this presentation is talking about the symptoms, causes, assessment, and treatment of anorexia nervous.

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

6. Repercussions
Physical
 Malnutrition Intestinal Ulcers
 Dehydration
 Born mass declines
 Serious heart, kidney, liver
damage
 Tooth/gum erosion
 Low PP and HR
 Hormone level change
 Neurological impairment
 Anemia
Psychological
 Depression
 Low self-esteem
 Shame or guilt
 Impaired relationships
 Mood swings
 Perfectionism

7. Medical Complications
 Death
 Central Nervous System
 Cardiovascular
 Genitourinary
 Stomach
 Intestine

10. Assessment
 Clinical interview
 Eating disorders inventory
 Assessing body image

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

13. Etiology
 Biopsychosocial
 Genetic
 Developmental
 Neurobiology
 Social pressure

14. Genetic
 MZ: 52%-66%
 DZ: 0%-11%
 AN family: ED, depression, anxiety,
perfectionism.

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)

19. Biopsychosocial interaction
Genetic Development Neurobiology
Social
pressure

20. Treatment
 Psycho-education
 CBT
 Exposure response prevention
 Family therapy
 Interpersonal therapy
 Psychopharmacology

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

24. Psychopharmacology
 Atypical antipsychotic
 Severe AN
 Antidepressant
 Gaining control

25. Hospitalization
 Day time hospitalization
 Full time hospitalization

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.