Questions and Answers
What percentage of middle and high school girls reported problems with body image?
41.5%
What percentage of middle and high school boys reported problems with body image?
24.9%
What is the purported role of personal (eating) choices/habits in appearance/weight?
Strongly emphasized
What does the AMA disavow as a measure of individual health?
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What is the immediate goal in (severe) AN treatment?
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What is the recommended length of treatment for AN?
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What is the focus of Family-Based Therapy (FBT) for AN?
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What is the role of medication in the treatment of AN?
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What is the common 'side effect' of Vyvanse in the treatment of BED?
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What is the focus of prevention efforts for eating disorders?
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What is the percentage of patients with severe eating disorders committed to a hospital for treatment against their will?
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What is the potential benefit of adding ERP to CBT in the treatment of eating disorders?
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What is the recommended treatment intensity for AN?
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What is the potential role of olanzapine in the treatment of AN?
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What is the focus of cognitive behavioral therapy (CBT) in the treatment of eating disorders?
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What is the focus of psychoeducational approaches in the prevention of eating disorders?
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What is linked to reinforced restricted eating and compulsive exercise in Anorexia Nervosa (AN)?
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What is related to feelings of satiety and low levels of its metabolites are found in Anorexia Nervosa (AN)?
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What are partially heritable in terms of eating disorders?
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What is linked to difficulties in emotion regulation and feelings of self-control in individuals with eating disorders?
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What is not specific to eating disorders but may precede disordered eating in some cases?
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What plays a role in the development of eating disorders according to the text?
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What is at greater risk for major depression, substance use disorders, and OCD?
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What is strongly genetically overlapped with eating disorders according to the text?
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What is not specific to eating disorders but contributes to disordered eating and poor mental health?
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Who is less likely to seek treatment for eating disorders according to the text?
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What are individuals with eating disorders often pessimistic about according to the text?
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What is the lifetime prevalence of Anorexia Nervosa (AN) in the US?
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At what age does Anorexia Nervosa (AN) typically have an average onset?
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What is the worldwide lifetime prevalence of Binge Eating Disorder (BED)?
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In which gender is Binge Eating Disorder (BED) more common?
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What is one of the most medically dangerous diagnoses in the DSM, with mortality rates 5-10x higher than the general population?
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What percentage of individuals with Anorexia Nervosa (AN) recover?
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What is the worldwide lifetime prevalence of Bulimia Nervosa (BN)?
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At what age does Bulimia Nervosa (BN) typically have an average onset?
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What percentage of individuals with Bulimia Nervosa (BN) recover?
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What does Binge Eating Disorder (BED) involve?
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What is the gender ratio for Anorexia Nervosa (AN) in the US?
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Which trait is associated with being outgoing and sociable?
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Which trait is associated with being somewhat careless?
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Which trait is associated with being helpful and unselfish with others?
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Which trait is associated with worrying a lot?
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What is the Diathesis of biologically grounded emotion dysregulation in Linehan’s “Biopsychosocial Model” primarily influenced by?
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What is the characteristic of Avoidant PD as compared to Social Anxiety Disorder according to Chambless et al. (2008)?
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What is the Ironic effect mentioned in the text?
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What is the analogy used to describe people with BPD in the text?
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What did DSM-5 consider but ultimately declined to do regarding psychopathy features?
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Which myth about psychopathy and prison is debunked?
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What does research on psychopathy historically suffer from?
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What is a moderately heritable trait that overlaps with risk for substance use problems?
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What is the strongest predictor of adult ASPD diagnoses?
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What do GxE interactions in ASPD refer to?
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What are environmental risk factors for psychopathy?
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What are the facets of narcissism?
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What is the focus of prevention efforts for psychopathy?
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What is the role of biological parents in shaping offspring’s lives?
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What did research on psychopathy historically suffer from?
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What is a risk factor for ASPD?
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What is the lifetime prevalence of personality disorders in the past 2-5 years?
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What is the primary factor contributing to the etiology of personality disorders?
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What percentage of individuals with personality disorders meet criteria for another PD?
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What is a common diagnosis for individuals who seem to meet the broad criteria for a personality disorder but don't meet criteria for any specific PD?
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What is a significant issue with the current DSM approach to personality disorders?
