Diagnostic Criteria and Core Pathological Features
Signs and Symptoms
Risk Factors
Health Risks and Comorbid Disorders
Family's Role in AN
100
According to the DSM-IV-TR, one of the diagnostic criteria for AN is maintaining a body weight at a level less than this percentage of one's normal weight for one's age and height.
What is 85%? In addition other criteria are: - Intense fear of gaining weight or becoming fat (even though underweight) - Disturbance in the way one's body weight or shape are experienced, undue influence of body weight or shape on self evaluation, or denial of the seriousness of the current low body weight
100
According to Koenig (2008) one of the most obvious personality traits that permeates disordered eating is this type of thinking. For AN individuals, it is difficult to identify others who are of average weight or who seem comfortable around food, as AN individuals fail to notice eating and weight spectrums and are only able to identify the extremes. AN individuals do not only polarize in the weight arena: much of life is viewed in extremes of good or bad, on or off, in or out, and easy or impossible.
What is (Black-and-White; All-or-Nothing; Dichotomous) thinking?
100
Those with a ___________ with or recovering from AN has a higher rate of developing the disorder
What is a mother? Children of patients with AN have a lifetime risk for AN that is tenfold that of the general population (5%) About 1/5 of people with AN have a relative with an eating disorder
100
All of the following are health risks associated with AN except: Heart failure Kidney failure Cancer Low protein stores Digestive problems Electrolyte imbalance
What is Cancer? AN has the highest mortality rate of any mental illness. Mortality (up to 20%) is primarily from cardiac arrest or suicide
100
Minuchin, Rosman & Baker (1978) have recognized a group of 4 family system characteristics that reflect the family dynamics of patients with AN. One transactional style is where family members are highly involved with one another. There is excessive togetherness, intrusion on other's thoughts, feelings and actions, lack of privacy, and weak family boundaries. Members often speak for one another, and perception of the self and other family members is poorly differentiated (Weiss, Katzman & Wolchik, 1985). A child growing up in this type of family learns that family loyalty is of primary importance. This pattern of interaction hinders separation and individuation later in life (Blinder, Chaitin & Goldstein, 1988)
What is Enmeshment?
200
Although many AN patients engage in compulsive exercising, this type of AN patients are distinguished by their resolute refusal to eat (much), whereas bulimic-type AN patients regularly engage in binge eating and purging.
What is the restricting type?
200
All of the following are warning signs of AN except: - Dramatic weight loss - Refusal to eat certain foods or food categories (e.g. no fats, no carbs) - Consistent excuses to avoid situations involving food - Decrease in grades/school performance - Excessive and rigid exercise routine Withdrawal from usual friends/relatives
What is decrease in grades/school performance
200
This age group and this gender from __________ countries are more likely to have AN
15-29 year old females from industrialized countries wher cultural ideals encourage women to be thin.
200
Similar to this disorder that is comorbid with AN, an indiviudal with AN may avoid meals with friends or family in an attempt to reduce their anxiety (Steinglass & Walsh, 2006). Also, an AN might disclose how she is frequently spending her time considering how she is going to structure her day around food avoidance.
What is Obessessive-Compulsive Disorder? While AN and OCD are comorbid, there appears to be distinct differences in the desire for change. OCD patients usually show a high degree of motivation for change and AN may have difficulty identifying their behaviors and thoughts as being maladaptive and thus do not see a need to change (Steinglass & Walsh, 2006)
200
Weiss, Katzman & Wolchik (1985) define this transactional characteristic as the excessive nurturing and protective responses are commonly observed. Pacifying behaviors and somatization are prevalent.
Overprotectiveness
300
One of the diagnostic features (according to DSM-IV-TR) of AN in females who have begun to menstruate is the absence of at least three menstrual periods in a row, a condition called this.
What is amenorrhea?
300
3 Anorexic food behavior signs and symptoms
What are 1. Dieting despite being thin 2. Obsession with calories, fat grams ,and nutrition 3. Pretending to eat or lying about eating 4. Preoccupation with food 5. Strange or secretive food rituals
300
Abnormalities in brain chemistry put some at a higher risk for developing AN. This brain chemical that's involved in depression may play a role.
