People with eating disorders struggle to control their disturbed attitudes and behaviors regarding food, and many put their lives at risk. Differences: Anorexics have distorted body image, bulimics have accurate body image; anorexics significantly below normal weight, bulimic’s weight is average or above-average.
Numbers of males with anorexia nervosa have increased.
Four symptoms characterize anorexia nervosa. Amenhorrhea: (for postpubescent females) the absence of at least three consecutive menstrual cycles.
1 in 10 die as a result of starvation, medical complications, or suicide.
Some people with anorexia nervosa also engage in compensating behaviors, but their primary symptom is that they starve themselves.
Also possible: fluid retention in hands and feet; destruction of the heart muscle; collapse of the heart valve. Effects occur throughout the gastrointestinal, cardiovascular, and nervous systems. For girls, the highest risk for development of binge behavior is age 16; purging, 18. 42% of bulimic men identify themselves as homosexual or bisexual; 58% anorexic men, asexual.
Norepinephrine and serotonin deficiencies are also implicated in mood and compulsive disorders, so it is interesting to note high co-morbidity between those disorders and the eating disorders. Victims of childhood abuse have higher rates of eating disorders. Individuals with eating disorders tend to avoid problems rather than resolve them; resort to wishful thinking rather than realistic appraisal; and don’t seek social support even when in serious trouble. The pursuit of emotional comfort through eating may also be seen as a desperate expression of unresolved feelings of dependency.
Given the multiple perspectives on the causes of eating disorders and the evidence to support each, it follows that effective treatment usually requires a combination of approaches. Medication: Fluoxetine (Prozac) can help control relapse, maintain weight gains, and reduce other symptoms. Regardless of the potential usefulness of medications, though, psychotherapy is clearly needed. Cognitive/behavioral: Establish good eating patterns; self-monitoring techniques; learn self-control, problem-solving, cognitive-restructuring. Interpersonal therapy: Therapy focuses on helping the client cope with stress in interpersonal situations and with feelings of low self-esteem. Family therapy: A review of research indicates that involvement of the parents and the teen is sufficient to bring about positive change.
Impulse-control disorders: Psychological disorders in which people repeatedly engage in behaviors that are potentially harmful, feeling unable to stop themselves and experiencing a sense of desperation if their attempts to carry out the behaviors are thwarted.
Most people with kleptomania are unsure what to do with the stolen items.
People with kleptomania are driven by a persistent urge to steal, although their theft is not motivated by a wish to own the object or by its monetary value. A serotonin deficiency might underlie kleptomania. Clinicians use techniques like covert sensitization to control the urge to steal. However, few cases come to clinical attention.
Often gamblers have experienced a big win , a gain of large amounts of money in one bet, propelling them into a pattern of addiction that inevitably becomes almost impossible to break. The big win was so reinforcing, they become obsessed with the need to re-experience it. From a biological perspective, the perpetual pursuit of the big win is similar to effects of substance addiction. Personality influences: High impulsivity and psychopathy are thought to predispose individuals to seek excitement like that provided by gambling.
Internet addiction is becoming the newest context for pathological gambling. Although more common among young people, it is also becoming prevalent among the adult population.
Achieve intense pleasure, gratification, relief when fire starts. Rooted in childhood problems . Adults often have substance abuse and interpersonal problems. Difficult to treat, but behavioral, cognitive, and psychodynamic therapy may help.
Some experts believe the easy availability of sexuality on the Internet has pulled some people into desperately seeking sexual gratification, addictedly viewing sexual images, participating in sexually oriented chat rooms, or contacting other people seeking sexual encounters.
Like other conditions in the obsessive-compulsive spectrum, this responds to SSRIs. Insight-oriented therapy focuses on analyzing underlying conflicts. Behavioral techniques include covert conditioning, imaginal desensitization, and behavioral contracting.
They tend to engage in hair-pulling only when alone. Some may eat the hair they pull out.
Trichobezoar (“Rapunzel syndrome”): Condition in which swallowed hair solidifies in the stomach or intestines.
Features of this disorder suggest a complex interaction of biological and environmental factors leading up to it. Learning theorists feel operant conditioning explains the behavior of people who explode occasionally, that it leads to powerful reinforcement for them. Based on findings of serotonergic abnormalities, clinicians advocates medications.
Information overload involves compulsive Web surfing or database searches.
In attempting to explain impulse-control disorders, experts have proposed that they fall on an “affective spectrum” that includes mood disorders, substance abuse disorders, anxiety disorders, and eating disorders. All these conditions share certain symptoms, hypothesized biological mechanisms, and treatments.