_disorders warren wilson college进食障碍沃伦威尔逊学院课件

Two Main Types Anorexia Nervosa Bulimia Nervosa Share Strong Drive to be Thin Largely a Westernized, Female Problem Largely an Upper SES Problem Interview Observation Reports from family/friends Objective Psychological Tests (e.g., Eating Disorder Inventory) Assessment of Eating Disorders Bingeing Eat Large Amounts of Food Eating is Out of Control Compensatory Behaviors Purging via Self-Induced Vomiting, Enemas Laxatives, Diuretics, Exercise, Fasting Binge-Purge occur, on average, at least 2 X wk for 3 months Self-evaluation is unduly influenced by body shape and weight Bulimia Nervosa Medical Consequences Salivary Gland Enlargement Eroded Dental Enamel Electrolyte Imbalance Intestinal Problems Calluses on Fingers and Hands Facts and Statistics 90-95% are Women Onset 16-19 Years of Age 6-8% of college women About 2.8% Population Overall Chronic if Left Untreated Clinical Description Intense fear of Gaining weight Becoming fat Refusal to maintain body weight 15% Below Expected Normal Distorted body image Amenorrhea (in females) Two Subtypes Restricting Type Excessive Dieting Binge-Eating / Purging Type Rely on Purging About Half of All Cases Medical Consequences Dry Skin, Brittle Hair or Nails Sensitivity to Cold (Lanugo) Risk of death (suicide, starvation, electrolyte imbalance, heart problems) Associated Features and Facts Begins in adolescence (onset often associated with a stressful life event) Perfectionistic High-Achievers All-or-None Thinking Obsessive and Orderly Comorbid DSM Disorders Obsessive-Compulsive Disorder Substance Abuse Causes Social and Cultural Factors - examples? Media Sets Impossible Idealized Images Causes Biological Influences Runs in Families Unclear What is Inherited The Serotonin-Hypothesis: BN represents an underlying hyposerotonergic condition Causes Dieting: When food is restricted, we become preoccupied with it! (The PsychoBiological Impasse) Family Influences (esp. in AN) Successful and Driven Concerned About Appearances Eager to Maintain Harmony Deny or Ignore Conflicts Lack of Open Communication Psychosocial Treatments for BN Cognitive-behavioral treatments Education about eating behavior Scheduled eating Exposure / Response prevention Psychosocial Treatments Anorexia Nervosa First restore normal weight! many will gain weight; keeping the weight on is harder residential treatment control issues? IPT Biological treatments Bulimia Nervosa Because serotonin is thought to play an important r