Eating disorders
This presentation is the property of its rightful owner.
Sponsored Links
1 / 69

Eating Disorders PowerPoint PPT Presentation


  • 47 Views
  • Uploaded on
  • Presentation posted in: General

Eating Disorders. Chapter 11. Slides & Handouts by Karen Clay Rhines, Ph.D. American Public University System. Eating Disorders. It has not always done so, but Western society today equates thinness with health and beauty Thinness has become a national obsession

Download Presentation

Eating Disorders

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Eating disorders

Eating Disorders

Chapter 11

Slides & Handouts by Karen Clay Rhines, Ph.D.

American Public University System


Eating disorders1

Eating Disorders

  • It has not always done so, but Western society today equates thinness with health and beauty

    • Thinness has become a national obsession

  • There has been a rise in eating disorders in the past three decades

    • The core issue is a morbid fear of weight gain

  • Two main diagnoses:

    • Anorexia nervosa

    • Bulimia nervosa

Comer, Abnormal Psychology, 8e DSM-5 Update


Eating disorders2

Eating Disorders

  • A third disorder – binge eating disorder – also appears to be on the rise

    • Fear of weight gain is not to the same degree as with anorexia or bulimia

    • People with this disorder display many of the other features found in those disorders

Comer, Abnormal Psychology, 8e DSM-5 Update


Anorexia nervosa

Anorexia Nervosa

  • The main symptoms of anorexia nervosa are:

    • A refusal to maintain more than 85% of normal body weight

    • Intense fears of becoming overweight

    • Distorted view of weight and shape

    • Amenorrhea

Comer, Abnormal Psychology, 8e DSM-5 Update


Anorexia nervosa1

Anorexia Nervosa

  • There are two main subtypes:

    • Restricting type

      • Lose weight by cutting out sweets and fattening snacks, eventually eliminating nearly all food

      • Show almost no variability in diet

    • Binge-eating/purging type

      • Lose weight by forcing themselves to vomit after meals or by abusing laxatives or diuretics

      • Like those with bulimia nervosa, people with this subtype may engage in eating binges

Comer, Abnormal Psychology, 8e DSM-5 Update


Anorexia nervosa2

Anorexia Nervosa

  • About 90%–95% of cases occur in females

  • The peak age of onset is between 14 and 18 years

  • Between 0.5% and 3.5% of females in Western countries develop the disorder

    • Many more display at least some symptoms

  • Rates of anorexia nervosa are increasing in North America, Europe, and Japan

Comer, Abnormal Psychology, 8e DSM-5 Update


Anorexia nervosa3

Anorexia Nervosa

  • The “typical” case:

    • A normal to slightly overweight female has been on a diet

    • Escalation toward anorexia nervosa may follow a stressful event

      • Separation of parents

      • Move away from home

      • Experience of personal failure

    • Most patients recover

      • However, about 2% to 6% become seriously ill and die as a result of medical complications or suicide

Comer, Abnormal Psychology, 8e DSM-5 Update


Anorexia nervosa the clinical picture

Anorexia Nervosa: The Clinical Picture

  • The key goal for people with anorexia nervosa is becoming thin

    • The driving motivation is fear:

      • Of becoming obese

      • Of giving in to the desire to eat

      • Of losing control of body size and shape

Comer, Abnormal Psychology, 8e DSM-5 Update


Anorexia nervosa the clinical picture1

Anorexia Nervosa: The Clinical Picture

  • Despite their dietary restrictions, people with anorexia nervosa are preoccupied with food

    • This includes thinking and reading about food and planning for meals

    • This relationship is not necessarily causal

      • It may be the result of food deprivation, as evidenced by the famous 1940s “starvation study” with conscientious objectors

Comer, Abnormal Psychology, 8e DSM-5 Update


Anorexia nervosa the clinical picture2

Anorexia Nervosa: The Clinical Picture

  • Persons with anorexia nervosa also think in distorted ways:

    • Usually have a low opinion of their body shape

    • Tend to overestimate their actual proportions

      • Assessed using an adjustable lens technique

    • Hold maladaptive attitudes and misperceptions

      • “I must be perfect in every way”

