Chapter 9 (Eating Disorders)
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Questions and Answers

Which disorder involves eating non-nutritive, non-food substances?

  • Anorexia Nervosa
  • Avoidant/Restrictive Food Intake Disorder
  • Binge-Eating Disorder
  • Pica (correct)

What is a common characteristic of Rumination Disorder?

  • Binge eating followed by purging
  • Recurrent regurgitation of food (correct)
  • Severe restriction of food intake
  • Intense fear of gaining weight

Which of the following is classified as a feeding disorder?

  • Avoidant/Restrictive Food Intake Disorder (correct)
  • Binge-Eating Disorder
  • Bulimia Nervosa
  • Anorexia Nervosa

Which eating disorder is characterized by episodes of eating large quantities of food without compensatory behaviors?

<p>Binge-Eating Disorder (D)</p> Signup and view all the answers

What does the term 'unspecified feeding or eating disorder' refer to?

<p>A disorder that does not meet the criteria for other specified eating disorders (C)</p> Signup and view all the answers

What social factor is commonly reported by individuals with bulimia nervosa?

<p>Increased critical comments about their eating habits (D)</p> Signup and view all the answers

Which biological factor is associated with binge-eating disorder?

<p>Dysfunction in the serotonin system (B)</p> Signup and view all the answers

What psychological factor is strongly supported in relation to binge-eating disorder?

<p>Strong support for the role of negative affect (C)</p> Signup and view all the answers

Which subtype of Bulimia Nervosa was found to be the most common according to the DSM-IV?

<p>Purging (A)</p> Signup and view all the answers

What is a common family-related contributing factor for individuals with bulimia nervosa?

<p>History of poor family functioning (B)</p> Signup and view all the answers

What emotional state is frequently associated with binge eating in individuals with binge-eating disorder?

<p>Negative affect and emotional eating (A)</p> Signup and view all the answers

What change was made in DSM-5 regarding the subtypes of Bulimia Nervosa?

<p>The nonpurging subtype was eliminated. (C)</p> Signup and view all the answers

Which disorder is considered to have similarities with the nonpurging subtype of Bulimia Nervosa?

<p>Binge-Eating Disorder (A)</p> Signup and view all the answers

How is the validity of the subtypes of Bulimia Nervosa regarded in recent classifications?

<p>Questionable validity (A)</p> Signup and view all the answers

Which of the following disorders is NOT included under Feeding and Eating Disorders in DSM-5?

<p>Obsessive-Compulsive Disorder (D)</p> Signup and view all the answers

What type of disorder is Rumination Disorder classified as?

<p>A Feeding and Eating Disorder (A)</p> Signup and view all the answers

What does the acronym BED stand for in relation to eating disorders?

<p>Binge-Eating Disorder (C)</p> Signup and view all the answers

Which of the following best describes Pica?

<p>Ingesting non-nutritive substances (D)</p> Signup and view all the answers

Which of the following is NOT a criterion for a binge-eating episode?

<p>Feeling a sense of control (A)</p> Signup and view all the answers

How frequently must binge-eating episodes occur to meet the diagnostic criteria?

<p>At least once a week for 3 months (A)</p> Signup and view all the answers

What emotional response often follows a binge-eating episode?

<p>Feeling disgusted or guilty (D)</p> Signup and view all the answers

Which characteristic is associated with binge-eating episodes?

<p>Eating a large amount of food in a short time (B)</p> Signup and view all the answers

Which statement is true regarding the diagnostic status of binge-eating disorder?

<p>It has full diagnostic status in DSM-5. (A)</p> Signup and view all the answers

What is one example of a behavior that characterizes binge-eating episodes?

<p>Eating alone due to embarrassment (D)</p> Signup and view all the answers

Which criterion is NOT associated with binge-eating disorder?

<p>Use of laxatives to control weight (C)</p> Signup and view all the answers

Which psychological factor is specifically associated with anorexia nervosa?

<p>Dysfunctional thinking (D)</p> Signup and view all the answers

What role do pro-anorexia websites play in the context of anorexia nervosa?

<p>They contribute to social pressures related to thinness. (C)</p> Signup and view all the answers

Which biological factor is associated with bulimia nervosa?

<p>Moderate hereditability (B)</p> Signup and view all the answers

What psychological triggers are involved in the Dual Pathway Model for bulimia nervosa?

