Term
| Bulimia Nervose DSM-IV Criteria |
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Definition
- Recurrent episodes of binge eating
- Recurrent compensatory behavior to prevent weight gain
- Behaviors occur at least twice a week for three months
- Self-evaluation is largely influenced by body shape and weight |
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Term
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Definition
1. Purging type: self-induced vomiting, misuse of laxative, diuretics or enemas
- Takes place to get rid of what was consumed
2. Non-purging type: fasting, excessive dieting and/or exercise |
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Term
Bulimia Nervosa
Clinical Features |
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Definition
- Negative view of self
- Binges (100-60k calories)
- Sense of lack of control
- Negative feeling following binge
- Purge
- Medical Complications |
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Term
Bulimia Nervosa
Medical Complications
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Definition
- Anemia (low iron)
- Rupture of heart
- Electrolyte imbalance
- Fertility difficulties
- Chronic sore throat and vomiting blood
- Irrregular periods
- Stomach cramps
- Constipation
- Cavities
- Acne |
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Term
Bulimia Nervosa
Prevalence |
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Definition
- 1-3% of women
- 10x less in men
- under diagnosed in men
- 18-30% in college female population
- Less prevalent in non-Western countries |
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Term
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Definition
- Mostly late adolescence or early adult (18 years)
- Frequently triggered by stressful event
- Starting a new phase in life ( college, breakup, etc) |
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Term
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Definition
- Persists for several years and is often untreated
- Can go unnoticed; people may be of normal weight
- Intermittent periods of remission |
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Term
Bulimia Nervosa
Comorbidity |
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Definition
- Mood disorder (up to 89%)
- Specifically depression or bipolar
- Anxiety disorder (OCD and GAD)
- Personality disorders
- Substance abuse
- Kleptomania |
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Term
Anorexia Nervosa
DSM-IV Criteria |
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Definition
- Refusal to maintain body weight at or above the minimally normal weight for age and height (less than 85% of what is expected)
- Intense fear of gaining weight or becoming fat, even though underweight |
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Term
Anorexia Nervosa
Subtypes |
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Definition
1. Restrictive type: During the current episode, the person has not regularly engaged in binge-eating/purging behavior
- Type most people think of
- Person consumes very small amounts of food per day
2. Binge-eating/Purging type: During the current episode, person has regularly binged and/or purged |
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Term
Anorexia Nervosa
Clinical Features |
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Definition
- Depressive symptoms
- Obsessive compulsive features (related or unrelated to food) - may be due to effects of starvation
- Fear of eating in public
- Negative evaluation of self
- Strong need to control
- Medical Complications |
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Term
Anorexia Nervosa
Clinical Features: Restricting type compared to binge/purge |
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Definition
Bing-eating/purging type have:
- Other impulse control problems
- Mood lability
- Sexually active |
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Term
Anorexia Nervosa
Clinical Features: Medical Complications |
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Definition
- SAME medical problems associated with Bulimia Nervosa, for binge-eating/purging type
- Semi-starvation also affects most major organ systems
- Hospitalization may be required - 10% of these will die from consequences of starvation or suicide |
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Term
Anorexia Nervosa
Prevalence |
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Definition
- 0.5-1% in women
- Less frequent in men
- Sub-clinical level of anorexia nervosa are more common
- Does not fit clinical definition but still a problem
- More prevalent in industrialized societies
- More prevalent in families of higher socio economic status |
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Term
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Definition
- Mean age of onset = 17
- Rarely begins before puberty, but when it does, it is associated with more problems
- Rarely begins after 40 years old
- When it begins in early adolescence > better prognosis
- Frequently triggered by stressful event |
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Term
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Definition
- Course is extremely variable
- Some recover after 1 episode, others struggle for years |
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Term
Anorexia Nervosa
Comorbidity |
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Definition
