Podcast
Questions and Answers
Which of the following statements accurately describes muscle dysmorphia?
What is a common behavior associated with muscle dysmorphia?
Which of the following is NOT a potential sign of muscle dysmorphia?
What percentage of adolescent boys in a national US sample expressed a desire to bulk up or gain weight?
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What is true regarding the boundaries of muscle building behaviors?
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What psychological factor is associated with substance use disorders?
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Which of the following statements accurately describes harm reduction treatment?
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Which environmental factor is considered a risk for developing substance use disorders in youths?
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What is a key characteristic of antagonist treatments in substance use therapy?
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What is the defining characteristic of binge eating disorder?
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What is one potential consequence of substance usage identified in the content?
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Which of the following is NOT a feature associated with bulimia nervosa?
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What distinguishes the binge-eating/purging type of anorexia nervosa from the restricting type?
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Which of the following substances is associated with a substitution treatment mentioned in the content?
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Which statement accurately describes the prevalence of eating disorders?
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What factor is highlighted as a barrier to successful inpatient treatment for substance use disorders?
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What is a common psychological consequence after binge eating episodes?
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How can smaller brain volumes in children relate to future substance use disorders?
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What is a defining DSM-5 criterion for anorexia nervosa?
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What common problems are associated with anorexia nervosa?
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What factor influences the onset of binge eating disorder compared to other eating disorders?
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What is one of the main criteria for diagnosing schizophrenia according to the DSM-5?
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Which symptom is not part of the negative symptoms associated with schizophrenia?
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During which phase of schizophrenia do individuals typically experience positive symptoms for the first time?
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What distinguishes schizoaffective disorder from other schizophrenia spectrum disorders?
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Which distinguishes a brief psychotic disorder from schizophrenia?
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What symptom can often be observed during the prodrome phase of schizophrenia?
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What is the typical age range for the onset of schizophrenia symptoms in men?
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What factor does aging commonly influence in individuals with schizophrenia?
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What does the heritability estimate of schizophrenia suggest?
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Which neurotransmitter is primarily implicated in the dopamine hypothesis related to schizophrenia?
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Which brain structure is commonly observed to be enlarged in individuals with schizophrenia?
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What role does stress play in the onset of schizophrenia?
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How does marijuana use affect individuals with schizophrenia?
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Which factor is associated with higher rates of schizophrenia in urban populations?
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What does expressed emotion (EE) in social factors indicate?
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Which neurotransmitter is noted to also play a role in schizophrenia alongside dopamine?
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Study Notes
Eating Disorders
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Bulimia Nervosa:
- Characterized by binge eating followed by compensatory behaviors (purging, restricting, exercising)
- Individuals often center their daily lives around weight, diet, and appearance.
- Sensitive to comments about their weight or appearance.
- May have a history of anorexia nervosa.
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Binge Eating Disorder:
- Recurrent episodes of binge eating at least once a week for three months without compensatory behaviors.
- Associated with rapid eating, feeling uncomfortably full, eating when not hungry, eating alone due to embarrassment, and experiencing negative emotions after eating.
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Anorexia Nervosa:
- Defined by severe restriction of energy intake leading to significantly low weight (BMI approximately 18.5).
- Intense fear of gaining weight or becoming fat, or persistent behavior that interferes with weight gain.
- Disturbance in the way one's body weight or shape is experienced, with an undue influence of body weight or shape on self-evaluation, or a persistent lack of recognition of the seriousness of the current low weight.
Anorexia Nervosa Specifiers
- Restricting type: individuals do not engage in recurrent episodes of binge eating or purging behavior.
- Binge-eating/purging type: individuals engage in recurrent episodes of binge eating or purging behaviors, which can be more severe due to the purging methods.
Problems Associated with Anorexia Nervosa
- Preoccupation with food
- Struggle for control over hunger
- Loss of interest in or sexual difficulties
- Medical problems
Diagnostic Specificity
- A diagnosis of anorexia nervosa takes precedence over a diagnosis of bulimia nervosa.
- A diagnosis of bulimia nervosa takes precedence over a diagnosis of binge eating disorder.
Onset and Prevalence of Eating Disorders
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Onset:
- Similar for both bulimia nervosa and anorexia nervosa.
- Anorexia nervosa may have an earlier onset (around 12-13 years old).
- Bulimia nervosa typically develops during high school or college years.
- Binge eating disorder can occur later in life (30s-40s).
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Prevalence:
- Rare in general populations.
