Abnormal Psychology- Ch 11 (Comer)
-Intense fear of gaining weight
-Disturbed body perception, undue influence of weight or shape on self-perception, denial of the seriousness of condition
Warped body image. Typically perceive themselves as upwards of 20% larger than they actually are.
OCD (typically food related, but can be broader)
Low blood pressure
Reduced bone mineral density
Slow heart rate
Rough, dry and cracked skin
Lanugo on the trunk (fine silky hairs)
Recurrent compensatory behavior to prevent weight gain (response to binge)
Symptoms presenting twice a week for three months
Undue influence of weight or shape on self-image
15-21 years of age
Weight stays within a normal range, but fluctuates wildly inside those parameters
Non-purging type- Fasting or exercising frantically
Binge-eating- Binge eating with no compensatory behavior.
Food is typically sweet, with soft texture. Highly caloric.
Binges are preceded by significant tension, with the person feeling irritable and unable to control an overwhelming need to eat.
Post-binge, there are feelings of self-recrimination, shame, guilt and depression. Also the fear of weight gain and being discovered.
The purging may alleviate much of the anxiety and self-loathing. However, this may open the door for increased binges, which then necessitate purges.
More trusting of those trying to help
Intense hunger experienced (vs denied)
Recognize behavior is abnormal
More sexually experienced
This leads to the child’s inability to interpret their own needs and appropriate responses. Unable to ‘trust’ their own feelings, the children feel they aren’t in control of themselves.
Manipulating their body-shape/eating habits provides the needed sense of control.
Impaired ability to describe emotions to others.
Impaired imaginative functions.
Cognitive functioning which is highly external and stimulus oriented.
Ventromedial Hypothalamus: When stimulated, suppresses hunger.
Along with two chemicals (CCK, GLP-1) these areas produce a weight-based homeostasis. When fasting, GLP-1 is suppressed and metabolism slows to encourage weight gain. When full, metabolism increases and GLP-1 is produced.
Hospital stay, in which patients are rewarded for gaining weight.
Supportive nursing care, nutritional counseling and a high-calorie diet.
They are also taught to identify their core belief that they SHOULD be judged based on their shape.weight and their control of those features.
Alternative coping behaviors (rather than restrictive eating) are taught.
Recovery recurs in 1/3 of recovered patients, typically triggered by new life stressors.
Individuals with psych or sexual issues prior to anorexia are less likely to recover.
The more weight lost and/or the longer before treatment begins, the less recovery is likely.
Having the client eat ‘forbidden’ foods, then staying with them until the desire to ‘purge’ has passed, to show that eating is not an activity that needs undoing.
The client is taught to identify and challenge the maladaptive thinking that precedes a binge.
Improvement has been shown in 40% of patients, reducing their binges by 67% and purges by 56%. Works best when concurrent with other therapies.
40% respond immediately to treatment, with significant improvement. A further 40% respond moderately.
Relapse occurs in 1/3 of patients within 2 years, but typically within six months. Those who experienced it longer are more likely to relapse.