<p>Dietary restriction, negative affect, or both (C)</p> Signup and view all the answers

Which psychological factor may contribute to anorexia nervosa?

<p>Perfectionism and unrealistic standards (C)</p> Signup and view all the answers

How do family factors influence the development of anorexia nervosa?

<p>Criticism from parents is linked to higher risk. (B)</p> Signup and view all the answers

Which of the following is NOT a psychological factor contributing to anorexia nervosa?

<p>Family nurture (A)</p> Signup and view all the answers

What is a characteristic of biological factors associated with bulimia nervosa?

<p>Familial predisposition to mood disorders (B)</p> Signup and view all the answers

What social factor contributes to the aetiology of binge-eating disorder?

<p>Reduced levels of affection (B)</p> Signup and view all the answers

Which statement best describes the influence of cultural imperatives on body image?

<p>Cultural imperatives suggest that thinness is equated with success and happiness. (C)</p> Signup and view all the answers

What is the effect of obesity stigma on individuals?

<p>It can lead to discrimination and negative attitudes. (C)</p> Signup and view all the answers

Which of the following is a potential consequence for North American minority populations regarding body image?

<p>Increased rates of obesity and eating disorders (C)</p> Signup and view all the answers

How do media standards affect eating disorders?

<p>They establish unattainable beauty ideals. (D)</p> Signup and view all the answers

What trend is observed with dieting in relation to anorexia nervosa (AN) and bulimia nervosa (BN)?

<p>Dieting consistently precedes the onset of AN and BN. (A)</p> Signup and view all the answers

What aspect differentiates ideal body size standards for men from those for women?

<p>Women typically aim for thinner ideals than men. (A)</p> Signup and view all the answers

What is a common misconception about the body image of women with distorted eating attitudes?

<p>They often have a distorted view of their ideal versus current shape. (C)</p> Signup and view all the answers

How do cultural values impact standards for body image?

<p>Cultural values determine the perception of body image in different populations. (A)</p> Signup and view all the answers

What role do perceived social standards play in eating disorders?

<p>They may contribute to the development of eating disorders. (A)</p> Signup and view all the answers

What observation is made about beauty standards over time?

<p>Beauty standards evolve and change rapidly. (D)</p> Signup and view all the answers

How is dieting experimentally linked to eating disorders?

<p>Experimental research on dieting has mixed results. (D)</p> Signup and view all the answers

Which factor is associated with poorer family functioning in relation to binge-eating disorder?

<p>Elevated levels of criticism (C)</p> Signup and view all the answers

What type of changes in body size standards are referenced?

<p>Body size standards change rapidly. (A)</p> Signup and view all the answers

Flashcards

Pica

Eating non-nutritive substances

Rumination Disorder

Repeatedly chewing and spitting out food.

Avoidant/Restrictive Food Intake Disorder

A problem with eating or eating certain foods

Anorexia Nervosa

A serious eating disorder

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Bulimia Nervosa

Eating large amounts of food then vomiting to prevent weight gain.

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Bulimia Nervosa Subtypes

DSM-IV categorized bulimia nervosa into purging (most common) and nonpurging subtypes. The validity of these subtypes was questioned.

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Nonpurging Bulimia

A less common type of bulimia characterized by methods other than purging to compensate for overeating, like fasting or excessive exercise.

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DSM-5

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition. This version eliminated specific subtypes for bulimia nervosa.

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Bulimia Nervosa and Body Image

Individuals with bulimia nervosa often have distorted body image perceptions, which strongly influence their eating behaviors.

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DSM-5-TR Feeding and Eating Disorders

A section of the DSM-5-TR focusing on several feeding and eating disorders, including those discussed in the passage.

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Binge-Eating Disorder

A disorder characterized by recurrent episodes of binge eating without compensatory behaviors.

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Binge-Eating Episode

A period of time where an individual consumes significantly more food than most people would, feeling out of control while eating.

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DSM-5-TR Criteria

The official diagnostic criteria for Binge-Eating Disorder as outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Text Revision.

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Recurrent Episodes

Binge-eating episodes happening regularly, at least once a week for three months, on average.

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Lack of Control

During a binge-eating episode, the individual feels unable to stop eating despite their intentions, feeling like they are losing control.

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Compensatory Behaviors

Actions taken to prevent weight gain, like purging or excessive exercising, not present in Binge-Eating Disorder.

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Marked Distress

Significant emotional discomfort or distress related to binge eating.

