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EXAM 3 MENTAL HEALTH
Eating Disorders & OCD
| Question | Answer |
|---|---|
| Anorexia Nervosa Definition | Life-threatening eating disorder characterized by the client's restriction of nutritional intake necessary to maintain a minimally normal body weight. Patient has intense fear of gaining weight or becoming fat with significantly disturbed perceptions of the shape or size of the body. |
| Bulimia Nervosa Definition | Recurrent episodes of binge eating followed by inappropriate compensatory behaviors to avoid weight gain, such as purging, fasting, or excessively exercising. The amount of food consumed during a binge episode is much large than a person would normally eat |
| Physical Characteristics of Anorexia Nervosa | Amenorrhea, constipation, sensitive to cold, limited hair on body, loss of body fat, muscle atrophy, hair loss, dry skin, dental caries, pedal edema, bradycardia, arrythmias, orthostasis, enlarges parotid glands and hypothermia, electrolyte imbalances (hyponatremia, hypokalemia) |
| Restricting Subtype of Anorexia Nervosa | Lose weight primarily through dieting, fasting, or excessively exercising. |
| Binge & Purge Subtype of Anorexia Nervosa | Regularly eat large amounts of food in a discrete period (such as 2 hours or less) and then eliminates the food by means of self-induced vomiting or misuse of laxatives, enemas, and diuretics. Some do not binge-just purge. |
| Anorexia Nervosa Behavior | Preoccupied with food-related activities, such as grocery shopping, collecting recipes or cookbooks, counting calories, creating fat-free meals, and cooking family meals. My refuse to eat around others, cut food into tiny pieces, or not allowing the food to touch their lips, along with excessive exercising |
| Bulimia Nervosa Behavior | Often eats in secret, often from responses of strong emotions and followed by guilt, remorse, shame, or self-contempt. May also exhibit high impulsivity, sensation seeking, novelty seeking, and traits associated with borderline personality disorder. |
| Bulimia Nervosa Physical Characteristics | Typically are within normal weight range, but some can be underweight/overweight. Vomiting destroys tooth enamel, chipped teeth. |
| Binge Eating Disorder Definition | Recurrent episodes of binge eating. No regular use of inappropriate compensatory behaviors such as purging or excessive exercise or laxative use. Person is often shameful, and feels guilt and disgust about eating behaviors. More likely to be obese, overweight. |
| Night Eating Syndrome | Consumes 50% of daily calories after the evening meal, and at night time wakening. Associated with life stress, low self-esteem, anxiety, depression, and adverse reactions to weight loss. Typically are obese. |
| Pica | Persistent ingestion of nonfood substances |
| Rumination | Repeated regurgitation of food that is then rechewed, swallowed, or spit out. |
| Orthorexia Nervosa | Obsession with proper or healthful eating. Some believe it is a form of anorexia, and others believe it is a form of OCD. Person often compulsively checks ingredients, cutting out a number of food groups. Spends hours thinking about healthy good, or pure foods. |
| Characterizing of Anorexia Nervosa & Bulimia Nervosa | perfectionism, obsessive–compulsiveness, neuroticism, negative emotionality, harm avoidance, low self-directedness, low cooperativeness, and traits associated with avoidant personality disorder. |
| Risk Factors for Eating Disorders | History of sexual abuse, childhood neglect (physical and emotional) |
| Anorexia Nervosa Biological Risk Factors | Obesity, dieting at an early age |
| Anorexia Nervosa Developmental Risk Factors | Issues of developing autonomy and having control over self and environment, developing a unique identity, dissatisfaction with body image |
| Anorexia Nervosa Family Risk Factors | Family lacks emotional support, parental maltreatment, cannot deal with conflict |
| Anorexia Sociocultural Risk Factors | Cultural Ideal of being thin, media focus on beauty, thinness, fitness, preoccupation with achieving the ideal body |
| Bulimia Nervosa Biological Risk Factors | Obesity, early dieting, possible serotonin and norepinephrine disturbances, chromosome 1 susceptibility |
| Bulimia Nervosa Developmental Risk Factors | Self-perceptions of being overweight, fat, unattractive, and undesirable. Dissatisfaction with body image |
| Bulimia Nervosa Family Risk Factors | Chaotic family with loose boundaries. Parental maltreatment including possible physical or sexual abuse |
| Bulimia Nervosa Sociocultural Risk Factors | Cultural Ideal of being thin, media focus on beauty, thinness, fitness, preoccupation with achieving the ideal body. Weight related teasing |
| Obsessive Compulsive Disorder | Thoughts, images, and impulses consume the person or they are compelled to act out the behaviors to a point at which they interfere with personal, social, and occupational functions |