What is Serotonin?
300
This psychological disorder has been found to coexist with AN at a relatively high rate such as 50% (Kent & Waller, 2000; Varner, 1999). Features that are common to both AN and this disorder (i.e., weight change, social withdrawal, decreased self-esteem, sleep disturbance, and concentration problems) can make differential diagnosis difficult.
What is Depression? The implications for clinicians is that it would be advisable to assess and treat depressive disorders among those who present with eating or weight problems as this may also facilitate recovery from AN (Johnson et al., 2003).
300
These families are heavily committed to maintaining the status quo. The need for change is denied, thereby preserving accustomed patterns of interaction and behavioral mechanisms. This pattern is commonly observed in the family cycle during periods of natural change where accommodation is necessary for proper growth and development. Such an example would be when an adolescent begins to request more independence (Blinder, Chaitin & Goldstein, 1988)
What is rigidity?
400
Those with AN frequently deny any illness and are often seen for treatment only for this reason.
What is only because of the concern of those close to them that their lives may be in imminent danger?
400
This personality trait has been identified in the literature as a common characteristic of AN. __________ is recognized as setting and striving for personal standards and striving to avoid criticism or rejection from others (Forbush, Heatherton, & Keel, 2007; Koenig, 2008).
What is Perfectionism?
400
Which Sport and/or Profession is NOT deemed a risk factor for developing AN? Dance Gymnastics Yoga Running Swimming Figure Skating Horse Racing Wrestling Acting
What is Yoga? Yoga practice is actually associated with greater awareness of and responsiveness to bodily sensations, lower self-objectification, greater body satisfaction, and fewer disordered eating attitudes.
400
Three of the physical effects of anorexia.
What are 1. Severe mood swings; depression 2. Lack of energy and weakness 3. Slowed thinking; poor memory 4. Dry, yellowish skin and brittle nails 5. Constipation and bloating 6. Tooth decay and gum damage 7. Dizziness, fainting, and headaches 8. Growth of fine hair all over the body and face
400
Family members who have a low tolerance for overt conflict, and discussions involving differences of opinion are avoided at all costs. Problems are often left unresolved and are prolonged by avoidance maneuvers (Blinder, Chaitin & Goldstein, 1988). Minuchin and colleagues (1978) deemed this family process to be called conflict ________
What is avoidance
500
What are the two major changes in the diagnostic criteria of AN in the DSM-V?
What is 1)Amenorrhea — the absence of a menstrual cycle in a woman — has been removed as a requirement for anorexia to be diagnosed in women (it wasn’t found to be very useful, since there were so many exceptions to it) 2)Criterion A now focuses on behaviors, like restricting calorie intake, and no longer includes the word “refusal” in terms of weight maintenance since that implies intention on the part of the patient and can be difficult to assess
500
This concept is common in AN patients. They have difficulty sitting with emotional discomfort or pain and often use preoccupation with thinness to ward off distress.
What is emotion regulation? Krause and Robin (2000) found that conflict over expressing emotions is an important construct for healing in individuals with AN. Wanlass et al. (2005) also recognized that AN participants had difficulty recognizing and verbalizing emotions.
500
Teenagers with this chronic illness are at greater risk for developing AN.
What is diabetes?
500
Despite their apparent distance in presentation and clinical picture between AN and this disorder, there are similarities (Mantero & Crippa, 2002). Both this disorder and AN contain ruminations, and these ruminations tend to be call obsessive by AN individuals and intrusive in individuals with this disorder. When compared with typical obsessions, both the intrusive thoughts of individuals with this disorder and the obsessive thoughts of anorexics have a stronger link with objective external reality.
What is Posttraumatic Stress Disorder?
500
It has been suggested that parents of anorexic offspring put high expectations on their children to over-compensate for this (Blinder, Chaitin & Goldstein, 1988).
What is the lack of love in their own marriage (underlying dissatisfaction and tension in the parental dyad) BONUS ? (500 more points!!!!!), Before 1960s, the family environment was seen as contributing to the devleopment of AN and the family was seen as a hindrance to treatment. Parents were generally excluded from treatment, refeered to as a "_________"
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