      • “I will be a better person if I deprive myself”

      • “I can avoid guilt by not eating”

Comer, Abnormal Psychology, 8e DSM-5 Update


Anorexia nervosa the clinical picture3

Anorexia Nervosa: The Clinical Picture

  • People with anorexia nervosa also display certain psychological problems:

    • Depression

    • Anxiety

    • Low self-esteem

    • Insomnia or other sleep disturbances

    • Substance abuse

    • Obsessive-compulsive patterns

    • Perfectionism

Comer, Abnormal Psychology, 8e DSM-5 Update


Anorexia nervosa medical problems

Caused by starvation:

Amenorrhea

Low body temperature

Low blood pressure

Body swelling

Reduced bone density

Slow heart rate

Metabolic and electrolyte imbalances

Dry skin, brittle nails

Poor circulation

Lanugo

Anorexia Nervosa: Medical Problems

Comer, Abnormal Psychology, 8e DSM-5 Update


Bulimia nervosa

Bulimia Nervosa

  • Bulimia nervosa, also known as “binge-purge syndrome,” is characterized by binges:

    • Repeated bouts of uncontrolled overeating during a limited period of time

      • Eat objectively more than most people would/could eat in a similar period

Comer, Abnormal Psychology, 8e DSM-5 Update


Bulimia nervosa1

Bulimia Nervosa

  • The disorder is also characterized by inappropriate compensatory behaviors, including:

    • Forced vomiting

    • Misusing laxatives, diuretics, or enemas

    • Fasting

    • Exercising excessively

Comer, Abnormal Psychology, 8e DSM-5 Update


Bulimia nervosa2

Bulimia Nervosa

  • Like anorexia nervosa, about 90%–95% of bulimia nervosa cases occur in females

  • The peak age of onset is between 15 and 21 years

  • Symptoms may last for several years with periodic letup

Comer, Abnormal Psychology, 8e DSM-5 Update


Bulimia nervosa3

Bulimia Nervosa

  • Patients are generally of normal weight

    • Often experience marked weight fluctuations

    • Some may also qualify for a diagnosis of anorexia

Comer, Abnormal Psychology, 8e DSM-5 Update


Bulimia nervosa4

Bulimia Nervosa

  • Many teenagers and young adults go on occasional binges or experiment with vomiting or laxatives after hearing about these behaviors from friends or the media

  • According to global studies, 25-50% of students report periodic binge-eating or self-induced vomiting

    • Only some of these individuals qualify for a diagnosis of bulimia nervosa

Comer, Abnormal Psychology, 8e DSM-5 Update


Bulimia nervosa binges

Bulimia Nervosa: Binges

  • People with bulimia nervosa may have between 1 and 30 binge episodes per week

  • Binges are often carried out in secret

    • Binges involve eating massive amounts of food very rapidly with little chewing

      • Usually sweet, high-calorie foods with soft texture

    • Binge-eaters commonly consume between as many as 10,000 calories per binge episode

Comer, Abnormal Psychology, 8e DSM-5 Update


Bulimia nervosa binges1

Bulimia Nervosa: Binges

  • Binges are usually preceded by feelings of great tension

  • Although the binge itself may be pleasurable, it is usually followed by feelings of extreme self-blame, guilt, depression, and fears of weight gain and being discovered

Comer, Abnormal Psychology, 8e DSM-5 Update


Bulimia nervosa compensatory behaviors

Bulimia Nervosa: Compensatory Behaviors

  • After a binge, people with bulimia nervosa try to compensate for and “undo” the caloric effects

    • Many resort to vomiting

      • Fails to prevent the absorption of half the calories consumed during a binge

      • Repeated vomiting affects the ability to feel satiated  greater hunger and bingeing

Comer, Abnormal Psychology, 8e DSM-5 Update


Bulimia nervosa compensatory behaviors1

Bulimia Nervosa: Compensatory Behaviors

  • Compensatory behaviors may temporarily relieve the negative feelings attached to binge eating