- Mood disorders
- Anxiety Disorders
- Personality Disorders
- Substance abuse, for binge-purge type
- Kleptomania |
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Term
Bulimia Nervosa & Anorexia Nervosa
Etiology: Socio cultural pressures |
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Definition
- Pressures for women to look thin
- Increase in amount of people dealing with obesity |
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Term
Bulimia Nervosa & Anorexia Nervosa
Etiology: Family Environment |
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Definition
- Emphasis from family on caring what you look like
- Some evidence that people develop Anorexia Nervosa as a result of family problems |
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Term
Bulimia Nervosa & Anorexia Nervosa
Etiology: Ego Deficit and Cognitive Disturbances |
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Definition
- Numb depression, make themselves happy
- Person has cognitive disturbance about the importance of food |
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Term
Bulimia Nervosa & Anorexia Nervosa
Etiology: Biological Models |
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Definition
- People who grow up eating a lot of fat in their diet; they will always be over weight; will always eat a lot of fats
- Mood Disorder - eating disorder is a manifestation of mood disorder |
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Term
Bulimia Nervosa & Anorexia Nervosa
Cognitive Behavioral Model |
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Definition
- Distorted attitudes about body weight and shape
- Dietary restrain based on rigid rules
- Break in dietary restrain
- Anxiety because of fear of fatness
- Purging to relieve anxiety and undo effects of binge - negative reinforcement
- Elimination of nutrients increases probability of binge. Electrolyte imbalance and lower metabolic rate increases probability or weight gain
- Cycle becomes habitual and uncontrollable |
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Term
Bulimia Nervosa
Cognitive Therapy |
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Definition
- Change distorted attitudes (weight/body shape)
- Establish a regular, healthy eating pattern
- Food log
- 3 meals and 2 snacks a day = immensely helpful
- Provide coping skills (deal with stressful events)
- Without these, "numb" themselves with a binge
- Binge = negative reinforcement
- Change errors of thinking (all or nothing thinking)
- Replace purging with other anxiety/depressive reducing measures
- Relapse prevention |
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Term
Substance Related Disorders
Three classes of drugs |
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Definition
Depressants
Stimulants
Hallucinogens |
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Term
Substance Related Disorders
Two types of substance disorders |
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Definition
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Term
Substance Related Disorders
Substance Dependence |
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Definition
- Maladaptive pattern of substance abuse, significant impairment in at least THREE of the following:
1) Tolerance (biological, not psychological)
2) Withdrawal (biological, not psychological)
3) Person consumes drug to reduce withdrawal symptoms
4) Taken in large amounts or over a longer period of time than intended (person can't control abuse)
5) Persistent desire or unsuccessful efforts to cut down
6) Great deal of time spent in activities to get or use substance or recover from its effect
7) Social, occupational, or recreational activities given up or reduced
8) Use continued despite knowledge of problems |
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Term
Substance Related Disorders
Substance Abuse |
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Definition
- Maladaptive pattern of substance use leading to clinically significant impairment (at least ONE of the follorwing):
1) Recurrent substance use resulting in failure to meet major obligations
2) Recurrent use in situations which is is physically hazardous
3) Recurrent substance related problems (ex: arrests)
- Symptoms have NEVER met criteria for dependence
- You keep the dependence label unless you completely stop using the substance |
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Term
Alcohol (depressant)
Prevalence |
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Definition
- 2/3 of americans drink
- 5% are heavy drinkers
- 3:1 male to female ratio for heavy drinking
- 7.4-9.7% meet criteria for abuse or dependence of ONE YEAR
- Lifetime: 13-23%, 5:1 male to female ratio |
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Term
Alcohol (depressant)
Three patterns of abuse |
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Definition
1. Steady
2. Weekend/evenings
3. Binges: men - 5 drinks @ one time; women - 4 drinks at one time |
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Term
Alcohol (depressant)
Costs |
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Definition
- 1 person every 23 minutes dies alcohol related death
- Family = higher levels of disharmony, physical/sexual abuse |
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Term
Alcohol (depressant)
Health Costs |
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Definition
- Liver damage (cirrhosis) 7th highest cause of death in U.S.
