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Eating Disorders (Clinical Topic 6)

Nichola Livermore Clinical Psychology Englisch 23 Karten

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  1. 1What are the main characteristics of Anorexia Nervosa (AN)? (LO1)AN is characterised by an intense fear of weight gain. It involves an
    ongoing pattern of self starvation and a preoccupation with control over
    food and weight.
    DSM-V further specifies that an individual may also present with persistent behaviour that infers with weight gain despite being at a low weight.
    Additionally, the DSM-V also specifies disturbances in the way body weight or shape is perceived, disproportionate influence of body weight on self evaluation, and lack of recognition of seriousness of current low body weight.
  2. 2What are some key physical symptoms of AN? (LO1)Amenorrhea (loss of
    period)
    `
    Low body weight
    Low pulse rate and sensitivity to
    cold
    loss of hair
  3. 3What is the weight requirement for AN? (LO1)Typically you'd expect to see weight below 85% of expected weight. However,DSM-V
    removed a definitive weight requirement for diagnosis and instead requires for
    weight to be considered in the context of age, sex, dev trajectory and physical health.
  4. 4What are some key psychological or behavioural symptoms of AN? (LO1)Perfectionism or high self criticism
    Nervousness at meal times
    Compulsive exercise or cleaning
    Playing with or cutting food into small pieces
    Social isolation
    May have alternating episodes of
    purging and binge eating
  5. 5What are the main characteristics of bulimia nervosa (BN)? (LO1)In constrast to AN, BN is characterised by recurrent episodes of binge eating followed by compensatory strategies including self induced vomiting, use of laxatives or diuretics, restriction
    or excessive exercise.
  6. 6How do could BN and AN be said to differentiate? (LO1)Whilst a pattern of purging and
    binging can be seen in AN, it is not
    the core feature of diagnosis where as a recurrent pattern of binging
    followed by inappropriate
    compensatory strategies is core to BN
    diagnosis. Further, the DSM requires
    that this pattern does occur
    exclusively during episodes of AN.
    Additionally, weight is typically average or above average in BN.
  7. 7What are some key physical symptoms of BN? (LO1)Frequent vomiting and tooth decay and oesophagus damage due to this.
    Weight fluctuation due to bingeing and
    fasting.
    Puffiness in Face
  8. 8What are key psychological or behavioural symptoms of BN? (LO1)Petty stealing of money to buy food for
    binges.
    Fear or inability to stop
    eating
    Secretive behaviour and inconspicuous binge eating
    Perfectionism
  9. 9What are the main characteristics of Binge Eating Disorder (BED)?BED is characterised by recurrent episodes of binge eating but, in contrast to BN, in the absence of inappropriate compensatory behaviours. Weight may be normal but is more likely to be
    overweight.
  10. 10What is a key physical symptom BED? (LO1)Possible history of marked weight
    fluctuations
  11. 11What are some key psychological or behavioural symptoms of BED? (LO1)Eating alone due to embarrassment over how much one is
    eating
    Sense of lack of control over
    binging
    Feeling guilty or depressed after
    binging
  12. 12What are the main characteristics of Avoidant/Restrictive Food Intake Disorder (ARFID)? (LO1)ARFID is characterised by eating or feeding disturbance and persistent failure to meet energy needs which is not
    accounted for by lack of available food or cultural practices.
  13. 13What are the three subtypes of ARFID? (LO1)Three subtypes; those who do not eat enough and/or show little interest in eating, those who accept limited diet in relation to
    sensory features, and where food refusal is related to aversive
    experiences.
  14. 14How is ARFID distinguished from AN and BN? (LO1)Distinguished from AN or BN as there is no disturbance in how one views or
    experiences body weight or shape. The focus of diagnosis is purely on restrictive or
    avoidant behaviour in relation to eating.
  15. 15What diagnoses are included under the Other Specified Feeding or Eating Disorder category (OSFED) ? (LO1)Atypical AN: despite sig weight loss, weight is at or above normal
    range.
    Purging disorder: recurring
    purging to influence shape or
    weight in the absence of
    binging.
    Sub threshold BN or BED: Behaviours occur less than one week or less than three
    months.
    Night eating syndrome: Recurrent episodes of night eating, associated with significant
    distress
  16. 16Why does the OSFED category exist? (LO1)In DSM-IV about 50% of patients fell into other specified eating disorder therefore this category was developed to provide more specific diagnosis to account for this.
  17. 17Why might it be more helpful to take a transdiagnostic approach to eating disorder? (LO1)Patients with eating disorders tend to migrate between the diagnostic categories of anorexia nervosa, bulimia nervosa,
    and the atypical eating disorders (Fairborn and Harrison,2003)
    This temporal movement, together with the fact that anorexia
    nervosa, bulimia nervosa, and the atypical eating disorders share the same distinctive psychopathology, suggest that
    common mechanisms are involved in their persistence.
  18. 18What is one potential issue with a transdiagnostic approach? (LO1)However, where do we draw the line? High co-morbidity means you could argue that there is significant overlap between EDs and other disorders and therefore, EDs could be considered part of these disorders.
    Yet, the fact that eating disorders do not tend evolve into other conditions lends
    support to the distinctiveness of the diagnostic category as a whole.
  19. 19What is one potential challenge with diagnosis? (LO1)There is a lot of overlap in symptoms so this can make diagnosis challenging.
  20. 20What treatments do NICE, in the 2017 draft guidelines, recommend for adults with AN? (LO4)- CBT-ED (Cognitive Behaviour Therapy- Eating Disorder)
    - Focal psychodynamic psychotherapy
    - MANTRA (Maudsley Model Anorexia Nervosa Treatment for Adults)
    - SSCM (Specialist Supportive Clinical Management)
  21. 21What treatments do NICE, in the 2017 draft guidelines, recommend for adolescents with AN? (LO4)AN focused family therapy (single/multifamily) (18-20 sessions over 1 year)
  22. 22What treatments do NICE, in the 2017 draft guidelines, recommend for adolescents and adults with BN? (LO4)For adults:
    - BN focused guided self help
    - CBT- ED (up to 20 sessions)
    For adolescents:
    - BN focused family therapy (18-20 sessions over 6 months)
    - BN focused guided self help
  23. 23—

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Clinical Psychology Karteikarten am Eating Disorders (Clinical Topic 6) , erstellt von Nichola Livermore am 25/07/2017.
Erstellt von
Nichola Livermore
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