    • Over time, however, a cycle develops in which purging  bingeing  purging…

Comer, Abnormal Psychology, 8e DSM-5 Update


Bulimia nervosa5

Bulimia Nervosa

  • The “typical” case:

    • A normal to slightly overweight female has been on an intense diet

    • Research suggests that even among normal participants, bingeing often occurs after strict dieting

Comer, Abnormal Psychology, 8e DSM-5 Update


Bulimia nervosa vs anorexia nervosa

Bulimia Nervosa vs. Anorexia Nervosa

  • Similarities:

    • Begin after a period of dieting

    • Fear of becoming obese

    • Drive to become thin

    • Preoccupation with food, weight, appearance

    • Feelings of anxiety, depression, obsessiveness, perfectionism

    • Heighted risk of suicide attempts

    • Substance abuse

    • Distorted body perception

    • Disturbed attitudes toward eating

Comer, Abnormal Psychology, 8e DSM-5 Update


Bulimia nervosa vs anorexia nervosa1

Bulimia Nervosa vs. Anorexia Nervosa

  • Differences:

    • People with bulimia nervosa are more concerned about pleasing others, being attractive to others, and having intimate relationships

    • People with bulimia nervosa tend to be more sexually experienced and active

    • People with bulimia nervosa are more likely to have histories of mood swings, low frustration tolerance, and poor coping

Comer, Abnormal Psychology, 8e DSM-5 Update


Bulimia nervosa vs anorexia nervosa2

Bulimia Nervosa vs. Anorexia Nervosa

  • Differences:

    • More than one-third of people with bulimia display characteristics of a personality disorder, particularly borderline personality disorder

    • Different medical complications:

      • Only half of women with bulimia nervosa experience amenorrhea vs. almost all women with anorexia nervosa

      • People with bulimia nervosa suffer damage caused by purging, especially from vomiting and laxatives

Comer, Abnormal Psychology, 8e DSM-5 Update


Binge eating disorder

Binge Eating Disorder

Comer, Abnormal Psychology, 8e DSM-5 Update

  • Like those with bulimia, individuals with binge eating disorder engage in repeated eating binges during which they feel no control

    • These individuals do not perform inappropriate compensatory behaviors

  • As a result of their binges, two-thirds of people with this disorder become overweight or obese

    • It is important to recognize, however, that most overweight people do not engage in repeated binges


Binge eating disorder1

Binge Eating Disorder

Comer, Abnormal Psychology, 8e DSM-5 Update

  • Between 2 and 7% of the population display binge eating disorder

  • The binges and many other symptoms that characterize this pattern are similar to those seen in bulimia

  • On the other hand, those with binge eating disorder are not driven to thinness, the disorder doesn’t start following a diet, and there are not large gender differences in the prevalence of this disorder


What causes eating disorders

What Causes Eating Disorders?

  • Most theorists and researchers use a multidimensional risk perspective to explain eating disorders:

    • Several key factors place individuals at risk

    • More factors = greater likelihood of developing a disorder

    • Leading factors:

      • Psychological problems

      • Biological factors

      • Sociocultural conditions

Comer, Abnormal Psychology, 8e DSM-5 Update


What causes eating disorders psychodynamic factors ego deficiencies

What Causes Eating Disorders? Psychodynamic Factors: Ego Deficiencies

  • Hilde Bruch developed a largely psychodynamic theory of eating disorders

  • Bruch argued that eating disorders are the result of disturbed mother–child interactions, which lead to serious ego deficiencies in the child and to severe perceptual disturbances

Comer, Abnormal Psychology, 8e DSM-5 Update


What causes eating disorders psychodynamic factors ego deficiencies1

What Causes Eating Disorders? Psychodynamic Factors: Ego Deficiencies

  • Bruch argues that parents may respond to their children either effectively or ineffectively

    • Effective parents accurately attend to a child’s biological and emotional needs

    • Ineffective parents fail to attend to child’s needs; they feed when the child is anxious, comfort when the child is tired, etc.

