Understanding Eating Disorders: Symptoms, Effects, and Treatment

1. Feeding and Eating Disorders;Elimination Disorders;Sleep-Wake Disorders; andDisruptive, Impulse-Control,and Conduct Disorders Chapter 10

2. Eating Disorders • Diagnosis for people who experience extreme disturbances in their everyday diet along with possible distress or concern about their body weight

3. Anorexia Nervosa • Characterized by an inability to maintain normal weight, an intense fear of gaining weight, and distorted body perception • Clinicians classify individuals as: • Restricted type • Binge-eating/purging type

4. Effects of Anorexia Nervosa • Bones, muscles, hair, and nails become weak and brittle • Develop low blood pressure, slowed breathing and pulse • Lethargic, sluggish, and fatigued • Gastrointestinal system functions abnormally • Heart and brain damage • Multiple organ failure

5. Effects of Anorexia Nervosa • Bones, muscles, hair, and nails become weak and brittle • Develop low blood pressure, slowed breathing and pulse • Lethargic, sluggish, and fatigued • Gastrointestinal system functions abnormally • Heart and brain damage • Multiple organ failure

6. Bulimia Nervosa • Alternation between the extremes of eating large amounts of food in a short time • Compensating for the added calories either by: • Vomiting • Other extreme actions to avoid gaining weight

7. Bulimia Nervosa • Binge eating • Ingestion of large amounts of food during a short period of time • Lack of control over what or how much is eaten

8. Bulimia Nervosa • Purging: Eliminating food through unnatural methods • Vomiting • Administering enemas • Taking laxatives or diuretics • Nonpurging type - Trying to compensate by fasting or excessive exercise

9. Effects of Bulimia Nervosa • Ipecac syrup has toxic effects • Dental decay • Laxatives, diuretics, and diet pills also have toxic effects over time • Gastrointestinal damage may be permanent

10. Binge-Eating Disorder • The ingestion of large amounts of food during a short period of time, even after reaching a point of feeling full, and a lack of control over what or how much is • Binges occur at least twice a week for 6 months. • Significant weight gain can occur since there are no compensatory behaviors.

11. Theories and Treatment Of Eating Disorders • Biological - • Medication • Psychological • Inpatient treatment • Outpatient • Cognitive-behavioral therapy

12. Theories and Treatment Of Eating Disorders • Sociocultural • Family component for clients • Clinicians use interventions incorporating a family component for clients with eating disorders who are still in their teens and who have had symptoms for only a brief time.

13. Avoidant/Restrictive Food Intake Disorder • Individuals show an apparent lack of interest in eating or food because they are concerned about the aversive consequences. • May be result of a conditioned negative response to having an aversive experience while eating, such as choking. • Food may be avoided based on its sensory characteristics: • Color, smell, texture, temperature, or taste. • As a result, significant weight loss occurs and psychosocial function is disturbed.

14. Eating Disorders Associated with Childhood • A condition in which a person eats inedible substances, such as dirt or feces. (Pica) • Significant medical consequences occur to due to lead poisoning or injury to the gastrointestinal tract • This is a serious disorder because even one incidence can cause the child to experience significant medical consequences due to lead poisoning or injury to the gastrointestinal tract

15. Rumination Disorder • Rumination Disorder is an eating disorder in which the infant or child regurgitates food after it has been swallowed and then either spits it out or re-swallows it. • Five common disturbances include: • (1) delayed or absent development of feeding and eating skills, • (2) difficulty managing or tolerating food or drink • (3) reluctance to eat food based on taste, texture, and other sensory factors, • (4) lack of appetite or interest in food • (5) the use of feeding behaviors to comfort, self-soothe, or self-stimulate.

16. Elimination Disorders • Elimination disorders are characterized by age-inappropriate incontinence and are generally diagnosed in childhood. • Enuresis: bed wetting or urination in their clothing after the age of age when they should be toilet trained • Daytime only • Night only • Both • Encopresis: child who is at least 4 years old repeatedly has bowel movements either in its clothes or in another inappropriate place.

