ANOREXIA NERVOSA_BULIMIA NERVOSA - ANOREXIA NERVOSA/BULIMIA...

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ANOREXIA NERVOSA/BULIMIA NERVOSA DSM-IV 307.1 Anoxexia nervosa 307.51 Bulimia nervosa 307.50 Eating disorders NOS Binge-eating disorder (proposed, requiring further study) Anorexia nervosa is an illness of starvation, brought on by severe disturbance of body image and a  morbid fear of obesity. Bulimia nervosa is an eating disorder (binge-purge syndrome) characterized by extreme overeating,  followed by self-induced vomiting. It may include abuse of laxatives and diuretics. Binge-eating is defined as recurrent episodes of overeating associated with subjective and behavioral  indicators of impaired control over and significant distress about the eating behavior but without the use of  inappropriate compensatory behaviors (e.g., purging, fasting, excessive exercise). ETIOLOGICAL THEORIES Psychodynamics The individual reflects a developmental arrest in the very early childhood years. The tasks of trust,  autonomy,   and   separation-individuation  are   unfulfilled,   and   the  individual   remains   in   the  dependent  position. Ego development is retarded. Symptoms are often associated with a perceived loss of control in  some aspect of life and may center on fears of sexual maturity / intimacy. Although these disorders affect  women primarily, approximately 5% to 10% of those afflicted are men. Additionally, eating disorders are  often associated with depression, anxiety, phobias, and cognitive problems. Biological These disorders may be caused by neuroendocrine abnormalities within the hypothalamus. Symptoms  are linked to various chemical disturbances normally regulated by the hypothalamus. Furthermore, a  physiological defect may make it difficult for the individual to interpret sensations of hunger and fullness. Family Dynamics Issues of control become the overriding factors in the family of the client with an eating disorder.  These families often consist of a passive father, a domineering mother, and an overly dependent child.  There is a high value placed on perfectionism in this family, and the child believes she or he must please  others and satisfy these standards. CLIENT ASSESSMENT DATA BASE Activity/Rest Disturbed sleep patterns (e.g., early morning insomnia; fatigue) Feeling “hyper” and / or anxious Increased activity / avid exerciser, participation in high-energy sports Employment in positions / professions that require control of weight (athletics, such as gymnasts, swimmers,  jockeys, wrestlers; modeling, flight attendants) Circulation Feeling cold even when room is warm Low BP; tachycardia, dysrhythmias
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Ego Integrity Powerlessness / helplessness, lack of control over eating (e.g., cannot stop eating / control what or how much 
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