- Heart problems
- Impairment of immune system
- Nutritional problems
- Mental disorders caused by vitamin and mineral deficiencies
- Fetal Alcohol Syndrome |
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Term
Cocaine (Stimulant)
Prevalence |
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Definition
- 23 million in U.S. have tried
- 2 million currently using (once a month)
- 1 out of 5 users meet criteria for abuse and dependence
-Crack cocaine is cheaper |
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Term
Cocaine (Stimulant)
Health costs |
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Definition
- 25% increase of cocaine related ER visits. 1982- 1991
- Linked to 20% of all intentional suicides (under 61) not overdose
- Overdose
- Heart problems
- Brain seizures
- Fetal Cocaine Syndrome
- Signs less evident than Fetal Alcohol but more sever consequences (ex: mental retardation) |
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Term
Cannabis (Hallucinogen)
Prevalence |
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Definition
- Increase of abuse and dependence, compared to 1970's
- Drug has become stronger and more addictive which leads to more use |
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Term
Cannabis (Hallucinogen)
Costs |
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Definition
- Deficits in sensory and motor skills
- Deficits in cognitive functioning (memory loss)
- Medical problems - lung disease
- Decrease of human reproduction
- Impact on immune system |
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Term
Substance Abuse
Etiology: Biological |
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Definition
- Twin studies- one twin has substance abuse, other twin:
1) Not identical 28% chance of substance abuse
2) Identical 54% chance of substance abuse problem |
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Term
Substance Abuse
Etiology: Psychodynamic |
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Definition
- Dependency/oral fixation
ex: Family with 19 children: children do not receive much attention; many of children develop substance abuse problem |
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Term
Substance Abuse
Etiology: Behavioral |
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Definition
- Operant conditioning - rat in cage receive shock vs rat that did not; Rate the received shock drank more alcohol to deal with pain
- Classical conditioning
- Modeling - way to get pleasure, decrease stress; children see this from parents and media |
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Term
Substance Abuse
Etiology: Socio Cultural |
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Definition
- Values reinforcing or tolerating use
Ex: friends, college |
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Term
Substance Abuse
Treatment: Biological |
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Definition
- Detox used in severe cases, frequent but not sufficient alone
- Drug antagonists - weakens impact of drug when taken or produces negative symptoms
- Drug substitutes (methadone instead of heroin |
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Term
Substance Abuse
Treatment: Psychodynamic |
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Definition
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Term
Substance Abuse
Treatment: CBT |
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Definition
- Aversive conditioning
- Alternative coping skills
- Behavioral self-control and relapse prevention |
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Term
Substance Abuse
Treatment: Self-help |
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Definition
| - support and spiritual involvement |
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Term
Sexual Disorder & Gender Identity Disorder
Sexual Response Cycle |
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Definition
- Desire - urge to have sex, day dream, sexual fantasies, etc
- Arousal/Excitement - general physical arousal
- Orgasm
- Resolution |
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Term
| Sexual Dysfunction Disorders |
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Definition
- Psychological disorders which make it impossible to have or enjoy intercourse
- 31% men, 43% women |
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Term
Sexual Disorders
4 major DSM-IV Categories |
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Definition
- Desire
- Excitement
- Orgasm
- Sexual pain |
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Term
Sexual Disorders
3 Specifiers |
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Definition
1. Lifelong vs. acquired
2. Generalized vs. Specific
3. Psychological factors vs. Combined (with a medical condition) |
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Term
Desire Disorders
Hypoactive Sexual Desire Disorder |
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Definition
- Persistent or recurrently deficient (or absent) sexual desire and sexual fantasies
- Can be less than 1 time every 2 weeks
- Varies depending on: age, culture, life events
- Lack of desire may cause stress
- 15% men, 20-35% women |
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Term
Desire Disorders
Sexual Aversion Disorder |
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Definition
- Person actively avoids sexual activities and experiences sex as unpleasant or anxiety provoking
- Rates are unknown, but supposed to be rare
- Sexual Phobia |
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Term
Sexual Arousal Disorders
Male Erectile Disorder |
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Definition
- Inability to attain or maintain an adequate erection until the completion of sexual activity
- 10% of men in last year
- Increases with age
- #1 sexual disorder men seek treatment for
- Interaction of psychological and biological factors |
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Term
Sexual Arousal Disorders
Female Sexual Arousal Disorder |
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Definition
: Inability to attain or maintain an adequate lubrication-swelling response of sexual excitement until completion of sexual activity
-11-48% of women
: prevalence greater in post-menopausal women
- Rarely diagnosed alone; usually with sexual arousal disorder |
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Term
Orgasmic Disorders
Male orgasmic disorder |
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Definition
: Inability to ejaculate following normal sexual excitement phase
- 1-3% of men during lifetime
- caused by performance issues |
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Term
Orgasmic Disorders
Premature Ejaculation |
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Definition
: Ejaculation occurs with minimal sexual stimulation
- 25-40% experience during lifetime
- Seen more often in younger men
- Maybe associated with hurried masturbation techniques |
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Term
Orgasmic Disorder
Female Orgasmic Disorder |
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Definition
: Persisten delay in/absence of orgasm
- 20-30% of female pop.
