Individual Differences by liaoqinmei

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									What are Eating Disorders?
             • = serious disruption of
               eating habits or
               appetite
             • Anorexia Nervosa (AN)
               and Bulimia Nervosa
               (BN) 2 of a number of
               eating disorders
             • Cases of eating
               disorders are rising.
               ‘epidemic’, or change in
               classification of AN?
             • All eating disorders are
               ‘abnormal’ – the DSM
               has specific guidelines
               for diagnosis.
            Anorexia - Background

Gender
• Occurs primarily in females
• 90% of cases are female
• 14/15 cases are female
Onset
• Commonly 14-16 years
• Late onset AN occurs in
  adults – around 32 years
• Can occur in children as
  young as 8yrs
Background (continued)

           • 70,000 cases in the UK
           • 1 % of population
           • Between 5-15% of
             cases are fatal (e.g.
             musician Karen
             Carpenter)
           • Anorexics may resist
             treatment
           • Suicide is a common
             cause of death
    Clinical Characteristics of AN
The DSM – IV (American Diagnostic & Statistical
 Manual version 4) lists 4 criteria for diagnosis:
• Anxiety
• Weight
• Distorted Body
  Image
• Amenorrhoea
  (cessation of periods
  in females)
Anxiety
    • People with AN have an
      excessive fear being fat
    • Can make them ‘fear’
      food – especially fatty
      food
    • People with AN are not
      just obsessed with
      weight gain, but
      actually fearful of it
    • ANY weight gain – or
      just the thought of it –
      can create intolerable
      anxiety for the anorexic
                           Weight
• Anorexics are underweight -
  typically they will be under
  85% of the normal weight
  for their age/height (i.e.
  15% below normal)
• People with AN will develop
  unusual eating habits such
  as: avoiding meals; carefully
  weighing very small
  quantities of food; eating
  only a few food types;
  cutting it into tiny pieces &
  arranging it on the plate.
• To control weight anorexics
  will not eat, eat only a little
  – and/or engage in over-
  exercise
Body image distortion
           • Anorexics do not see
             their thinness
           • They often continue to
             see themselves as fat
             even when their bones
             can be clearly seen
           • People with AN also
             deny the seriousness of
             their low body weight
           • They regard thinness as
             a vital component of
             their high self – esteem
           • (being thin is really
             important to feeling ok)
                  Amenorrhoea
• Amenorrhoea is cessation of
  the menstrual cycle
• Absence of menstrual
  periods for 3 months is a
  clinical characteristic of AN
• Cessation of periods happens
  because of the reduced body
  fat
• Other associated symptoms
  include paleness & hair
  falling out
• (It can also be a problem for
  female athletes who also
  have very little body fat)
Secondary Characteristics of
           AN
              • Physiological
                characteristics –
                low body
                temperature, blood
                pressure,
              • dehydration,
                emaciation, decline
                in health due to
                poor nutrition,
              • poor sleep patterns
 Secondary Characteristics of
            AN

• Psychological
  characteristics,
  e.g.. Food aversion
  coupled with
  obsession,
  depression, anxiety,
  low self-esteem
BULIMIA NERVOSA
        Background
        • Recognised by DSM IV –
           means ‘Ox Hunger’
        • Friends & family may not
           know because body weight is
           near normal
        Gender
        • 50 x more females than males
        Onset
        • Usually occurs in later
           adolescence/early adulthood
         Distribution
        • More common than AN –
           about 5% of population
Clinical Characteristics of BN
The DSM – IV lists 4 criteria for diagnosis:
                      • Binge
                      • Purge
                      • Frequency     (of
                        binge/purge episodes)
                      • Body Image
                        Distortion
binge
   • Numerous compulsive
     episodes of secret binge
     eating
   • Involves eating an excessive
     amount of food within a
     short period of time
   • Feeling of a lack of control
     during the episode
   • (typically large quantities of
     foods rich in carbohydrates
     are eaten – between 2000 –
     4000 calories)
purge
    – compensatory
      behaviour to prevent
      weight from being
      gained
    – May include self-
      induced vomiting,
      misuse of laxatives or
      other medications
    – May exercise
      excessively
    – Or stop eating for a
      very long time to
      compensate for binging
     Frequency of binging &
            purging
• In order to be
  diagnosed with Bulimia
  the individual would
  have been binging &
  purging
• 2-3 times per week over
  a three month period
• Can be as often as 40
  times per week
                Body-Image Distortion
 Body-Image Distortion and
   weight
• As with people with Anorexia, the
   self-image and self esteem of the
   individual with Bulimia unduly
   influenced by their body shape
• Someone with BN has
   inappropriate perception of their
   own body shape
• there is often a discrepancy
   between desired and actual body
   weight
• Normal body weight is usually
   maintained (+ or – 10%)
Secondary Characteristics of BN
 • Physiological – damage caused by
   excessive vomiting (glands, digestive tract,
   calluses, teeth), dehydration and sodium and
   potassium levels upset
 • Psychological – anxiety, depression, low
   self-esteem
      Differences between anorexia nervosa and bulimia
                           nervosa
         Anorexia N.                     Bulimia N.
• Weight                        • Weight
  severely underweight –          only slightly underweight /
  below 85% of normal for         near normal (within 10%
  age & height                    of normal weight)
• Hunger                        • Hunger
  Doesn’t experience              Feels hunger which leads
  feelings of hunger leading      to eating & guilt & then
  to reduced food intake          the need to purge to
• Personality                     reduce weight & guilt
  Tends to be obsessional &     • Personality
  be overcontrolling (greater     Tends to be impulsive and
  self – control)                 emotionally unstable

								
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