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What is the stability of personality disorders compared to other classes of disorders?
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What is the diagnostic category for individuals who need to endorse 5 of 9 criteria for diagnosis?
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What is a common issue with the diagnostic criteria for personality disorders?
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What is the primary factor contributing to diagnostic unreliability of personality disorders?
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What is the primary challenge posed by the high rate of comorbidity with other DSM disorders?
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What is the primary challenge in the current approach to diagnosing personality disorders?
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What percentage of individuals diagnosed with BPD report at least one suicide attempt?
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What is the gender ratio of individuals diagnosed with BPD in clinical settings?
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What are the core dimensions included in a dimensional model of BPD?
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What is the focus of the DSM-5 working group's BPD proposal?
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What is associated with high rates of non-suicidal self-injurious behavior?
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What is the approximate percentage of individuals diagnosed with BPD who end their lives by suicide?
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What may confer predisposition to temperament and personality traits associated with BPD?
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What is evident in individuals with BPD according to evidence?
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What are highly correlated with BPD according to the text?
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What is the proposed role of olanzapine in the treatment of BPD?
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What is the focus of psychoeducational approaches in the treatment of BPD?
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What are individuals with BPD more likely to have compared to the general population?
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What did the DSM-5 committee recommend for identifying and describing personality disorders?
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How many personality disorders did the AMPD reduce the number to?
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What does the AMPD focus on in relation to long-standing dysfunction?
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How many broad trait domains does the AMPD emphasize?
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What do the dimensions in the AMPD provide in comparison to traditional methods?
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How was the AMPD proposal received by the DSM-5 Task Force?
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How many comments were received during two months of public comments on the AMPD proposal?
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What was one of the criticisms faced by the AMPD proposal?
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What was the AMPD proposal criticized for in terms of the group of disorders?
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What was the AMPD not the only one of?
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What did the proposal generate debate about in terms of the ethics of conceptualizing and diagnosing personality disorders?
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What did the text discuss specifically in relation to personality disorders?
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What did the DSM-5 committee recommend for identifying and describing personality disorders?
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How many personality disorders did the AMPD reduce to from the DSM-IV PDs?
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What does the AMPD focus on in relation to dysfunction and personality traits?
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How many broad trait domains are emphasized in the AMPD?
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What do the dimensions in the AMPD provide in comparison to the previous system?
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How was the AMPD proposal received by the DSM-5 Task Force?
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What was a criticism of the AMPD proposal?
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What was the criticism related to the number of disorders eliminated by the AMPD?
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What was the response of the proposal generating debate about the ethics of conceptualizing and diagnosing personality disorders?
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What is the AMPD in relation to other proposed frameworks for personality disorders?
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What did the rejection of the AMPD generate in terms of feedback?
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What are the specific personality disorders discussed in the text?
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Which substance was available in Europe around 10,000 years ago?
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In what region were coca leaves chewed for cocaine around 8,000 years ago?
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Which of the following substances is listed in the DSM-5?
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Which quote reflects a struggle with alcohol use disorder?
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What is the primary focus of AA/NA treatment?
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Why is it challenging to conduct research on the effectiveness of AA?
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What is the reported effectiveness of AA based on?
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What is the focus of harm reduction programs in the context of substance use?
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What is the 'Drunken monkey hypothesis' related to?
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In the long-term, what reinforces and maintains substance use?
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When is the human brain most vulnerable to the long-term effects of drugs?
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What is historically separated out from other psychopathologies?
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Which term is associated with biochemical changes affecting neuronal sensitivity in substance use disorders?
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What does the DSM-5 combine into a single diagnosis of substance use disorder?
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What is responsible for over 480,000 deaths per year in the US, including nearly 30% of all cancer deaths?
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What do nearly all addictive drugs, including alcohol, stimulate in the brain?
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What theory emphasizes the distinction between liking (pleasure) and wanting (craving) in substance use disorders?
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What is associated with chronic, heavy alcohol use?
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What plays a role in substance use disorders, with heritability estimates higher in environments with fewer constraints on behavior?
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What do substance use disorders involve, affecting decision-making and learning?
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What is the focus of prevention efforts for substance use disorders?
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What is a controversial topic among researchers in the field of addiction?
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What is the variability in alcohol-related consequences not solely explained by?