- 10-15% of women report never having had an orgasm
- 10-15% rarely experience orgasm |
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Term
Sexual Pain Disorders
Vaginismus |
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Definition
: involuntary muscle spasms at the entrance to the vagina that prevents penetration and intercourse
- 1% of general pop.
- Conditioned fear response- set off by thought that penetration may be painful or damaging |
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Term
Sexual Pain Disorders
Dyspareunia |
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Definition
: extreme pain in genitals during sexual activity
- 1-5% of men; 10-15% of women
- Usually has a physical cause:
a) pelvic inflammatory disease
b) allergic reaction to contraceptive
c) tumor
d) sexual assault |
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Term
Sexual Dysfunctions
Causes: Biological |
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Definition
- chronic illness
- medical conditions
- hormonal or vascular abnormalities: high levels of prolactin, low testosterone, too high or too low estrogen
- Drug use |
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Term
Sexual Dysfunction Disorders
Causes: Psychosocial |
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Definition
- relationship difficulties
- stress/anxiety
- depression
- trauma
- maladaptive attitudes and cognitions
- performance anxiety |
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Term
Sexual Dysfunction Disorders
Treatment History |
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Definition
- 1st half of 20th century: long term psychodynamic
- 1950's-60's: behavioral therapy (dysfunction caused by fears)
- 1970's: William Master's and Virginia Johnson "SexTherapy" |
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Term
Sexual Dysfunction Disorder
Treatment: Biological |
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Definition
- Treatment of medical condition
- Adjustment of drug use
- Hormone replacement therapy
- "Technical interventions" |
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Term
Sexual Dysfunction Disorder
Treatment: Sex Therapy |
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Definition
- Short term, directive therapy using cognitive, behavioral, and communication building techniques
- Sensate focus: partners alternate between giving and receiving stimulation in a relaxed, openly communicating atmosphere |
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Term
Gender Identity Disorder
DSM Criteria |
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Definition
A. Strong and persistent and cross-gender identification
B. Persistent discomfort with his or her sex or sense of inappropriateness in the gender role of the sex
C. Disturbance is NOT concurrent with a physical intersex condition
D. Disturbance causes clinically significant distress or impairment |
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Term
Gener Identity Disorder
Prevalence |
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Definition
- 1:100,000 females
- 1: 24,000 males
- 4x more likely in men than women
- Occurs in homosexuals and heterosexuals |
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Term
Gender Identity Disorder
Comorbidity |
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Definition
- Substance use
- Depression
- Suicidal Behavior |
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Term
Gender Identity Disorder
Causes/Contributors |
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Definition
- Parent/Family Factors
- Biological Factors (insufficient testosterone) |
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Term
Gender Identity Disorder
Treatment |
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Definition
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Term
Sexual Dysfunction Disorders
Paraphilias |
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Definition
: Repeated intense sexual urges, fantasies, or behaviors, in response to objects or situations that society deems inappropriate (non-human, non-consenting, suffering/humiliation, children)
- Last 6 months at least
- Exclusive or preferred means of arousal
- Cause distress |
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Term
Sexual Dysfunction Disorders
Paraphilia: 8 types |
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Definition
Fetishism
Transvestic fetishism
Exhibitionism
Voyeurism
Frotteurism
Pedophilia
Sexual masochism
Sexual sadism |
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Term
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Definition
| - use of inanimate objects to achieve sexual arousal |
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Term
Paraphilias
Transvestic Fetishism |
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Definition
- need to dress in clothes of the opposite sex to achieve sexual arousal
- cross dressing
- typically person is heterosexual, married male
- hard to determine in women |
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Term
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Definition
- person experiences recurrent and intense sexual urges, sexually arousing fantasies or behaviors with young children
- common in people that were abused as a child
4% 3 years and younger, 18% 4-7, 40% 8-11 |
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Term
Paraphilias
Pedophilia: Two Types |
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Definition
Exclusive: children are their primary and only means of sexual pleasure
Non-exclusive: Children are not their only means of sexual pleasure |
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Term
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Definition
Fine, downy hair on face/trunk of body
Associated with anorexia |
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Term
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Definition
| Absence of at least 3 consecutive menstruations |
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Term
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Definition
| Regurgitation and re-chewing of food |
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Term
| Abstinence Violation Effect |
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Definition
| Guilt and perceived loss of control a person feels when they slip up and do their drug |
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