17. SLEEP DISORDERS

18. Sleep Disordershttp://www.youtube.com/watch?v=X2yfUL8uct0 (6 min) ~~~ Dyssomnias • Characterized by disturbances in the amount, quality, or timing of sleep. • Five specific types: • Primary insomnia • Primary hypersomnia • Narcolepsy • Breathing-related sleep disorder • Circadian rhythm sleep disorder. Parasomnias • Characterized by abnormal behaviors or physiological events taking place during sleep or at the threshold of wakefulness and sleep. • The problem is not with sleep itself • Abnormal events during sleep, or upon waking • Two Types of Parasomnias • Those that occur during REM sleep • Those that occur during non-REM

19. Stage Four Sleep Disorders • Night Terrors • Somnambulism • Sleep Talking • Enuresis (nighttime)

20. Disruptive, Impulse-Control,and Conduct Disorders

21. Disruptive, Impulse-Control,and Conduct Disorders • This grouping of disorders includes diagnoses assigned to individuals who have difficulties regulating their emotions and behavior whose disorder violate the rights of others.

22. Oppositional Defiant Disorder • A disorder characterized by angry or irritable mood, argumentative or defiant behavior, and vindictiveness that results in significant family or school problems. • Oppositional defiant disorder typically becomes evident between ages 8 and 12. • Oppositional Defiant Disorder often progresses to conduct disorder. • Preadolescent boys are more likely to develop this disorder than are girls of the same age, but after puberty it tends to be equally common in males and females.

23. Conduct Disorder • Individuals with conduct disorder violate the rights of others and society’s norms or laws. • Their delinquent behaviors include: • Aggression to people and animals (such as bullying and acts of animal cruelty) • Destruction of property • Deceitfulness or theft • Serious violations of rules (such as school truancy or running away from home).

24. Intermittent Explosive Disorder • An impulse-control disorder involving an inability to hold back urges to express strong angry feelings and associated violent behaviors. • Angry outbursts, either verbal (temper tantrums, tirades, arguments) or physical, in which individuals become assaultive or destructive in ways that are out of proportion to any stress or provocation are common. • The rage shown by people with this disorder is out of proportion to any particular provocation or stress, and their actions are not premeditated. Afterward, they feel either significantly distressed, suffer interpersonal or occupational consequences, or may suffer financial or legal consequences. • Estimated 4 to 7 percent of people in the U.S. population have intermittent explosive disorder • Treatment • SSRIs, mood stabilizers • Cognitive behavioral therapy

25. Impulse-Control Disorders • People with impulse-control disorders repeatedly engage in behaviors, often ones that are harmful, that they feel they cannot control. • Before they act on their impulses, these individuals experience tension and anxiety that they can relieve only by following through on their impulses. • After acting on their impulses, they experience a sense of pleasure or gratification, although later they may regret that they engaged in the behavior.

26. Pyromania • Impulse-control disorder involving the persistent and compelling urge to start fires. • To be diagnosed with pyromania, the individual must not set fires for monetary reasons or have other medical or psychiatric conditions • Deliberately set fires. • Feel tension and arousal before they set fires. • Fascinated with and curious about fire and its situational contexts. • Derive pleasure, gratification, or relief when setting or witnessing fires. • Majority of people with pyromania are male. • Pyromania may reflect abnormalities in dopamine functioning in areas of the brain involving behavioral addictions. • Treatment • Cognitive-behavioral therapy for pyromania include imaginal exposure and response prevention, cognitive restructuring of responding to urges, and relaxation training.

27. Kleptomania • Impulse-control disorder that involves the persistent urge to steal. • Don’t actually wish to have the object, or the money that it’s worth. Instead, they seek excitement from the act of stealing. • People feel an urge or state of craving prior to stealing and a sense of gratification after they steal. • Researchers believe that these features of kleptomania also bear similarities to substance dependence.