Psyc+eating+disorders

Leereenheid 8Learning unit 8

Eet en voedingsversteuringsEating and feeding disorders

Eetversteurings: Klassifikasie / Eating disorders: Classification

Anoreksie Nervosa

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Versteurde self- en liggaamsbeeld

Doel is betekenisvolle gewigsverlies

inperking

purgering

oefening

ontkenning en gebrek aan insig

obsessiefkontrolerendperfeksionisties

Mediese gevolge:Staking van menstruasie, droë vel, bros hare, koue-sensitief, lanugo

Komorbied:Depressie; OKV; PV; Impuls-kontrole versteuring

Gewigsverlies > 15% v normale liggaams-gewig

Inperkings-tipe

Ooreet / purgeertipe

Anorexia Nervosa

Fear of becoming fat

Disturbance of body & self perception

Aim is significant weight loss

restricting

purgingexercise

denial & lack of insight

obsessivecontrollingperfectionistic

Medical consequences:cessation of menstruation, dry

skin, brittle hair, cold sensitivity, lanugo

Comorbid:Depression; OCD; PD; Impulse control disorder

Weight loss > 15% of normal body weight

Restricting type

Binge eating / purging type

Bulimie Nervosa

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Oorweldige drang na eet + ooreetepisodes

Doel is om NIE gewig op te tel

self-geinduseerde braking

Oormatige oefening

verlies van beheer

Mediese gevolge:Vergrote speekselkliere; elektrolietwanbalans; verweerde tand-emalje;

kolonskade; hardlywigheid

Komorbied:Depressie; Substans misbruik & afhanklikheid; grenslyn PV

Gewigsverlies of toename binne 10% v normale liggaamsgewig

Purgeertipe

Nie-purgeer tipe

Bulimia Nervosa

Fear of becoming fat

Overwhelming urge to eat + binges

Aim is not to gain weight

self-induced vomiting

exercise

‘ox hunger’

loss of control

Medical consequences:

enlarged salivary glands; electrolyte imbalance; eroded tooth enamel;

calluses; colon damage; constipation

Comorbid:Depression; Substance abuse & dependence; borderline PD

Weight loss or gain within 10% of normal body weight

Purging

Ooreetversteuring/ Binge-eating disorder

Psychological theories

Psigodinamies: Anoreksie: ANGS: fobiese vermyding van voedsel

Behoeftebevrediging? / Need fulfillment?

Vermyding van seksuele rypheid

Hilde Bruch – swak ontwikkelde persoonlike effektiwiteit

Bulimie: chaotiese moeder-dogter verhouding

Gehegtheidsteorie / Attachment theory

Kognitief: Foutiewe liggaamsbeeld

Swak selfbeeld & hoë negatiewe affek

Personality

Low self-esteemLack of controlPerfectionismAgreeable, compliant & shySocially anxiousLow interoceptive awareness

AN: anxiety; social isolation. BN: extraversion, affective instability; histrionic tr.

Mood & anxiety: causes or result?

Etiologie / Aetiology

Gesinskonteks / Family context

Moeder as ‘gemeenskap se boodskapper’, perfeksionisties & ambisieus / Mother as ‘society’s messenger’, perfectionistic & ambitious

Psigodinamiese perspektief: Kontrolerende ouers; gesinne verwaarloos en verwerp / Psychodynamic view: Controlling parents; families neglect and reject.

Gesin-sisteemteorie / Family Systems Theory (Minuchin):Eating disorder assists the family in escaping conflicts.

Enmeshment, over protectiveness, rigidity, lack of conflict resolution

Family concerned with diet, appearance, and control.

Role of abuse / sexual abuse among those with eating disorders?

Thinness as Western ideal.

Tension: ideals of beauty / thinness vs general population becoming heavier.

Body ideals for men also emergingFemale models increasingly thinner over

the decades.Media plays a large roleWomen have general dissatisfaction with

their bodies.Being ‘fat’ is associated with being lazy,

unsuccessful, and having little self-control.

Women equate thinness not only with attractiveness, but also with intelligence and professional success.

Socio-cultural factors

Crosscultural / SA perspective

In many non-Western cultures, plumpness is associated with prosperity, success, and fertility

Cultural change / Westernisation / Urbanisation

Westernised SA females have similar rates to international figures (AN: 1%; BN: 1%-4%)

Lower prevalence in rural settings.

Dramatic political and social change in South Africa is increasing the risk for urban, black females