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What is a key term associated with substance use disorders and refers to the need for higher doses to achieve the same effect?
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What is often the initial stage of treatment for substance use disorders?
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What is a common approach in the treatment of substance use disorders?
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What factor influences drinking behavior and is often established in childhood?
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What percentage of individuals with substance use disorders receive treatment from a mental health professional?
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What are the treatment goals for substance use disorders?
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What is a factor associated with increased substance use?
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What type of factors contribute to substance use?
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What is a potential use of medications in the treatment of substance use disorders?
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What is an example of a developmental pathway to substance use?
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What is the focus of effective treatment for substance use disorders?
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What is often affiliative and influenced by peer factors and sociocultural attitudes?
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What is a potential goal of treatment for substance use disorders?
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What term did Kurt Snyder use to describe his divergence from reality?
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Who is credited with the detailed clinical description of 'dementia praecox'?
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What did Eugen Bleuler coin in 1911?
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What did Kurt Snyder wonder about his whole existence?
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What is the main effect of early antipsychotics?
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What is a common property of many antipsychotic medications?
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What is a concern associated with long-term use of antipsychotics?
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What is the aim of some novel medications targeting systems other than dopamine/serotonin?
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What is recommended as a combination with medication in current treatment recommendations?
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What is a feature not unique to schizophrenia according to the text?
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What is schizophrenia influenced by, according to the text?
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What is the focus of prevention efforts for schizophrenia, according to the text?
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What does the text suggest about the impairment associated with schizophrenia?
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What is a challenge for schizophrenia research and clinical practice, according to the text?
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What is the gender ratio of individuals diagnosed with schizophrenia in clinical settings?
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What is the focus of effective community programs for schizophrenia, according to the text?
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What are the three main symptom clusters that characterize schizophrenia?
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What do negative symptoms of schizophrenia involve?
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What are examples of positive symptoms of schizophrenia?
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What is the lifetime prevalence of schizophrenia?
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What are some consequences experienced by individuals with schizophrenia?
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What are schizophrenia spectrum disorders that are mentioned in the text?
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What are some etiological factors mentioned in relation to schizophrenia?
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What is the gender prevalence of schizophrenia?
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What do disorganized symptoms of schizophrenia encompass?
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What is the course of schizophrenia like among individuals?
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What are some of the consequences of receiving a schizophrenia diagnosis?
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What are some of the challenges related to early detection and intervention of schizophrenia?
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What does the revised dopamine hypothesis attribute excessive presynaptic synthesis of dopamine to?
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Which structural abnormality is observed in the prefrontal cortex in schizophrenia?
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What is associated with worse neuropsychological performance and functioning in some individuals with schizophrenia?
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What is found in first-degree relatives of those with schizophrenia?
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What environmental influence on neurodevelopment may contribute to schizophrenia?
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What is cannabis use during adolescence associated with in relation to schizophrenia?
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What structural and functional abnormalities are observed in individuals with schizophrenia?
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What is a potential contributor to loss of dendritic spines and connectivity in brain white matter observed in schizophrenia?
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What may impact schizophrenia manifestations and outcomes?
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What does the glutamate hypothesis suggest in relation to schizophrenia?
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What is the primary neurotransmitter implicated in the dopamine hypothesis of schizophrenia?
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What does the genetic variants associated with risk in GWAS not fully account for in schizophrenia heritability?
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Study Notes
Eating Disorders: Clinical Description and Epidemiology
- Eating disorders are characterized by psychological addiction to behaviors affecting the body and mind
- Anorexia Nervosa (AN) may not cause overt distress and can be a source of personal satisfaction or pride
- "Atypical anorexia" can occur in overweight individuals, leading to underdiagnosis and treatment delays
- Binge Eating Disorder (BED) involves frequent binging without compensatory behaviors
- Many with eating disorders experience diagnostic crossover, meeting criteria for different disorders over time
- AN has a lifetime prevalence of <1% in the US, with a gender ratio of 3+:1 and an average onset of 14-20
- BN has a worldwide lifetime prevalence of ~1%, with a large gender gap and an average onset of 15-24
- BED has a worldwide lifetime prevalence of ~2%, more common in women, with a slightly later average age of onset
- Eating disorders are associated with increased risk for negative consequences and comorbidity with other mental disorders
- AN is one of the most medically dangerous diagnoses in the DSM, with mortality rates 5-10x higher than the general population
- Prognosis for AN: 50-75% recover, relapse is common, and there is a high rate of suicide
- Prognosis for BN: ~75% recover, early intervention associated with improved outcomes, and suicide attempts are made in 25-30% of cases
Reforming the Diagnosis of Personality Disorders: The AMPD and its Controversy
- The DSM-5 committee recommended a shift towards a dimensional system for identifying and describing personality disorders.
