Study Guides (238,472)
United States (119,817)
Psychology (412)
PSY 322 (19)
schlauch (2)

Exam 3 Study Guide

19 Pages
Unlock Document

University at Buffalo
PSY 322

EXAM 3 – STUDY GUIDE (remember only a guide) Lecture 12 and 13 – Eating Disorders/Obesity What is Anorexia Nervosa Characterized by an intense fear of gaining weight and a refusal to maintain even a minimally low body weight - Including: subtypes, prevalence rates, age of onset, course/outcome o AN- Restricting Sub-type  Persistent efforts to limit food intake o AN-Binge-eating/purging sub-type  Binge- out of control consumption of an amount of food far greater than what most people would eat in the same amount of time, under same circumstances  Purge- removal of the food eaten • Self inducing vomiting; misusing laxatives, diuretics o Distorted thinking  “I have a rule when I weigh myself. If ive gained then I starve the rest of the day. But if ive lost, then I starve too”  “anorexia is not a self inflicted disease, it’s a self controlled lifestyle”  “its not deprivation, its liberation  People with AN that have this distorted thinking have a lot of control issues, guilt issues, and very negative thinking o Prevalence:  0.9% women, 0.3% men o Age of Onset  15-19 years o Course/ Outcome  After 21 years after first seeking treatment • Vast majority fully recovered • 21% partially recovered • 10% not recovered • 16% pass away after 21 years  Anorexia and Suicide • After medical complications, suicide is the second highest cause of death o 3-23% attempt suicide o Rates of completed suicide are 50% higher than among the general population because they are so underweight and have very weak immune function  Better prognosis for BN and BED than AN • 70% with BN tend to recover, 60-70% with BED  However, residual symptoms often remain, and high rates of diagnostic crossover - Controversial diagnostic symptom in the DSM? o An important change from DSM 4 to 5 is that in 5 amenorrhea (cessation of menstruation) is no longer required for a person to be given the diagnosis  Studies have suggested that women who continue to menstruate but meet all the other diagnostic criteria for AN are very similar psychologically to women who have ceased menstruating]  Also amenorrhea is not a criterion that can be assessed for males or prepubescent girls or women who use hormonal contraceptives What is Bulimia Nervosa Characterized by uncontrollable binge eating and recurrent, inappropriate behaviors to prevent weight gain - Including: subtypes, prevalence rates, age of onset, course/outcome o Need to specify purging or non purging type to compensate for binge eating  Purging- most common  Non-purging- fasting, excessive exercise to compensate o Prevalence  1.5% women, 0.5% men o Age of Onset  20-24 years o Course/Outcome o After 21 years after first seeking treatment  Vast majority fully recovered  21% partially recovered  10% not recovered  16% pass away after 21 years o Better prognosis for BN and BED than AN  70% with BN tend to recover, 60-70% with BED o However, residual symptoms often remain, and high rates of diagnostic crossover What are the common features between AN and BN - People diagnosed share a fear of becoming fat What is the distinguishing feature between AN and BN o Those diagnosed with bulimia tend to be of normal weight or overweight** o Those diagnosed with AN are underweight o Researchers have argued that binge-eating/purging subtype of anorexia should be another form of bulimia o If both diagnosis are met, ANOREXIA is diagnosed o People with anorexia often deny the seriousness of their disorder o Those with bulimia often preoccupied with shame and guilt and try to hide their behavior What is Binge Eating Disorder Characterized by excessive eating during a discrete period of time and a feeling of lack of control over eating - Including: prevalence rates. age of onset, course/outcome o Prevalence  Binge Eating Disorder is the most common • Lifetime prevalence- 3.5% in women, 2% in men • 6-8% in obese individuals o Age of Onset  30-50 years o Course/Outcome - What is unique about BED compared to other disorders (hint: look at gender differences) o 10:1 females to male o However current research is suggesting 3:1 female to male o After a binge, the person does not engage in any form of compensatory behavior o Much less dietary restraint o Associated with being overweight/obese o More likely to have overvalued ideas about the importance of weight and shape than overweight or obese patients who do not have BED Know who is at a greater risk for EDs and WHY - *Being Caucasian is a risk factor and being African American is a protective factor - ED are not limited to western culture - Culture plays a role in clinical presentation - AN is not culture bound, but BN may be - Men and Eating Disorders o 10% of people with Eating Disorders are men o For existing ED diagnoses, males exhibit similar symptoms to females o More likely to have a history of being overweight before their ED developed o Mixed evidence about sexual orientation as a risk factor o Other risk factors for men  Sports • Wrestling, jockeys • Advantage of being in lower weight class o Muscle dysmorphia  New ED that’s more common in men  Idea that men feel they need to bulk up as much as possible • Excessively eating high caloric food for example  Ideal body has changed over time due to changes occurring in culture What are the most common comorbid disorders with eating disorders - Very commonly overlap with depression (as many as 50%), OCD, substance abuse disorders (particularly with BN and binge eating/ purging subtypes