      • Such children may grow up confused and unaware of their own internal needs and turn, instead, to external guides

  • Clinical reports and research have provided some empirical support for this theory

Comer, Abnormal Psychology, 8e DSM-5 Update


What causes eating disorders cognitive factors

What Causes Eating Disorders? Cognitive Factors

  • Bruch’s theory also contains several cognitive factors, like improper labeling of internal sensations and needs

    • According to cognitive theorists, these deficiencies contribute to a broad cognitive distortion that lies at the center of disordered eating (e.g., negative self-judgment based on body shape and weight)

Comer, Abnormal Psychology, 8e DSM-5 Update


What causes eating disorders depression

What Causes Eating Disorders? Depression

  • Many people with eating disorders, particularly those with bulimia nervosa, experience symptoms of depression

    • Theorists believe depressive disorders may “set the stage” for eating disorders

Comer, Abnormal Psychology, 8e DSM-5 Update


What causes eating disorders depression1

What Causes Eating Disorders? Depression

  • There is empirical support for the claim that mood disorders set the stage for eating disorders:

    • Many more people with an eating disorder qualify for a clinical diagnosis of major depressive disorder than do people in the general population

    • Close relatives of those with eating disorders seem to have higher rates of depressive disorders

    • People with eating disorders, especially those with bulimia nervosa, have serotonin abnormalities

    • Symptoms of eating disorders are helped by antidepressant medications

Comer, Abnormal Psychology, 8e DSM-5 Update


What causes eating disorders biological factors

What Causes Eating Disorders? Biological Factors

  • Biological theorists suspect certain genes may leave some people particularly susceptible to eating disorders

    • Consistent with this idea:

      • Relatives of people with eating disorders are up to 6 times more likely to develop the disorder themselves

      • Identical (MZ) twins with anorexia: 70%

      • Fraternal (DZ) twins with anorexia: 20%

      • Identical (MZ) twins with bulimia: 23%

      • Fraternal (DZ) twins with bulimia: 9%

    • These findings may be related to low serotonin

Comer, Abnormal Psychology, 8e DSM-5 Update


What causes eating disorders biological factors1

What Causes Eating Disorders? Biological Factors

  • Other theorists believe that eating disorders may be related to dysfunction of the hypothalamus

    • Researchers have identified two separate areas that control eating:

      • Lateral hypothalamus (LH)

      • Ventromedial hypothalamus (VMH)

Comer, Abnormal Psychology, 8e DSM-5 Update


What causes eating disorders biological factors2

What Causes Eating Disorders? Biological Factors

  • Some theorists believe that the hypothalamus, related brain areas, and chemicals together are responsible for weight set point – a “weight thermostat” of sorts

    • Set by genetic inheritance and early eating practices, this mechanism is responsible for keeping an individual at a particular weight level

      • If weight falls below set point:  hunger,  metabolic rate  binges

      • If weight rises above set point:  hunger,  metabolic rate

    • Dieters end up in a battle against themselves to lose weight

Comer, Abnormal Psychology, 8e DSM-5 Update


What causes eating disorders societal pressures

What Causes Eating Disorders? Societal Pressures

  • Many theorists believe that current Western standards of female attractiveness are partly responsible for the emergence of eating disorders

    • Western standards have changed throughout history toward a thinner ideal

      • Miss America contestants have declined in weight by 0.28 lbs/yr; winners have declined by 0.37 lbs/yr

      • Playboy centerfolds have lower average weight, bust, and hip measurements than in the past

Comer, Abnormal Psychology, 8e DSM-5 Update


What causes eating disorders societal pressures1

What Causes Eating Disorders? Societal Pressures

  • Members of certain subcultures are at greater risk from these pressures:

    • Models, actors, dancers, and certain athletes

      • Of college athletes surveyed, 9% met full criteria for an eating disorder while another 50% had symptoms

      • 20% of surveyed gymnasts appear to have an eating disorder

Comer, Abnormal Psychology, 8e DSM-5 Update


What causes eating disorders societal pressures2

What Causes Eating Disorders? Societal Pressures

  • Societal attitudes may explain economic and racial differences seen in prevalence rates