- Binge eating disorder and bulimia nervosa are more common than anorexia nervosa.
- Disordered eating behaviors are common, but not necessarily disorders themselves.
- Cohort effect: Eating disorders are more common in recent cohorts compared to depression.
- Most prevalent in industrialized nations, including the US, Western Europe, China, Korea, and Japan.
- Higher prevalence in women than men.
Muscle Dysmorphia
- Technically classified under obsessive-compulsive disorder and related disorders.
- Included as a specifier for body dysmorphic disorder in the DSM-5.
- Characterized by a preoccupation with the belief that one's body is not muscular enough, even if objectively the person is muscular.
- May involve excessive dieting, exercising, weightlifting, and potential use of dangerous anabolic steroids.
- Almost exclusively occurs in men.
Signs to Look Out For
- Regimented workouts, meals, or food restrictions, particularly focusing on high-protein options.
- Disrupting normal activities to exercise.
- Obsessively taking photos of muscles to track improvement.
- Weighing oneself multiple times a day.
- Dressing to emphasize a muscular physique or hiding it because it's not considered good enough.
Growing Trend Among Men
- A nationally representative US sample found that 30% of adolescent boys want to bulk up or gain weight, including 40% who are objectively at a normal weight by BMI standards.
- 22% of adolescent boys report muscle-building behaviors, including eating differently to build muscle, supplement use, and androgenic-anabolic steroid use.
Substance Use Disorder
- After substance usage, there is a reduction in brain volume.
- Four drinks per day are associated with more significant volume loss.
- Smaller brain volumes in children can also predict substance use disorder.
Psychological Factors Contributing to Substance Use Disorder
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Personality:
- Risk-taking behavior
- Impulsivity
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Emotional Regulation:
- Heightened negative emotionality
- Difficulty regulating emotions
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Comorbidity:
- Substance use may be used as a way to self-medicate or dampen other symptoms.
Social and Environmental Factors Contributing to Substance Use Disorder
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Social:
- Peer pressure
- Lack of social connection
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Family Environment:
- Early life experiences
- Family history of substance use
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Community:
- Stressors such as trauma and poverty
- Advertisement and media influence
Substance Use Disorder Treatment
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Abstinence:
- Treatment requires complete abstinence from substance use.
- This approach can be very punitive, with low retention rates due to potential relapse.
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Harm Reduction:
- Reduces substance use with a goal of improving function and quality of life.
- Primarily uses cognitive behavioral therapy (CBT) to help individuals manage substance use.
Medications for Substance Use Disorder
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Substitution:
- Replaces one drug with a similar drug considered less dangerous.
- Examples: methadone (for heroin/opiate addicts), nicotine gum/patch.
- Methadone is highly controversial, and requires a gradual reduction in dosage over time.
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Antagonistic Treatment:
- Uses drugs that block or counteract pleasurable drug effects.
- Naltrexone is used for opiate and alcohol problems.
- Over time, individuals may stop taking the substance because they do not experience their desired effects.
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Aversive Treatment:
- Makes substance use extremely unpleasant.
- Antabuse for alcoholism causes individuals to feel sick rapidly after drinking alcohol, associating alcohol with negative sensations.
- This treatment is only effective for individuals highly motivated to quit.
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Efficacy of Biological Treatments:
- Biological treatments should be combined with talk therapy for the best outcomes.
Treatment for Substance Use Disorder
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Inpatient Care:
- Mainly used for detoxification (withdrawal from substances under medical supervision).
- Some drugs are more difficult to detox from, such as benzodiazepines, which can lead to unsafe withdrawal symptoms like hallucinations.
Catatonia
- Characterized by peculiar increased or repeated gestures or immobility.
- Rarely seen today due to the effectiveness of medications.
Schizophrenia
- Diagnosed when an individual experiences at least two of the following symptoms for at least six months, with at least one of these symptoms being delusions, hallucinations, or disorganized speech:
- Delusions: False beliefs that are not based on reality.
- Hallucinations: Perceptual experiences that are not real, such as hearing voices or seeing things that don't exist.
- Disorganized Speech: Incoherent or illogical speech patterns.
- Disorganized (or Catatonic) Behavior: Unusual or disjointed behavior.
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Negative Symptoms: A decrease in motivation, emotional expression, or speech. This can include:
- Anhedonia: Loss of interest or pleasure.
- Asociality: Social withdrawal.
- Flat Affect: A lack of emotional expression.
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Case Study:
- Symptoms observed in a case study included delusions, disorganized speech and behavior, and hallucinations.
