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Leereenheid 8Learning unit 8
Eet en voedingsversteuringsEating and feeding disorders
Eetversteurings: Klassifikasie / Eating disorders: Classification
Anoreksie Nervosa
Vrees om vet te word
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
Vrees om vet te word
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