- individuals refusal to maintain body weight at the minimal normal weight for the individuals age and height. (a body weight that is 15% or more below the expected minimum leads to a diagnosis of anorexia)
- intense fear of gaining weight or becoming fat and a distortion of body image. (no matter how thin and emaciated the person becomes they are still afraid of becoming fat)
- the absence of at least three consecutive menstrual cycles >>amenorrhea
anorexia nervosa: secondary symptoms
- slow heart rate (bradycardia)
- low blood pressure (hypotension)
- low body temperature (hypothermia)
- depressions, obsessions, and compulsions
- individual with anorexia will not lose interest in food.
Bulimia Nervosa: Major symptoms
- eating binges (carefully planned and carried out in secret, often accompanied by a feeling of lack of control over the eating behavior. it ends only when the person can not eat anymore, and develops stomach pains)
- self induced vomiting, laxatives, enemas, (purging) to get rid of the food.
Purging can lead to physical problems such as....
- sore throats
- ulcers of the mouth
- swollen salivary glands
- destruction of tooth enamel
Historical Trends associated with eating disorders
- evidence of eating disorders can be traced back to ancient Greeks.
- studies showed a steady increase in the instances of eating disorders, however this can most likely be attributed to greater willingness to admit to the disorder due to the attention it has been receiving
Women vs Men regarding eating disorders
- women are 10 times more likely to suffer from eating disorders than men.
- the disease has an earlier onset in women than in men. (could be b/c women mature faster than men)
onset of eating disorders
- eating disorders are most frequently experience in adolescents between the ages of 15-19.
- in most cases, eating disorders usually only last for a few years. (however, about 30% of people suffering from the disease will experience issues into adulthood)
socioeconomic status and eating disorders
- the notion that eating disorders are more prevalent in higher social classes is a common misconception.
- eating disorders are more commonly found in lower social classes.
- this class related misconception could be due to the fact that people of higher social classes will more likely seek treatment
possible reasons behind lower social classes and higher rates of eating disorders
- they are less likely to seek treatment, and when they do get help it is usually to treat physical problems
- the rate of depression is also higher in lower social classes, which could be related to the higher levels of stress these individuals experience in contrast to their counter-parts of higher social classes.
different cultures and eating disorders
virtually all studies conducted across different cultures concerning eating disorders show similar rates of anorexia.
strategic eating disorders
individuals who have voluntary control over the symptoms of an eating disorder. (these individuals induce the disorder inorder to achieve a specific goal >>lose weight before a social event)
psychodyamic explanation for eating disorders
- by not eating girls were denying their emerging sexual urges
- young women would refuse to eat as a way of passively rebelling against over controlling mothers
- eating disorder are connected to child-abuse
- extreme stress can lead to the binge eating seen in bulimia
learning explanations for eating disorders
- society 'rewards' slimmer people.
- the complements and positive attention that comes with losing weight/ being slimmer can lead to the fear of becoming fat, which then turns into an eating phobia.
- a classically conditioned anxiety response is developed towards eating, and the only way to avoid the anxiety is to avoid eating.
Cognitive explanation for eating disorders
- stems from incorrect beliefs concerning their weight combined with unhealthy exaggerations concerning consequences of gaining weight
- selective attention regarding a non-existent weight problem increases the symptoms of anorexia
Physiological explanations for eating disorders
- the hypothalamus (the part of the brain that is responsible for appetite controle) is not working properly
- the malfunctioning hypothalamus is due to low levels of serotonin (the more serious the eating disorder, the lower the level of serotonin)
- low levels of serotonin also can account for the depression/ obsessive compulsive symptoms that are associated with eating disorders.
- low levels of serotonin is usually caused by either genetic factors, or prolonged stress.
PHysiological explanations continued...
problems during prenatal development/ birth can also lead to eating disorders
- relieve depression, and improve self-concept.
- evidence for effectiveness in limited at best.
- associate rewards such as visitors, television, and tokens with weight gain.
- the absence of controlled research makes it impossible to conclude tha tthese techniques are effective.
- cognitive behavioral therapy: help convince patients that they are not fat.
- CBT seems to be an effective treatment for some individuals. it has also been shown to be effective in some cases in reducing binge eating.
- use antidepressant drugs to increase the levels of serotonin.
- although research shows that antidepressants are fast-acting and effective, no drug could treat all patients.
- antidepressant appear to be more effective for treating bulimia than anorexia
- characterized by persistent eating of nonnutritive substances such as paint, plaster, hair, cloths, ect...
- can result in serious weight loss, malnutrition/ poisoning, and intestinal problems.
- disorder is most commonly found in young children and adults who suffer from mental retardation.
- characterized by the regurgitation of partially digested foods, the person then either rechews and swallows it or spits it out.
- act of regurgitation is not associated with the unpleasantness of vomiting, instead it results in pleasure
- can result in malnutrition or death
- usually occurs in young children, but is also found in about 10% of people who suffer from mental retardation.