Timeline of Schizophrenia
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Premorbid Phase:
- Occurs before the development of positive symptoms.
- Home movie study:
- Fewer expressions of positive emotions, such as smiles and laughter.
- Reduced responsiveness to peers.
- Involuntary hand or body movements.
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Prodrome Phase:
- Typically emerges in early adolescence.
- Functional decline, including difficulty at school, attention problems, and completing homework.
- Increased social withdrawal.
- Hearing whispers or seeing shadows.
- Disheveled appearance.
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Psychotic Phase:
- Active positive symptoms such as delusions and hallucinations.
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Stable Phase (Chronic):
- Positive symptoms are managed or less severe.
- Negative symptoms are present.
- Cognitive symptoms may be evident.
- Individuals may cycle between psychotic and stable phases, with aging often associated with reduced psychosis.
Other Schizophrenia Spectrum Disorders
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Schizoaffective Disorder:
- Experiences symptoms of both schizophrenia and mood disorders.
- Psychotic symptoms must be independent of mood episodes.
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Brief Psychotic Disorder:
- Shares the same symptoms as schizophrenia but has a shorter duration (1 day to 1 month).
- Can be triggered by stress.
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Delusional Disorder:
- Characterized by persistent delusions lasting at least one month.
- Other schizophrenia symptoms are not present.
Facts and Statistics about Schizophrenia
- One of the top 10 leading causes of disability worldwide.
- Affects approximately 1% of the population.
- Typical age of onset for men is 18-25 years old, while it can begin later for women.
- Gender differences in prevalence are debated, with recent research suggesting equal rates or slightly higher rates in men.
- Higher rates of suicide, substance use, and depression.
Epidemiology of Schizophrenia: Biological Factors
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Heritability:
- Estimated to be about 77%.
- Higher concordance rates in monozygotic (MZ) twins (45%) compared to dizygotic (DZ) twins (12%), suggesting a significant genetic component.
- Overlapping genetic risk factors with other diagnoses, such as bipolar disorder and autism spectrum disorder.
Biological Factors: Neurotransmitters
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Dopamine Hypothesis:
- Proposes that schizophrenia is caused by an excess of dopamine.
- Evidence:
- Medications that increase dopamine levels, such as those used to treat Parkinson's disease, can induce psychotic symptoms.
- Cocaine, which increases dopamine, can also cause psychotic symptoms.
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Problem with the Dopamine Hypothesis:
- It doesn't fully explain cognitive and negative symptoms.
- Decreasing dopamine levels with medication does not eliminate all symptoms.
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Dopamine in Schizophrenia:
- Schizophrenic patients have increased dopamine levels in the limbic system.
- While dopamine is a contributing factor, it is not the sole cause of schizophrenia.
Neurotransmitters: It's Complicated
- The role of neurotransmitters in schizophrenia is complex.
- It likely involves multiple neurotransmitters beyond dopamine, such as serotonin and glutamate.
Biological Factors: Brain Structure and Function
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Brain Structure:
- Enlarged ventricles (fluid-filled spaces in the brain).
- Reduced volume in the frontal and temporal lobes, and hippocampus (involved in memory).
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Brain Function:
- Reduced activation in the prefrontal cortex, limbic system (during anticipation), and hippocampus.
Social and Environmental Factors Contributing to Schizophrenia
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Stress:
- Genetic susceptibility combined with environmental stressors may trigger the onset of psychosis and future episodes.
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Complications During Pregnancy or Birth:
- Prenatal infections and malnutrition can contribute to the development of schizophrenia.
Environmental Factors
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Marijuana Use:
- In individuals with existing schizophrenia, marijuana use is associated with worsening symptoms.
- Some research suggests that marijuana use can trigger psychosis, particularly in those vulnerable to schizophrenia.
- Further research is needed to fully understand this relationship.
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Urbanicity:
- Higher rates of schizophrenia (about three times higher) among people living in urban areas compared to rural areas.
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Poverty:
- Higher rates of schizophrenia among urban poor populations.
Social Factors: Expressed Emotion (EE)
- Characterized by hostile, critical, and overinvolved comments from family members.
- EE is associated with a greater risk of relapse but does not cause schizophrenia.
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Description
This quiz explores the characteristics and symptoms of various eating disorders, including Bulimia Nervosa, Binge Eating Disorder, and Anorexia Nervosa. Delve into the behaviors, emotional factors, and physical consequences associated with these conditions. Assess your understanding of the psychological aspects and implications of eating disorders.