    • Historically, women of higher SES expressed more concern about thinness and dieting

      • These women had higher rates of eating disorders than women of the lower socioeconomic classes

    • Recently, dieting and preoccupation with thinness, along with rates of eating disorders, are increasing in all groups

Comer, Abnormal Psychology, 8e DSM-5 Update


What causes eating disorders societal pressures3

What Causes Eating Disorders? Societal Pressures

  • The socially accepted prejudice against overweight people may also add to the “fear” and preoccupation about weight

    • About 50% of elementary and 61% of middle school girls are currently dieting

    • A recent survey of adolescent girls tied eating disorders and body dissatisfaction to social networking, Internet activities, and television browsing

Comer, Abnormal Psychology, 8e DSM-5 Update


What causes eating disorders family environment

What Causes Eating Disorders? Family Environment

  • Families may play an important role in the development of eating disorders

    • As many as half of the families of those with eating disorders have a long history of emphasizing thinness, appearance, and dieting

    • Mothers of those with eating disorders are more likely to be dieters and perfectionistic themselves

Comer, Abnormal Psychology, 8e DSM-5 Update


What causes eating disorders family environment1

What Causes Eating Disorders? Family Environment

  • Abnormal interactions and forms of communication within a family may also set the stage for an eating disorder

    • Influential family theorist Salvador Minuchin cites “enmeshed family patterns” as causal factors of eating disorders

      • These patterns include overinvolvement in, and overconcern about, family member’s lives

Comer, Abnormal Psychology, 8e DSM-5 Update


What causes eating disorders multicultural factors racial and ethnic differences

What Causes Eating Disorders? Multicultural Factors: Racial and Ethnic Differences

  • A widely publicized 1995 study found that eating behaviors and attitudes of young African American women were more positive than those of young white American women

    • Specifically, nearly 90% of the white American respondents were dissatisfied with their weight and body shape, compared to around 70% of the African American teens

    • The study also suggested that the groups had different ideals of beauty

Comer, Abnormal Psychology, 8e DSM-5 Update


What causes eating disorders multicultural factors racial and ethnic differences1

What Causes Eating Disorders? Multicultural Factors: Racial and Ethnic Differences

  • Unfortunately, research conducted over the past decade suggests that body image concerns, dysfunctional eating patterns, and eating disorders are on the rise among young African American women as well as among women of other minority groups

    • The shift appears to be partly related to acculturation

Comer, Abnormal Psychology, 8e DSM-5 Update


What causes eating disorders multicultural factors racial and ethnic differences2

What Causes Eating Disorders? Multicultural Factors: Racial and Ethnic Differences

  • Eating disorders among Hispanic American female adolescents are about equal to those of white American women

  • Eating disorders also appear to be on the increase among Asian American women and young women in several Asian countries

Comer, Abnormal Psychology, 8e DSM-5 Update


What causes eating disorders multicultural factors gender differences

What Causes Eating Disorders? Multicultural Factors: Gender Differences

  • Males account for only 5% to 10% of all cases of eating disorders

  • The reasons for this striking difference are not entirely clear, but Western society’s double standard for attractiveness is, at the very least, one reason

  • A second reason may be the different methods of weight loss favored:

    • Men are more likely to exercise

    • Women more often diet

Comer, Abnormal Psychology, 8e DSM-5 Update


What causes eating disorders multicultural factors gender differences1

What Causes Eating Disorders? Multicultural Factors: Gender Differences

  • It seems that some men develop eating disorders as linked to the requirements and pressures of a job or sport

    • The highest rates of male eating disorders have been found among:

      • Jockeys

      • Wrestlers

      • Distance runners

      • Body builders

      • Swimmers

Comer, Abnormal Psychology, 8e DSM-5 Update


What causes eating disorders multicultural factors gender differences2

What Causes Eating Disorders? Multicultural Factors: Gender Differences

  • For other men, body image appears to be a key factor

  • Last, some men seem to be caught up in a new kind of eating disorder – reverse anorexia nervosa or muscle dysmorphobia

Comer, Abnormal Psychology, 8e DSM-5 Update


How are eating disorders treated

How Are Eating Disorders Treated?