- daily cycle of wakefulness and sleep
- controlled by an internal 'biological clock'
- average length of CR is about 25 hours
disorder that involves problems with the amount, quality or timing of sleep.
abnormal behavior that is associated with sleep.
Dyssomnias: Primary Insomnia
- characterized by difficulty getting to sleep, difficulty staying asleep long enough, and issues getting sleep that is restful.
- caused by excessive levels fo internally generated neurological arousal. (the reticular activating system carries too much activity from the brain to the cortex, preventing sleep)
physiological way of treating insomnia
- use Hypnotics (benzos) to reduce the general arousal of the brain to induce sleep.
- benzo hypnotics are used b/c they have short half-lives ( the amount of 1/2 the drug dose to leave the body) >> a short half-life is important to reduce drug hangovers.
- use antidepressants to increase levels of serotonin to allow the hypothalamus to function properly.
issues concerning "rebound effect"
some professionals are skeptical about using drugs due to the notion that it is possible for symptoms to become worse upon the patient being taken off the drug.
psychological way of treating insomnia
- cognitive therapy: individuals beliefs about sleep are changed
- relaxation training: person is taught how to relax muscles, so tension and arousal are reduced.
- stimulus control: when the person does not use his bedroom for anything other than sleeping.
- paradoxical intention: the anxiety of not being able to sleep is reduced when the patient is given 'permission' to stay awake.
Dyssomnias: Primary Hypersomnia
- characterized by excessive sleepiness; long periods of sleep at night and naps during the day. (the time spend sleeping does not relieve the sleepiness)
- caused by insufficient neurological arousal being made in the brain stem. (can be due to lesions in the hypothalamus)
- stimulants such as ritalin and other amphetamines.
- irresistible attacks of sleep. (1. sleep is irresistible 2. often associated with loss of muscle tone 3. REM sleep induces vivid dreams that can described as hallucinations. 4. sleep is temporarily refreshing.
- cataplexy: person collapses but remains conscious of what is happening around them (associated with sudden emotions such as fear, joy, or surprise.
- stems from early brain damage that does not progress
- there aren't any satisfactory methods for treating narcolepsy
- stimulants are used sometimes, but they lead to high heart rates, anxiety and insomnia.
breathing related sleep disorder
- person wakes up due a reduction in oxygen intake caused by a 'brief cessation of breath' (this will occur hundreds/thousands of times during the night resulting in poor sleep, but b/c the person falls back asleep almost instantly, they are unaware of why they are so tired in the morning)
- the lack of sleep can lead to a variety of psychological problems such as depression.
Obstructive apnea (1 of 2 types of sleep apnea)
obstruction of the airway to the lungs that causes the individual to be briefly deprived of oxygen.
- 3 factors can cause obstruction of the airway; 1. due to a lack of stimulation the muscles of the airway collapse (most likely to occur during REM sleep and can be cause by the use of sedatives) 2. obesity 3. the position in which the person sleeps.
treatment of obstructive apnea
- behavioral treatment: avoiding sedative, losing weight so the airway widens, and sleeping on side or face down.
- the use of antidepressants to suppress REM sleep which is the time when the airway muscles are stimulated the least.
- various mechanical methods can be implemented, such as devices to hold down the person's tongue/ reposition their jaw/ push air through the nose.
central apnea (2nd type of sleep apnea)
- stems from a problem in the brain that causes a brief interruption in breathing.
- occurs most often in the elderly
circadian rhythm sleep disorder
- involves a mismatch between the timing of a person's natural sleep-wakefulness cycle and the demands made of the individual by the circumstances in the which he lives.
- can be treated by exposure to bright lights to reset the cycle.
nightmare disorder (Parasomnias)
- characterized by being awakened by frightening dreams.
-individual remembers the dream, and is immediately aware that it was just a dream.
- nightmares occur frequently in children (they should not be diagnosed with the actual disorder unless the nightmares cause serious distress and impairment)
Sleep terror disorder (parasomnias)
- characterized by suddenly waking up with a panicky scream, which is accompanied by feeling of intense fear and very high heart rate.
- person is disoriented and cannot be comforted.
- once they are calmed down they cannot remember the nightmare that caused the attack. (due to the fact that attacks occur during non-REM when dreaming does NOT occur)
- it could be that terror disorders are nocturnal panic attacks.
- this disorder is very rare (6% of children, less than 1% of adults)
sleepwalking disorder (parasomnias)
- characterized by rising from bed and walking while asleep.
- although usually unresponsive, individuals will sometimes respond to simple commands.
- if awakened while sleep walking will be confused, and will not remember sleep walking
- occurs during non-REM sleep, so is most likely unrelated to dreams.
-more frequent in children then in adults
- some individuals engage in relatively complex activities.
a problem that places a great demand on an individual and lead to high levels of both psychological arousal (anxiety) and physiological arousal (increased heart rate/blood pressure).
