1. Disorders of Basic Physical Functions
Chapter 13
Disorders of Basic Physical Functions
Bilge Yağmurlu
PSYC 330
Developmental Psychopathology

2. Feeding and Eating Problems
Undereating, finicky eating, and overeating not uncommon - 50% of parents report some concern
Rumination Disorder - child voluntarily regurgitates food
Pica - eating substances that are not food
More common in 2-3 year olds
More common in children with developmental disabilities
May be related to nutritional deficits, parent inattention and lack of stimulation

3. Eating Disorders Anorexia
failure to maintain or meet expected weight based on age and height (below 85th percentile)
Wish to be 14 kg. less than medically accepted weight
Intense fear of gaining weight
Emotional reactions
Disturbance in body image, denies seriousness
Amenorrhea (Absence of 3 consecutive menstrual cycles)

4. Eating Disorders Bulimia Body weight not below expected levels
Recurrent episodes of binge eating
70% of ideal cal.
Recurrent attempts to compensate for overeating
Purging
range: 1-2/day to episodes/wk
Must occur 2 times/week for 3 months
Self-evaluation based on body shape and weight
Concern with weight

5. Eating Disorders Eating Disorder NOS (EDNOS) Binge eating disorder
No compensatory behaviors

6. Eating Disorders Cross-sectional Retrospective/concurrent Sample
Biological, social and psychological transformations
Continuum hypothesis
Denial and secrecy are components of the disorders
Risk factors Developmental course

7. Epidemiology Prevalence for AN: 0.2 - 0.8% BN: 1 - 2% EDNOS: 6-15%
Research indicates increasing body image concerns in young males and females and at younger ages
May be underestimated
More common in females: AN:10:1 and BN: 20:1
SES
Caucasian females
Westernized cultures have higher prevalence rates

8. Epidemiology
Typical age of onset is adolescence (puberty) to early adulthood
AN: 17 (SD: 3) yrs.
BN: 21 (SD: 6) yrs.
Course of illness can be chronic, even deadly
70-76 % recover
Many patients may decrease symptoms to a subclinical level - Eating Disorder NOS

9. Epidemiology
Can co-occur with depression, anxiety, and personality disorders
Histrionic personality disorder: characterized by a pattern of excessive emotionality and attention seeking, including an excessive need for approval and inappropriately seductive behavior, usually beginning in early adulthood.
Avoidant personality disorder (or anxious): characterized by a pervasive pattern of social inhibition, feelings of inadequacy, extreme sensitivity to negative evaluation, and avoidance of social interaction.

10. Etiology Cultural influences Early feeding problems Weight problems
Developmental stress
Sexual abuse
Family
Biological
Figure 13-6 can lead to a discussion of body image which is associated with developmental stress.
See Accent on male body image concerns
Neurotransmitters such as serotonin; higher than expected rates of ED in families of those with ED. Twin studies also suggest genetic influence

11. Etiology Physical changes: “fat spurt” adds body fat
Research on weight and body image
Pubertal timing: early, on-time and late-maturing
Early menarche and other problems
Sociocultural influences:
Ideal shape: slim and “prepubertal” are unattainable
Peer pressure and conformity
Vocations
Gender role:
Mimic males, ambivalent response to complex roles
Figure 13-6 can lead to a discussion of body image which is associated with developmental stress.
See Accent on male body image concerns
Neurotransmitters such as serotonin; higher than expected rates of ED in families of those with ED. Twin studies also suggest genetic influence

12. Etiology Family Emotional autonomy Renegotiation of relationships
Overprotective
Underinvolved and unnurturing
Cohesion is low
Modeling, disapproval regarding weight, rating attractiveness and body mass
Figure 13-6 can lead to a discussion of body image which is associated with developmental stress.
See Accent on male body image concerns
Neurotransmitters such as serotonin; higher than expected rates of ED in families of those with ED. Twin studies also suggest genetic influence

13. Etiology Characteristics Regulation of affect and impulse Esteem
Interpersonal relations
Insecurity, approval seeking
Perfectionism and high expectations
Negative affect
Figure 13-6 can lead to a discussion of body image which is associated with developmental stress.
See Accent on male body image concerns
Neurotransmitters such as serotonin; higher than expected rates of ED in families of those with ED. Twin studies also suggest genetic influence

14. Eating Disorders Treatment Prevention Family Decrease enmeshment
Increase communication
Address conflict/abuse
Cognitive behavioral
Focus on cognitive and perceptual distortions
Reinforce weight gain and maintenance
Pharmacology
Limited research, more support for bulimia
Prevention
Healthy eating and lifestyle education
Self-esteem enhancement
Learn to critically evaluate cultural messages