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Exclusive to Bulimia Nervosa or Anorexia Nervosa

Binge-eating episodes in Binge-Eating Disorder should not be exclusively occurring within the course of Bulimia Nervosa or Anorexia Nervosa.

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Social Factors in Bulimia

People with bulimia often experience negative comments about their eating, body shape, and weight, and come from families with poor functioning. These social factors contribute to the development of bulimia.

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Trigger for Binge Eating in Bulimia

Negative interpersonal interactions, like arguments or stressful social events, can trigger binge eating episodes in individuals with bulimia.

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Heritability of Binge-Eating Disorder

Binge-eating disorder has a moderate genetic component, suggesting that family history can play a role in its development.

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Serotonin System Dysfunction in Binge-Eating Disorder

Dysfunction in the serotonin system, a neurotransmitter involved in mood regulation and appetite, may contribute to the development of binge-eating disorder.

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Emotional Eating and Binge-Eating Disorder

People with binge-eating disorder often use food to cope with negative emotions, a pattern known as emotional eating. This can lead to uncontrolled binge episodes.

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Neuroendocrine Systems in Eating Disorders

These systems regulate hunger and fullness. They may be abnormal in people with eating disorders.

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Low Self-Esteem in Anorexia

People with anorexia often have a negative view of themselves. They may set unrealistic standards for their appearance.

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Perfectionism in Anorexia

People with anorexia strive for unrealistic perfection. They may be overly critical of themselves and their bodies.

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Family Factors in Anorexia

Anorexia may be influenced by family dynamics, such as criticism from parents or a lack of emotional support.

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Peer Pressure and Anorexia

Peer groups and social media can contribute to eating disorders through pressure to conform to unrealistic body ideals.

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Heritability in Bulimia

Bulimia has a genetic component. It may run in families, like other conditions.

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Dietary Restriction and Bulimia

A major factor in binge eating is restricting food intake. It can trigger intense cravings.

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Negative Affect and Bulimia

People with bulimia may binge eat when experiencing negative emotions such as stress or sadness.

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Obesity Stigma

Negative attitudes and behaviors directed towards individuals with obesity.

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Cultural Imperatives for Thinness

Societal expectations that equate thinness with success, happiness, and desirability.

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Ideal Body Size Standards

Constantly evolving societal expectations about the 'perfect' body size and shape.

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Media Standards of Beauty

The portrayal of specific body types in media, often reinforcing unrealistic beauty ideals.

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Social and Gender Standards of Beauty

Internalized beliefs about ideal body image, often influenced by societal expectations for men and women.

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Eating Disorders in Minority Populations

Higher prevalence of eating disorders among certain minority groups, especially after migration to Western cultures.

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Cultural Values and Body Image

The intersection of cultural beliefs and societal expectations shaping attitudes toward body image.

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Standards of Body Image for Men vs. Women

Different societal expectations and perceptions of ideal body image for men and women.

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Distorted Body Image Perception

A distorted view of one's own body size and shape, often leading to unhealthy eating behaviors.

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Dieting and Eating Disorders

A strong correlation between dieting and the development of eating disorders like Anorexia Nervosa and Bulimia Nervosa.

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Prospective Studies of Dieting

Research following individuals over time to assess the impact of dieting on the development of eating disorders.

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Experimental Research on Dieting and Eating Disorders

Studies manipulating dietary practices to investigate their influence on eating disorder development.

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Animal Research on Dieting and Eating Disorders

Studies using animal models to understand the underlying mechanisms of dieting and eating disorder development.

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Beauty Standards in Society

Societal expectations of physical beauty, often reinforcing unrealistic ideals and contributing to body image dissatisfaction.

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BMI of Miss America Winners

The Body Mass Index (BMI) of Miss America winners, reflecting changing societal beauty standards over time.

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Study Notes

  • This material is reproduced by the University of South Australia.
  • Reproduction or communication may be subject to copyright.

Chapter 9: Eating Disorders

  • The DSM-5-TR includes a chapter on 'Feeding and Eating Disorders.'
  • These disorders involve a persistent disturbance in eating or eating-related behavior that significantly impairs physical or psychosocial functioning.

