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Chapter 8

Chapter 8 - Eating and Sleep Disorders

7 Pages

Course Code
PSYC 3140
Stephen Fleming

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Chapter 8 Bulimia Nervosa  amount of food, out of control - Out-of-control eating episodes (binges) - Eating a larger amount of food, typically more junk food than fruits and veg - Followed by self-induced vomiting, excessive use of laxatives or other attempts to “purge” (get rid of ) food - Purging techniques  self-induced vomiting immediately after eating  Using laxatives  Using diuretics – results in loss of fluids, through increased frequency of urination - Others compensate in other ways: o Fast for long periods during binges o Exercise excessively (normally more a characteristic of anorexia) - Subtyped in DSM-IV-TR into purging type and non-purging type (Exercise or fasting) - Within 10% of their normal weight Medical Consequences - Salivary gland enlargement from repeated vomiting – gives face a chubby appearance - Repeated vomiting may erode the dental enamel on the inner surface of the front teeth - Continued vomiting may upset the chemical balance of bodily fluids, including sodium and potassium levels – electrolyte imbalance. Can result in cardiac arrhythmia (disrupted heartbeat) and renal (kidney) failure, if unattended. Both can be fatal. - Laxative abuse – severe constipation or permanent colon damage - Marked calluses on fingers or back of hands caused by friction of contact with teeth and throat - Usually presents with additional psychological disorders – anxiety and mood disorders, substance use disorders, borderline personality disorders and impulse control disorders - If untreated, can be chronic Anorexia Nervosa - Person eats nothing beyond minimal amounts of food, so body weight sometimes drops dangerously - As many as ½ of the deaths related to anorexia are suicides - 20% die as a result of disorder (study) - 5% die within 10 years (study) - Differ from people with bulimia because they are so successful at losing weight that they put their lives in considerable danger - Anorexia  bulimia - Most commonly begins in adolescence - Subtyped in DSM-IV-TR into restricting type (diet to limit calorie intake) and binge-eating/purging type (rely on purging) - Binge purge anorexics engage in impulsive behaviour – stealing, alcohol and drug use and self-mutilation - Individuals with anorexia are never satisfied with his or her weight loss - Marked disturbance in body image • With both diseases there is an overwhelming all-encompassing drive to be thin. • Mortality rate for eating disorders, particularly anorexia, is the highest for any psychological disorder, even depression. Medical Conditions - Amenorrhea  cessation of menstruation - Dry skin, brittle hair or nails - Sensitivity to or intolerance of cold temperatures - Lanugo – downy hair on the limbs and cheeks - Cardiovascular problems – chronically low blood pressure and heart rate - Low body weight - Development of osteoporosis and bone fractures - OCD - Substance abuse – binge/purge subtype Binge Eating Disorder - Pattern of eating involving distress-inducing binges not followed by purging behaviours; being considered as a new DSM diagnostic category. Sleep Disorders Sleep can be divided into two broad states: 1. Slow wave state – Person sleeps deeply 2. Rapid eye movement (REM) state (limbic region) – The brain appears as if it is awake – Sleeper experiences dreams Stage 1 - Person transitions through wakefulness into drowsiness and then sleep - Person drifts in and out of awareness of his or her surroundings Stage 2 - Person is truly sleeping - Sleep is light - When woken from this stage of sleep, 70% of people report that they didn’t think they were asleep, but were ‘dozing’ Stages 3 & 4 - Deep slow wave sleep - Stage 3 – moderately deep sleep - Stage 4 – very deep sleep. Hard to wake a person up from stage 4 sleep and when you do they seem disorientated Light sleep  deeper sleep  light sleep  REM sleep and dreaming When we wake up in the morning, we typically wake out of REM sleep during a dream. Normal sleepers spend 20% in deep sleep, 30% dreaming and 50% in light sleep. Sleep disorders are divided into two major categories: 1. Dyssomnias - Involves difficulties in getting enough sleep o Not being able to fall asleep until 2am o Complaints about quality of sleep  Not feeling refreshed after sleeping the whole night 2. Parasomnias - Abnormal events that occur during sleep o Nightmares o Sleepwalking The clearest and most comprehensive picture of your sleep habits can be determined only by a polysomnographic (PSG) evaluation. Measures: - Respiration, leg movements, brain wave activity  electroencephalograph (EEG) - Eye movements  electrooculograph (EOG) - Muscle movements  electromyography (EMG) - Heart activity  electrocardiogram (ECG) Actigraph  records the number of arm movements – can help in insomnia treatment. Sleep efficiency (SE)  the percentage of time actually spent asleep, not just lying in bed trying to sleep. Calculated by dividing the amount of
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