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involves at least 15% loss of body weight through purging and/or voluntary restriction, as well as active pursuit of thinness
anorexia nervosa
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type of anorexia that relies solely on strict dieting; not regularly engaged in binge-eating or purging behavior
restricting type
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type of anorexia that alternates between dieting & binge eating, followed by self-induced vomiting or purging
binge-eating/purging type
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among the secondary symptoms of anorexia, _____ is one of the most common
excessive activity
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____ is another common secondary symptom of anorexia, with menstruation often ceasing prior to weight loss
amenorrhea
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two peak periods of onset for anorexia are ages ___ and ___
14 & 18
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____ is often present in adolescents with anorexia, w/ one study reporting a comorbidity rate of 73%
depression
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These personality characteristics are commonly seen in youths with anorexia
low self-esteem, anxiety, obessionality, perfectionism
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Anorexics who restrict tend to be
more rigid & conforming, socially insecure, obessional, and lacking in insight
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Anorexics who binge-purge are
more extroverted and sociable but are more emotionally dysregulated and alternate b/t rigid overcontrol and undercontrol
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Anorexia is _____
ego syntonic: they view the symptoms as consistent with their self-image & personal goals, view achieving an extremely low weight as a triumph of self-discipline
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Characteristic patterns of interaction in families of adolescents with anorexia
enmeshment, overprotectiveness, rigidity, lack of conflict resolution
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Early onset anorexia happens before age ___, and may be associated with a less negative prognosis in that the d/o has yet to become chronic and an entrenched pattern of behavior
16
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characterized by recurrent episodes of binge eating, followed by attempts to prevent weight gain
bulimia nervosa
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In this type of bulimia, attempts to prevent weight gain include vomiting, laxatives, and diuretics
purging type
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In this type of bulimia, attempts to prevent weight gain include fasting and excessive exercise
nonpurging type
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Individuals with bulimia usually have a weight that
is within average range
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Individuals with bulimia are terrified of _____ rather than the amount of food consumed.
losing control over their eating
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Mean age of onset for bulimia
18
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Predisposing personality factors of bulimics
inability to regulate negative feelings, need for immediate gratification, fragile sense of self
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The intrapersonal factors associated with bulimia are
perfectionism, need for approval, self-criticism, low self-esteem, sensitive to rejection, high achievers
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Anorexics & bulimics tend to have a ____ cognitive style marked by black-or-white, all-or-none thinking
rigid
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Unlike anorexia, bulimia tends to be more _____
ego dystonic: inconsistent with one's goals and self-perceptions
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The family members of youth with bulimia are more likely to be
overtly disturbed, have discord
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When compared to anorexia, rates of recovery from bulimia are ____
relatively high
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Types of treatment for eating disorders
pharmalogical intervention, psychodynamic psychotherapy, behavior modification, cognitive therapy, family therapy
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For bulimia, the binging and purging must occur, on average, at least
twice a week for 3 months
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common features of both AN and BN
dieting; unhealthy relationship to body and food; elevated risk of self-harm/suicide attempts; anxiety, depression, perfectionism; substance abuse
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Differences between AN & BN
weight, distortions, personality, family, medical complications
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associated features of AN
obsessionality, ritualistic behaviors, extreme perfectionism, low self-esteem, self-consciousness, cognitive impairment (when underweight)
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associated features of BN
depressed mood, irritability, low self-esteem, shame/guilt, impulsive behavior, alcohol/drug problem
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Types of child maltreatment
physical, sexual, neglect, emotional
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young maltreated children show significant delays in ____ and ____ development
cognitive and language
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Physically abused children are most likely to show a pattern of _____
avoidant attachment: refrain from seeking attention or contact when under stress
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The most frequently detected form of neglect in children age 2 and younger is called
failure to thrive: significant delay in growth resulting from inadequate caloric intake
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____ is the most prevalent form of maltreatment
neglect
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____ children do poorest in school
neglected
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____ is a major consequence of neglect
insecure attachment: less able to tolerate stress of separation, to modulate their own affect and distress, and to cope with new situations
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In neglect ____ and ____ development are characterized by passivity and avoidance
emotional & interpersonal
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____ is the most strongly predicted by economic distress
neglect
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Examples of emotional abuse
rejection, degradation, terrorization, isolation, corruption, exploitation, denial of emotional responsiveness
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Most studies find that sexually abused children have _____ problems
internalizing problems including fears, anxiety, depression, low self-esteem, and excessive shyness
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Teens with a history of maltreatment are at a much greater risk of _____
substance abuse
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sexually abused children may develop
chronic impairments in self-esteem, self-concept, and emotional and behavioral self-regulation, including PTSD, depression, dissociative states, and sexual maladjustment
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traumagenic model of sexual abuse
betrayal, stigmatization, traumatic sexualization, powerlessness
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