◦ Maintaining control ◦ Deal with strong emotions ◦ Sense of pride, accomplishment ◦ Self-soothing ◦ Communicating distress/anger ◦ Safeguard against failure ◦ Avoidance of sexuality/fears of maturity ◦ Avoidance of memories/feelings ◦ Get attention ◦ Self-punishment ➔ Case Study: Linda ◦ 34 yr old woman ◦ Caucasian ◦ Protestant ◦ Divorced ◦ 2 children (13 yr old girl and 15 yr old boy) ◦ Unemployed, on disability ◦ College education ◦ Resides in small town ▪ Lives close to her sisters ▪ They all got along ▪ She is the oldest ▪ The second sister had a competitive relationship with her and on one hand she idealized her but on the other hand she competed with her and wished she could be more like her ▪ Trauma history –sexually and physically abused by a relative and a family friend ▪ Relationships – only one serious partner in high school, she married him after they graduated and started having kids right away ▪ Husband emotionally and verbally abused her calling her fat and ugly. This brought back memories from her childhood traumas ▪ She started to withdraw from others – isolation ▪ She and the husband were invited to attend a wedding – she decided she was going to lose some weight – as she started to lose weight she started to get positive attention from others – continued to diet and restrict her weight gain ▪ She started to exercise to lose weight faster – up to 3 hours everyday ▪ She felt a sense of control over her self, her life, and her body ▪ She found it harder to stop herself from eating because she started to crave food ▪ She started to over indulge in food → turned into a binge, she felt disgusted and guilty, and she started inducing vomiting. She started to get stuck in this cycle. ▪ Symptoms became severe, she lost her job, she referred herself for treatment, left her husband, caring for her kids. ▪ What facts do you need to know about her to diagnose her? • Her BMI – she weighs a 100 pounds and she is 5'7 which makes her BMI 15.7 → extremely underweight • Her period stopped for over 3 cycles – her last cycle was 5 years ago • How often she binges – at least 3 times a week and induce vomiting every day and sometimes twice a day • She has been doing it for 3 years • Calories a day – 300 • Diagnosis – Anorexia Nervosa – bingeing-purging type ◦ Anorexia – her body mass index was so low ◦ Inpatient Treatment ▪ 1 step : paying attention to physical problem – help her restore her physical hndlth – she has to give up some of her sense of control ▪ 2 step: intervention involved group therapy and CBT to help her restore her sense of control and dealing with her traumatic experiences as a child and in her marriage ➔ Video ◦ Case of Sonia and Julia on Intervention ◦ Twins Diagnosed with eating Disorder ▪ There is a sister without an eating disorder ▪ Treatment is successful ▪ The twins are competitive with each other and co-dependent ▪ Family – loving, parents are holocaust survivors – faced starvation in childhood ▪ Twins – engaged in restricting their diets and intense exercise ➔ Mood Disorders -Unipolar Depression ◦ 1) Major Depression – not just the kind of sad emotional state that everyone feels from time to time ◦ Serious enough to cause interference in daily functioning ◦ Emotional aspects, thinking aspects, physiological aspects ◦ Beck Depression Inventory emphasizes cognitive symptoms ◦ Hamilton Rating Scale for Depression (HRSD) emphasizes physiological symptoms ▪ Life is not worth living ▪ I am worthless ▪ Negative attitude toward future ▪ Hopelessness ▪ I feel like deserve to be punished, I'm bad ▪ I am a failure • This is like The Beck Depression Inventory ▪ Difficulty falling asleep ▪ Restless ▪ Appetite loss ▪ Fatigue all the time ▪ No motivation ▪ No sex • This is an example of the Hamilton Rating Scale for Depression • If a researcher was proposing an anti-depressant drug study – which outcome measure might be more sensitive to the impact of the treatment? ◦ Hamilton Scale ▪ Not all measures of depression are the same ➔ Unipolar Depression ◦ 2) Dysthymia – is a milder than major depression but more persistent ◦ It is chronic and lasts for at least two years ◦ People with this may also experience episodes of majo
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