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Eating Disorders: Anorexia Nervosa

Eating Disorders: Anorexia Nervosa. Refusal to maintain ‘normal’ body weight 85% less than expected (e.g., BMI) Intense fear of gaining weight / becoming fat Disturbance in self-perception of body weight And/or denial of seriousness of low weight

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Eating Disorders: Anorexia Nervosa

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  1. Eating Disorders: Anorexia Nervosa • Refusal to maintain ‘normal’ body weight • 85% less than expected (e.g., BMI) • Intense fear of gaining weight / becoming fat • Disturbance in self-perception of body weight • And/or denial of seriousness of low weight • Amenorrhea (in women): absence of 3 or more menstrual cycles

  2. Eating Disorders: Bulimia Nervosa • Recurrent Binge Eating (both a & b below) • A) Amount in 2-hours much larger than most for situation • B) Lack of control over eating • Recurrent inappropriate compensatory behavior • (e.g., vomiting, laxatives, fasting, excessive exercise) • Both Binge Eating & Compensatory Behavior atleast 3x a week for 3 months.

  3. Eating Disorders • Anorexia Nervosa • Restricting Type • Binge-Eating/Purging Type • Bulimia Nervosa • Purging Type • Nonpurging Type (fasting, excessive exercise) • Eating Disorder NOS • (spitting, purging after minimal food, Binge Eating d/o)

  4. Eating Disorders • Anorexia Nervosa (“nervous loss if appetite”; misnomer) • Up to 20% die from AN • Highest Mortality rate of all • 1/2 deaths from suicide; 50x the risk of death by suicide • “lanugo” specific hair on limbs and cheeks • Often comorbid with OCD • Bulimia Nervosa • Purging has many medical consequences • Nonpurging Type is rare (fasting, excessive exercise)

  5. Borderline Personality Disorder • One of the most common PD’s in Clinical Settings • Approx. 2% of population • Approx. 10% of outpatient clients • Diagnosed mostly in females (75%) • Seen in every culture

  6. Borderline Personality Disorder • 6% eventually complete suicide • Thoroughly researched treatment is: Dialectical Behavior Therapy (DBT), developed by Dr. Marsha Linehan • Prognosis: tendency to gradually improve during 30s and 40s (yet many continue to have difficulties throughout life)

  7. Borderline Personality Disorder Common Characteristics of BPD: • Extreme fear of abandonment • Turbulent relationships • Lack of control over emotions & Impulsivity

  8. Borderline Personality Disorder Instability in Relationships, Self-image, Affect, Impulsivity since early adulthood & 5 (of 9): • Frantic efforts to avoid real or imagined abandonment • Unstable and intense relationships • Devaluation – Idealization • Identity Disturbance: unstable sense of self

  9. Borderline Personality Disorder Instability in Relationships, Self-image, Affect, Impulsivity since early adulthood & 5 (of following criteria in next few slides): • Recurrent Suicidal Behavior, Gestures, Threats OR self-mutilating behavior • Affective Instability / reactivity of mood • Intense and extreme emotional reactions that fluctuate frequently • Chronic Feelings of Emptiness

  10. Borderline Personality Disorder • Instability in Relationships, Self-image, Affect, and Impulsivity since early adulthood and 5: • Impulsivity in two areas, self-damaging: • Spending • Sex • Substance abuse • Reckless Driving • Binge Eating

  11. Borderline Personality Disorder Instability in Relationships, Self-image, Affect, Impulsivity since early adulthood & 5: • Inappropriate, Intense Anger / Difficulty controlling anger • Stress related Paranoia or Dissociative symptoms

  12. Antisocial Personality Disorder Pervasive Pattern of Disregard and Violation of Rights of others, since age 15 or earlier, & 3 (of 7): • Won’t conform to social norms and laws (repeatedly breaking laws) • Deceitfulness (lying, conning for profit or pleasure) • Impulsivity / failure to plan • Irritability and Aggressiveness (frequent fights)

  13. Antisocial Personality Disorder Pervasive Pattern of Disregard and Violation of Rights of others, since age 15 or earlier, & 3 (of 7): • Disregard for safety of self or others • Consistent Irresponsibility (work behavior, finances) • Lack of Remorse • *APD is the only PD that cannot be diagnosed before 18*

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