Learning Objectives

  • 9.1: Describe the diagnostic features of eating disorders.
  • 9.2: Describe current understandings regarding the epidemiology, aetiology, and treatment of anorexia nervosa.
  • 9.3: Describe current understandings regarding the epidemiology, aetiology, and treatment of bulimia nervosa.
  • 9.4: Describe current understandings regarding the epidemiology, aetiology, and treatment of binge-eating disorder.
  • 9.5: Understand key challenges facing the eating disorders field and evaluate the various responses to these challenges.

DSM-IV versus DSM-5 (and 5-TR)

  • DSM-IV and DSM-5 (and 5-TR) have different categories for eating disorders.
  • DSM-5 includes Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder, Pica, Rumination Disorder, and Avoidant/Restrictive Food Intake Disorder.

DSM-5-TR Feeding and Eating Disorders

  • Contains categories for Pica, Rumination Disorder, Avoidant/Restrictive Food Intake Disorder, Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder, and other unspecified eating disorders.

Eating Disorders

  • The chapter aims to cover general description, epidemiology, aetiology, and treatment.
  • The chapter distinguishes between "Anorexia" and "Bulimia" and "Anorexia Nervosa" and "Bulimia Nervosa," recognizing the need for clarity.

Anorexia Nervosa - Clinical Description

  • Persistent energy intake restriction
  • Historically, the DSM has used specific weight criteria (e.g., 15% below expected weight or BMI of <17.5).
  • Now criteria are more general and vague.
  • Intense fears related to gaining weight.
  • Difficulty controlling eating.
  • Significant body image disturbance.

Anorexia Nervosa - DSM-5-TR Criteria

  • Energy intake significantly lower than needed, leading to significantly low body weight for age, sex, and developmental trajectory.
  • Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even at low weight.
  • Disturbances in how one's body weight or shape is perceived, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low weight.
  • Two types: Restricting type or Binge-eating/purging type.

Anorexia Nervosa - Severity

  • Severity levels categorized by BMI (e.g., mild >= 17, extreme <15).

Anorexia Nervosa - Subtypes

  • Restricting type: No binge eating or purging; strict adherence to rules and morals.
  • Binge-eating/purging type: Binge eating or purging behaviors.

Bulimia Nervosa - DSM-5-TR Criteria

  • Recurrent episodes of binge eating and compensatory behaviours to avoid weight gain (e.g., vomiting, laxatives), occurring at least once a week for three months.
  • Intense fear of gaining weight or becoming fat.
  • Self-evaluation unduly influenced by body shape and weight.

Bulimia Nervosa

  • DSM-IV had subtypes (purging, non-purging).
  • DSM-5 eliminated these subtypes and focused on purging behaviours.

Body Image and Bulimia Nervosa

  • Body image is essential and central to disordered eating, including bullimia.

Feeding Disorders

  • Types like Pica, Rumination Disorder, and Avoidant/Restrictive Food Intake Disorder are also included in the DSM-5-TR.

Binge-Eating Disorder

  • Recurrent episodes of binge eating, without compensatory behaviors.
  • Disordered eating that involves food binges that are out of control.
  • Distress about binge eating is present.
  • The binge eating occurs at least once a week for three months.

DSM-5-TR

  • Eating disorders were formerly categorised under Eating Disorders Not Otherwise Specified (EDNOS).
  • EDNOS was replaced by Other Specified Feeding or Eating Disorder (OSFED) in DSM-5-TR.

The Epidemiology of Anorexia Nervosa

  • Commonly affects adolescent girls and young women.
  • Lifetime prevalence rate is approximately 0.9%.
  • Mortality rate is high (5-10%).
  • Typically begins in late adolescence.
  • Medical complications associated with starvation are common.
  • High association with psychological disorders like anxiety, mood disorders, substance abuse.

The Epidemiology of Bulimia Nervosa

  • Predominantly affects females (90–95%).
  • Onset usually occurs in late adolescence or young adulthood.
  • Relatively less severe medical consequences compared to anorexia.
  • Commonly associated with anxiety, mood disorders, and substance use.

The Epidemiology of Binge-Eating Disorder

  • Affects a significant percentage (3-5%) of the adult population.
  • Onset typically occurs during late adolescence or young adulthood.
  • Medical consequences can be significant, although less severe than in anorexia.

Aetiology of Eating Disorders (Causes)

  • Disorder specific approaches
  • Transdiagnostic approaches

Treatment of Eating Disorders

  • Self-help approaches (CBT, IPT, BWL).
  • Medication (antidepressants, anti-convulsants).
  • Family-based therapies (for adolescents).

Any Questions?

  • Students can post questions online.

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