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Anorexia
1. Anorexia Nervosa
By: Abdifatah H. Daud
Training Clinical
Psychologist
Department of Clinical
Psychology
UMT
2. Anorexia Nervosa
Nervous want of appetite”
Weight gain phobia
Weight drops 15% below ideal body weight
Intense fear of getting fat, even though
underweight
Obsessive about food
Body image problems
No Periods
3. Types
Restricted
Limited food intake
More exercise
Bing-eating-purging
Binging than purging
Use laxatives
Can switch one another
4. Eating Disorder Statistics
8 million people in the United States suffer from eating
disorders
3% of all young women and girls suffer from anorexia
1 male: 10-15 female
15% of young women have some kind of disordered
eating patterns
Eating disorders have the highest mortality rate of any
psychological disease
5. Symptoms
Significant weight loss
Fear of becoming fat
Excessive dieting/exercising
Counting calories, fats, etc.
Constipation
Dry, sallow skin
Menstrual periods stop
Mood Swings
Sensitivity to cold
Obsession and compulsion
12. Differential Diagnosis
Medical conditions, depression,
schizophrenia and substance use
No fear of gaining weight
No desire for weight loss
Social phobia other then eating
OCD other then eating
Body dimorphic, distortion related other
than body shape and size
Bulimia normal above body weight
15. Developmental
Gene-environment interaction
On and off gene
Repressed sex (rebelling against mother)
Childhood sexual abuse
16. Neurobiology
Imbalance of serotonin
All symptoms and comorbidity are coursed
by serotonin imbalances.
Inherited from family
Parents lower level of serotonin
Less serotonin level make vulnerable
17. Social pressure
Imitation
Media, stars
Career requirement
Ideal thinness
Fiji case
Before culture of thinnest
Less in non western societies
Classically conditioning phobia
Reward from environment (get loved)
18. Cont…
Incorrect beliefs
Exaggerating consequences
Focusing information supporting weight
gain
Ignoring contrary (selective attention)
21. CBT
Common beliefs
“if I eat, then I have to compensate”
“I weight what I weight now because I purse, don’t
eat and exercise….. Imagin what would happen if I
did not do that”
“I gain weight very easily…effect of – water
retention, slowed metabolism”
Exposure and response prevention
Eating and stopping for compensation
22. Family therapy
Initially focus on eating and weight gain
Family meal; parent receive coaching
Separate illness from person with it
Slowly return control to her
Differentially reinforce
23. Interpersonal Therapy
Therapy for emotion disturbances
Counseling for interpersonal problems
26. Outcome
Good adjustment in 40-50%
Anxiety about weight gain and preoccupation
with body image can be persist
6-7 years recovery takes
Relapse after hospitalization within 2 years in
about 1 in 5
Chronicity, extent of weight loss and
perfectionistic
27. References
American Psychiatric Association. (2013). Diagnostic
and statistical manual of mental disorders (5th
ed.). Arlington, VA: American Psychiatric
Publishing
Barlow, D. H., & Durand, V. M. (2011). Abnormal
Psychology: An Integrative Approach: An
Integrative Approach: Cengage Learning.
Comer, R. J. (2010). Abnormal psychology: Macmillan.
DeAngelis, T. (2002). Promising treatments for anorexia
and bulimia. Monitor on Psychology, 33, 38-41.
Fairburn, C.G., & Harrison, P.J. (2003). Eating Disorders.
Lancet, 361, 407-417.