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Eating Disorders (Clinical Topic 6)
Fichas del conjunto (23)
- 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. - 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 - 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. - 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 - 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. - 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. - 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 - 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 - 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. - 10What is a key physical symptom BED? (LO1)Possible history of marked weight
fluctuations - 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 - 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. - 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. - 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. - 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 - 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.
- 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. - 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. - 19What is one potential challenge with diagnosis? (LO1)There is a lot of overlap in symptoms so this can make diagnosis challenging.
- 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) - 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)
- 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—
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- Clinical Psychology Fichas sobre Eating Disorders (Clinical Topic 6) , creado por Nichola Livermore el 25/07/2017.
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- Nichola Livermore
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