| Obsessive Compulsive Spectrum | Group of disorders which includes repetitive behaviors including self-soothing behaviors, reward-seeking behaviors, and disorders related to the appearance or function of ones body |
| Self-Soothing Behaviors | Trichotillomania, Dermatillomania,, and Onychophagia |
| Reward-Seekiing Behaviors | Hoarding, Kleptomania, Pyromania, or Oniomania |
| Body Appearance Disorders | Body Dysmorphic Disorder and Body Identity Disorder |
| Trichotillomania | Chronic or repetitive hair-pulling. It is a self-soothing behavior that can cause distress and functional impairment. Onset occurs in childhood and is the most common but it can also persist into adulthood with development of anxiety and depression. Successfully treated with behavioral therapy |
| Dermatillomania/Excoriation | Self-soothing behavior, skin-picking. The behavior is an attempt to sooth or comfort themselves, even though the picking itself may not provide a sensitive sensation. Eventually can lead to medical complications and loss of occupational functioning. |
| Obsessions | Recurrent, persistent, intrusive, and unwanted thoughts, images, or impulses that cause marked anxiety and interfere with interpersonal, social, or occupational function. Patient knows these thoughts are excessive but cannot control them. |
| Compulsions | Ritualistic or repetitive behaviors or mental acts that a person carries out continuously in an attempt to neutralize anxiety. Checking rituals, counting rituals, washing and scrubbing until skin is raw, praying or chanting rituals. Touching, rubbing, or tapping rituals. Ordering rituals, exhibiting rigid performance rituals, having aggressive urges. |
| Body Dysmorphia Disorder (BDD) | Preoccupation with an imaged or slight defect in physical appearance that causes significant distress and interferes with daily life. The person ruminates and worries about the defect, often blaming all of life's problems on their "flawed" appearance. Treatment is often SSRIs. |
| Hoarding Disorder | Progressive, debilitating, compulsive disorder, only recently diagnosed on its own. Usually keeps excessive acquisition of animals or apparently useful things, cluttering the living spaces that become inhabitable, and significant distress or impairment for the individual. Compromises the persons quality of life and even becomes a health, safety, and/or public health hazard. Treatment is often cognitive behavioral therapy, self-help groups, or the involvement of outside community agencies. |
| Onychophagia | Chronic Nail Biting. A self-soothing behavior. Typically begins in childhood and decreases by age 18, but some persist into adulthood. May lead to psychosocial problems or cause complications involving the nails and oral cavity. Treatment often includes SSRIs |
| Kleptomania | Compulsive stealing, a reward-seeking behavior. The reward is not the stolen item, but rather the thrill of stealing and not getting caught. More common in females with a diagnoses of depression and substance abuse, with significant legal repercussions. Often steals items unneeded or of little value. Lack of standardized treatment, but longer therapy is often needed |
| Oniomania | Compulsive Buying. Type of reward-seeking behavior. Please is acquiring the purchased object rather than any subsequent enjoyment of its use. It is often out of control, well beyond the persons financial means. Once acquired may be infrequently or never used. 80% are females. It often runs in families and in those with depression or substance abuse |
| Body Identity Disorder (BID) | People feel overcomplete or alienated from a part of their body and desire amputation. Also known as amputee identity disorder, and apotemnophilia (amputation love). People have feelings of anguish and distress with their intact bodies and report feeling "natural, like they were intended to be" after amputation. May resort to actions such as packing limb in dry ice until damage is so advanced amputation becomes medically necessary. Some cases the amputation is done by power tools |
| Relaxation Techniques | Guided Imagery & Progressive Muscle Relaxation & Deep Breathing |
| Optimal Treatment for OCD | Combined medication and behavioral therapy. |
| First-Line Treatment of OCD | SSRI antidepressants - fluvoxamine (Luvox) and sertraline (Zoloft). Followed by venlafaxine (Effexor). Alerting health care providers to the increased risk of suicidal ideation in children, adolescents, and young adults. Monitor in patients with hepatic impairment, critical illnesses. Meds can cause a risk of GI bleeding, hypertension, ,hyperpyrexia, extreme agitation |
| Second-Line Treatment of OCD | Second-Generation Antipsychotics - risperidone (Risperdal), quetiapine (Seroquel), or olanzapine (Zyprexa). |
| Antianxiety (Antianxiolytic) | Also used in OCD, however psychological dependence is possible. Also can lead to the overuse or abuse of ingestion. They treat the symptoms of anxiety but do not treat the underlying cause |
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