of AN), personality disorders, self-harm behaviors, anxiety disorders (for BED) Biological causal factors - Genetics  Risk of AN for relatives with An is 11.4 times greater  Risk of BN for relatives with BN is 3.7 times greater  Twin studies suggest that both AN and BN are heritable • However none that have tried to separate the genetic vs environmental factors - What is set-point Theory o Can be altered due to brain abnormalities o The set point is the weight that our body tries to “defend” o Patients with BN may experience impulses to binge after attempting to fall below their set point - Neurotransmitters o Serotonin  Involved in appetite and feeding behavior  Can be helpful in the treatment of eating disorders Sociocultural causal factors - What is meant by the thin ideal - How has the thin ideal changed over time o The thin ideal does not characterize all of US history nor cultures  Women with curve were the ideal back in the day  Thin ideal emerged in the 60s o Womens actual body weights compared to playboy centerfolds and miss America contestants  Avg womens weight is increasing  Models- going down  This is causing the distorted perception - Fiji Study – Influence of media o Becker and colleagues  Early 1990s • High rates of overweight women • Associated with being strong, able to work, kind and generous ( all valued traits in the culture) • Being thin viewed negatively (sick, incompetent)  Emergence of tv and American shows such as Beverly hills, 90210, and Melrose place • Young women began to express concerns about weight and dislike for their body • Dieting increase - Family influences on AN and BN o Family influences of An  Family dysfunction • Rigidity, parental over-protectiveness, excessive control, ad marital discord o All associated with higher rates of e. disorders within the family unit  Parental attitudes regarding desirability of thinness, dieting, eating habits physical appearance, perfectionism  Influences may be bi-directional • Family member with eating disorder family dysfunction • Probably causal and maintaining factor o Family influences of BN (risk factors)  High parental expectations (setting bar too high)  Other family members dieting or eating habits  Critical comments about shape, weight, eating Other individual risk factors - negative body image, o Perceptions of how “fat” one is o Women  Huge discrepancy  Their current image is far from their own ideal which is better than attractive, however peer ideal is even less than that  Peer ideal, attractive, own ideal (close but not same)….current is far away on spectrum o Men  Not as much of a difference as women, but still there  Own ideal, attractive, current, and peer ideal - Perfectionism o Relentless pursuit of the perfect body  More in AN and women - internalizing the thin ideal o Buying into the notion that being thin is highly desirable  Not because other people telling them  They tell themselves - Dieting o Most EDs start with normal dieting o Diet fails when distorted perceptions/cognitions develop when diets turn bad - negative emotionality o Neuroticism o May be a causal factor for body dissatisfaction- distorted thinking o May maintain binge eating o Comfort eating when in bad mood - sexual abuse o Childhood abuse?- some evidence but weak Treatment - Why is treating ED very difficult (hint: How often do the actual patients seek tx?) o Difficult to treat, people are very resistant to treatment o Don’t seek treatment very often o Often very conflicted about getting well o Approximately 17 percent of patients with severe eating disorders have to be committed to a hospital for treatment against their will - What are types of treatment for AN o Reluctance to seek treatment and high dropout rate  Especially binge/purge subtype  Often pessimism of treatment don’t think its going to work o Immediate goal is to restore weight to a level that is no longer life-threatening  Iv feeding, feeding tubes  Monitoring of caloric intake o Medications  Antidepressants and some antipsychotics (help with distorted thinking, delusions-psychotic symptom) • Evidence not that strong  SSRIs often prescribed—serotonin o Family therapy – number 1 treatment for AN  Treatment of choice among adolescents  10-20 sessions over 6-12 months (intense)  Important aspects include • Use family to help build healthier eating habits • Teach family how to provide appropriate support o Family dysfunction= risk factor • Deal with other family issues  75-90% will show full recovery o CBT  Change maladaptive behaviors and thoughts  Treatment length recommended for 1-2 years if used alone  Primary focus is on challenging and changing maladaptive cognitions  * not as successful as family therapy, and perhaps higher relapse rate  Bc treatment focuses primarily on cognitions, much more difficult to change over time - What are types of treatment for BN o Antidepressants or other medications o CBT- better than for anorexia  Main focus is on normalizing eating patterns and restructuring maladaptive patterns of thinking • Regular eating/stop purging • Alternatives to binge eating • Examining food avoidance • Challenging dysfunctional thought patterns • Preventing relapse • **better coping factors - What are types treatment for BED o Not a lot of research to date o CBT  Seems more effective than antidepressants  Primary focus is on changing maladaptive behaviors: • Meal planning • Identification of triggers • Alternatives to bingeing  Does not result in weight loss - How effective are medications, and what are they effective for o not a lot of evidence for medications for treating these disorders