  • Eating disorder treatments have two main goals:

    • Correct dangerous eating patterns

    • Address broader psychological and situational factors that have led to, and are maintaining, the eating problem

      • This often requires the participation of family and friends

Comer, Abnormal Psychology, 8e DSM-5 Update


Treatments for anorexia nervosa

Treatments for Anorexia Nervosa

  • The immediate aims of treatment for anorexia nervosa are to:

    • Regain lost weight

    • Recover from malnourishment

    • Eat normally again

Comer, Abnormal Psychology, 8e DSM-5 Update


Treatments for anorexia nervosa1

Treatments for Anorexia Nervosa

  • In the past, treatment took place in a hospital setting; it is now often offered in day hospitals or outpatient settings

  • In life-threatening cases, clinicians may need to force tube and intravenous feedings on the patient

    • This may breed distrust in the patient and create a power struggle

    • In contrast, behavioral weight-restoration approaches have clinicians use rewards whenever patients eat properly or gain weight

Comer, Abnormal Psychology, 8e DSM-5 Update


Treatments for anorexia nervosa2

Treatments for Anorexia Nervosa

  • The most popular weight-restoration technique has been the combination of supportive nursing care, nutritional counseling, and high-calorie diets

    • Necessary weight gain is often achieved in 8 to 12 weeks

  • Researchers have found that people with anorexia nervosa must overcome their underlying psychological problems to achieve lasting improvement

Comer, Abnormal Psychology, 8e DSM-5 Update


Treatments for anorexia nervosa3

Treatments for Anorexia Nervosa

  • Therapists use a combination of therapy and education to achieve this broader goal, using a combination of individual, group, and family approaches; psychotropic drugs have been helpful in some cases

Comer, Abnormal Psychology, 8e DSM-5 Update


Treatments for anorexia nervosa4

Treatments for Anorexia Nervosa

  • In most treatment programs, a combination of behavioral and cognitive interventions are included

    • On the behavioral side, clients are required to monitor feelings, hunger levels, and food intake and the ties among those variables

    • On the cognitive sides, they are taught to identify their “core pathology”

Comer, Abnormal Psychology, 8e DSM-5 Update


Treatments for anorexia nervosa5

Treatments for Anorexia Nervosa

  • Therapists help patients recognize their need for independence and control

  • Therapists help patients recognize and trust their internal feelings

  • A final focus of treatment is helping clients change their attitudes about eating and weight

    • Using cognitive approaches, therapists correct disturbed cognitions and educate about body distortions

Comer, Abnormal Psychology, 8e DSM-5 Update


Treatments for anorexia nervosa6

Treatments for Anorexia Nervosa

  • Family therapy is important for anorexia nervosa treatment

    • The main issues are often separation and boundaries

Comer, Abnormal Psychology, 8e DSM-5 Update


Treatments for anorexia nervosa7

Treatments for Anorexia Nervosa

  • The use of combined treatment approaches has greatly improved the outlook for people with anorexia nervosa

    • But even with combined treatment, recovery is difficult

  • The course and outcome of the disorder vary from person to person

Comer, Abnormal Psychology, 8e DSM-5 Update


Treatments for anorexia nervosa8

Treatments for Anorexia Nervosa

  • Positives of treatment:

    • Weight gain is often quickly restored

      • As many as 90% of patients still showed improvements after several years

    • Menstruation often returns with return to normal weight

    • The death rate from anorexia nervosa seems to be falling

Comer, Abnormal Psychology, 8e DSM-5 Update


Treatments for anorexia nervosa9

Treatments for Anorexia Nervosa

  • Negatives of treatment:

    • As many as 25% of patients remain troubled for years

    • Even when it occurs, recovery is not always permanent

      • Anorexic behavior recurs in at least one-third of recovered patients, usually triggered by new stresses