-prolonged physiological arousal can result in a variety of physical disorders. (heart attacks, hypertension, and headaches.)
central nervous system.
- consists of the brain and the spinal cord
- it's major function is to interpret information and initiate responses
peripheral nervous system
- involves all of the nerves not in the brain and spinal cord.
- it's major function is to carry information to and from the central nervous system
- broken down into two divisions: 1. somatic division 2. autonomic division
connects the central nervous system to the muscles and skin
connects the central nervous system to various glands and organs
- divided into the sympathetic branch (responsible for increasing arousal) and parasympathetic branch (responsible for decreasing arousal). these two branches are connected so activity in one
three important points to recognize concerning the organization and function of the nervous system.
1. stressors cause intense/prolonged stimulation of the sympathetic branch of the autonomic system, overwhelming the calming effect of the parasympathetic branch, leaving the person at a state of high arousal.
2. the sympathetic branch responds as a unit, when it is activated there is general arousal (this might have been useful when our ancestors dealt with wild animals, but is problematic today when dealing with cognitive stressors.
3. we cannot control the arousal made by the sympathetic branch
Coronary artery disease
- characterized by the buildup of fat in the arteries that reduces blood flow.
- an occluded (clogged/closed) artery can result in tissue death.
- occurs when the atereis that supply blood to the heart become occluded, resulting in the muscles of the heart to die.
- when its muscles die, the heart stops pumping blood to the rest of the body, often resulting in death.
- is often a result of atherosclerosis
- the early signs of a heart attack, characterized by sharp pain in the chest or in the left shoulder/arm.
- usually occurs with exercise
- nitroglycerin is usually used as a treatment, however it is only a short-term solution.
Type A vs type B behavior patterns
- type A people are more prone to be hostile, competitive, and time urgent thus making them more prone to CAD (hostility is primarily the cause).
Type A personality's relation to CAD
- studies show that the characteristic of hostility in type A personalities is directly related to CAD
- a study showed that, out of 400 participants, 70% of the participants that scored high for hostility also had occultions
- studies show that type A's show signs of higher arousal when stressed, and tend to set higher/more challenging goals for themselves.
4 ways that increased arousal can lead to cardiovascular disease
1. arousal leds to increased production of cholesterol
2. arousal leads to greater clotting of cholesterol (this is the result of catecholamines combining with the cholesterol in the blood)
3. higher heart rates result in a rapid collection of cholesterol in the artery walls
4. high blood pressure results in the stretching of the artery walls making them rough and easier for cholesterol to collect
- high blood pressure
- essential hypertension
- secondary hypertension
- the cause for the high blood pressure can not be found, so it's assumed that the elevated pressure is due to psychological factors
- occurs when stress temporarily increases blood pressure, causing arteries to stretch. this is detected by 'baroreceptors' that tells the central nervous system to reduce blood pressure. however, once pressure is elevated for a long time, this elevation soon becomes the norm, resulting in high blood pressure.
- high blood pressure that stems from a known physiological cause. (salty diet, atherosclerosis, kidney malfunction)
personality effects on Hypertension
- angry/hostile people who hold in their emotions are more likely to be at risk for high blood pressure.
- more likely to effect african americans.
- risk grows with age.
systolic blood pressure
- the high level of pressure that occurs immediately after each heartbeat, when blood is suddenly forced through the system.
- the number that comes first in a blood pressure analysis
diastolic blood pressure
- the low level of pressure that occurs just before each heartbeat.
- the number that come second in a blood pressure analysis
coronary bypass surgery
treatment for CAD, involves grafting an unclogged piece of arter at the location of the occlusion so that blod can make it to the heart.
treatment for CAD that involves taking a small flexible tube with an inflatable balloon on the end and inserting it into the occluded artery. when the balloon is inflated, it forces the fat to the side expanding the artery wall, allowing for blood to pass to the heart.
drug that reduces heart rate, accordingly reducing the likelihood of a heart attack
reduces the amount of fluid in the body, there by reducing the pressure on the cardiovascular system.
causes the blood vessels to dilate, wich reduces blood-pressure.
Preventing high blood pressure and heart rate
- stress management: designed to help turn type A people in to Type B people
- social support
- positive attitude
- aerobic exercise
- biofeedback training: electronic equipment that provides immediate feedback about changes in autonomic responses
the body's way of fighting off disease causing agnets
disease causing agents the enter the body
white blood cells
blood cells created by the immune system to fight off antigens
- also called leukocytes
white blood cells that are produces in the lymph nodes.
- effective for controlling antigens
another type of white blood cell that kills antigens
lymphocytes that identifies antigens and signals the lymph notes to produce more killer cells.
lymphocytes that signal lymph nodes to produce less killer cells when the killer cells are no longer needed
refers to how well the imune system is working to fight off antigens
a virus that kills lymphocytes so that the body cannot recognize the presence of antigens and mount a defense against them thus leading to disease
the consequence of an HIV infection, that stems from a lack of killer cells
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