however they are effective in helping with distorted thinking and delusions (which is a psychotic symptom) in anorexia o SSRIs- serotonin helps with appetite, depression, etc Obesity - What is meant by obesity (is it in the DSM?) o from a diagnostic perspective, obesity is not an eating disorder, and it is not included in the DSM o some forms are driven by an excessive motivational desire for food o 1/3 are obese in US o A major public health problem o Can be regarded as a state of excessive, chronic fat storage o Defined on the basis of BMI (weight/height * 703) o Many clinicians regard the central problem as a habit of overeating, or a food addiction - Risk factors for obesity o Found in all racial and ethnic groups, but most prevalent in black women o Other risk factors  Old  Women  Of low SES  Children of obese parents o Risk and causal factors  Genetic inheritance  Hormones involved in appetite and weight regulation • Increased body fatincreased leptindecreased food intake • (obese individuals-lack of leptin) • Grehlin- causes hunger at certain times of day  Sociocultural influences • Culture= stress • Personality, genetics= diathesis  Family influences • High fat/calorie diets • Learned habits of eating to decrease negative mood or increase positive mood  Stress and comfort food o Pathways to Obesity  Binge eating is a predictor of later obesity  Social pressure to conform to the thin ideal  Depression and low self esteem - Treatment for obesity o Lifestyle modification  Weight loss groups  Behavioral management o Medications o Bariatric surgery Once people become obese it’s difficult for them to lose weight and maintain their new low weight Therefore prevention is important* Lecture 14 – Somatoform Disorders What are somatoform disorders (generally speaking) - Soma means body - Somatic symptom disorders are characterized by complaints of bodily symptoms or defects that suggest the presence of medical problems. However, no organic basis (i.e physical pathology) can be found that satisfactory explains the symptoms such as pain or paralyses o often show up in the doctor’s office first - Somatic Symptom Disorder o Characterized by chronic somatic symptoms that are distressing, as well as dysfunctional thoughts, feelings, or behaviors o Can be 1 symptom or many o Hypochondriasis, somatization disorder, and pain disorder are all included in former diagnoses of somatic sensory disorder What was Hypochondriasis - Part of a somatic symptom disorder o 75% that originally have hypochondriasis will be captured in somatic sensory disorder o Other 25% will be illness anxiety disorder - Characterized by preoccupations with fear of contracting a serious disease or with the idea that they actually have such a disease even though they do not o Usually obsessed with bodily functions (heartbeat)  Signs (cough) o do a lot of self diagnosing - Old DSM criteria  preoccupation with fears of contracting or idea that one has a serious disease based on misinterpretation of bodily symptoms  persists despite appropriate medical evaluation and reassurance  clinically significant distress/impairment  6 month duration  **not malingering (faking symptoms) or factitious disorder What was Somatization Disorder - Characterized by many different complaints of physical ailments in the absence of physical pathology - Old DSM criteria o History of physical complaints starting before age 30 that occur over several years and result in treatment being sought, or significant impairment in functioning o Each of the following must have been met at some time (in new DSM 8 out of 33 symptoms)  Four pain symptoms, in different sites  Two GI symptoms other than pain  One sexual symptom other than pain (e.g. sexual dysfunction)  One pseudoneurological symptom (e.g loss of sensation) - Either o After appropriate investigation, cannot be accounted for by medical condition o When there is medical condition, the physical complaints are in excess of what would be expected - Symptoms are not intentional produced or faked How do Hypochondriasis and Somatization Disorder differ - Both were characterized by preoccupation with physical symptoms however o Only those with hypochondriasis tend to be convinced that they have organic disease  Somatization, not convinced, just complain a lot o Hypochondriasis has only one or a few primary symptoms, but in somatization disorder, there are by definition multiple - Very limited research about whether or not they should be two diagnoses - DSM 5 o No longer a concern about differentiating between the two o Both fall under somatic system disorder What was Pain Disorder Characterized by the experience of persistent and severe pain in one or more areas of the body that is not intentionally faked Chronic pain > 6 months not acute without physical damage to body Old dsm criteria Pain in one or more sites as a primary focus of clinical presentation Pain causes significant distress or impairment in functioning Psychological factors judged to have an important role in the pain Symptom or deficit is not intentionally produced or faked
More Less

Related notes for PSY 322

Log In


Don't have an account?

Join OneClass

Access over 10 million pages of study
documents for 1.3 million courses.

Sign up

Join to view


By registering, I agree to the Terms and Privacy Policies
Already have an account?
Just a few more details

So we can recommend you notes for your school.

Reset Password

Please enter below the email address you registered with and we will send you a link to reset your password.

Add your courses

Get notes from the top students in your class.