      • Many patients still express concerns about their weight and appearance

    • Lingering emotional problems are common

Comer, Abnormal Psychology, 8e DSM-5 Update


Treatments for bulimia nervosa

Treatments for Bulimia Nervosa

  • Treatment is frequently offered in eating disorder clinics

  • The immediate aims of treatment for bulimia nervosa are to:

    • Eliminate binge-purge patterns

    • Establish good eating habits

    • Eliminate the underlying cause of bulimic patterns

  • Programs emphasize education as much as therapy

Comer, Abnormal Psychology, 8e DSM-5 Update


Treatments for bulimia nervosa1

Treatments for Bulimia Nervosa

  • Cognitive-behavioral therapy is particularly helpful:

    • Behavioral techniques

      • Diaries are often a useful component of treatment

      • Exposure and response prevention (ERP) is used to break the binge-purge cycle

Comer, Abnormal Psychology, 8e DSM-5 Update


Treatments for bulimia nervosa2

Treatments for Bulimia Nervosa

  • Cognitive-behavioral therapy is particularly helpful:

    • Cognitive techniques

      • Help clients recognize and change their maladaptive attitudes toward food, eating, weight, and shape

      • Typically teach individuals to identify and challenge the negative thoughts that precede the urge to binge

Comer, Abnormal Psychology, 8e DSM-5 Update


Treatments for bulimia nervosa3

Treatments for Bulimia Nervosa

  • Other forms of psychotherapy

    • If clients do not respond to cognitive-behavioral therapy, other approaches may be tried

    • A common alternative is interpersonal therapy (IPT); a treatment that seeks to improve interpersonal functioning may be tried

    • Psychodynamic therapy has also been used

Comer, Abnormal Psychology, 8e DSM-5 Update


Treatments for bulimia nervosa4

Treatments for Bulimia Nervosa

  • Other forms of psychotherapy

    • Various forms of psychotherapy are often supplemented by family therapy and may be offered in either individual or group therapy format

      • Group formats provide an opportunity for patients to express their thoughts, concerns, and experiences with one another

      • Group therapy is helpful in as many as 75% of cases

Comer, Abnormal Psychology, 8e DSM-5 Update


Treatments for bulimia nervosa5

Treatments for Bulimia Nervosa

  • Antidepressant medications

    • During the past 15 years, all groups of antidepressant drugs have been used in bulimia nervosa treatment

      • Drugs help as many as 40% of patients

    • Medications are best when used in combination with other forms of therapy

Comer, Abnormal Psychology, 8e DSM-5 Update


Treatments for bulimia nervosa6

Treatments for Bulimia Nervosa

  • Left untreated, bulimia nervosa can last for years

  • Treatment provides immediate, significant improvement in about 40% of cases

    • An additional 40% show moderate response

  • Follow-up studies suggest that 10 years after treatment about 75% of patients have fully or partially recovered

Comer, Abnormal Psychology, 8e DSM-5 Update


Treatments for bulimia nervosa7

Treatments for Bulimia Nervosa

  • Relapse can be a significant problem, even among those who respond successfully to treatment

    • Relapses are usually triggered by stress

    • Relapses are more likely among persons who:

      • Had a longer history of symptoms

      • Vomited frequently

      • Had histories of substance use

      • Have lingering interpersonal problems

Comer, Abnormal Psychology, 8e DSM-5 Update


Treatments for binge eating disorder

Treatments for Binge Eating Disorder

Comer, Abnormal Psychology, 8e DSM-5 Update

  • Given the key role of binges in both bulimia and binge eating disorder, treatments, too, are often similar

    • Cognitive-behavior therapy, other forms of psychotherapy, and, in some cases, antidepressant medications are provided to reduce or eliminate binge patterns and to change disturbed thinking

  • People with binge eating disorder who are overweight require additional intervention


Treatments for binge eating disorder1

Treatments for Binge Eating Disorder

Comer, Abnormal Psychology, 8e DSM-5 Update

  • Now that binge eating disorder has been identified and is receiving considerable study, it is likely that specialized treatment programs will be emerging

    • In the meantime, little is known about the aftermath of the disorder


  • Login