- The Alternative Model of Personality Disorders (AMPD) reduced the number of PDs to 6 out of the 10 DSM-IV PDs.
- The AMPD focuses on long-standing dysfunction and how personality traits might explain these difficulties.
- It emphasizes two types of dimensional ratings: 5 broad trait domains and 25 narrower facets of those traits.
- The dimensions in the AMPD provide more specificity, richer index of “how much” and have higher internal consistency and test-retest stability.
- The AMPD proposal was unanimously approved by the PD working group but was rejected by the DSM-5 Task Force and relegated to an obscure appendix.
- The rejection of the AMPD generated significant pushback, with approximately 8,600 comments received during two months of public comments.
- The proposal faced criticism for being complex and incoherent, with clinicians and researchers expressing concerns about its clinical utility.
- The proposal was criticized for eliminating half of the group of disorders and received opposition from those invested in the status quo.
- The AMPD is not the only alternative framework or dimensional model proposed for personality disorders.
- The proposal generated debate about the ethics of conceptualizing and diagnosing a person’s “personality” as “disordered”, and the stigma associated with personality disorders among mental health professionals and researchers.
- The text also discusses specific personality disorders, such as schizotypal and psychopathy, and their overlap and differences with other disorders.
Substance Use Disorders: Factors, Treatment, and Outcomes
- Alcohol expectancies influence drinking behavior and are often established in childhood
- Personality dimensions like negative affectivity and low constraint predict the onset of substance use disorders
- Family factors such as parental alcohol use, modeling, and lack of emotional support are associated with increased substance use
- Substance use is often affiliative, influenced by peer factors and sociocultural attitudes
- Environmental and sociocultural factors, including availability and stress, contribute to substance use
- Developmental pathways to substance use include internalizing and externalizing pathways
- Only 18% of those with substance use disorders receive treatment from a mental health professional
- Treatment goals may include complete abstinence, reduced use, or harm reduction
- Detox is often the initial stage of treatment, and medications may be used to reduce cravings or block receptor binding
- Psychotherapy, including cognitive behavioral therapies and relapse prevention training, is a common treatment approach
- Residential care can be expensive and controversial, with its effectiveness compared to outpatient care not clear
- Effective treatment should address multiple needs of the individual, including environmental factors, social relationships, and comorbid disorders
Understanding Schizophrenia: Insights into Causes and Manifestations
- Genetic variants associated with risk in GWAS do not fully account for schizophrenia heritability
- Dopamine hypothesis suggested excess dopamine levels as the cause of schizophrenia
- Revised dopamine hypothesis attributes excessive presynaptic synthesis of dopamine to positive and disorganized symptoms
- Glutamate hypothesis suggests interactions with dopamine in schizophrenia
- Enlarged ventricles correlated with worse neuropsychological performance and functioning in some with schizophrenia
- Reduction in gray matter and overall volume observed in prefrontal cortex in schizophrenia
- Structural and functional abnormalities in the temporal cortex and reduced hippocampal volume observed in some with schizophrenia
- High stress reactivity found in first-degree relatives of those with schizophrenia
- Loss of dendritic spines and connectivity in brain white matter observed in schizophrenia
- Early environmental influences on neurodevelopment, such as maternal stress and malnutrition, may contribute to schizophrenia
- Cannabis use during adolescence associated with greater schizophrenia risk and symptom severity
- Environmental and sociocultural factors, such as poverty and urbanicity, impact schizophrenia manifestations and outcomes
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Description
Test your knowledge of eating disorders with this quiz on their clinical description and epidemiology. Learn about anorexia nervosa, binge eating disorder, and bulimia nervosa, as well as their prevalence, gender ratios, onset age, and associated risks.