-If a person is suicidal, front line treatment they are going to get the person

on fast acting mediaction

-for suicidal and suicidal dialetc and (DBT), another posibility to trae individ
uals of sicudality
-high risk among teen, elderly, people who have made attempts before, depressed
individuals, MAINLT HIGH RISK GROUP
-Prevention is the are we save for last
-crisis hotlines can be helpful in hte sense that if an indivuadual call, they a
re a preventive mechanish
-not have randomized trial on use of crisis calls (
-they give a risk assement n will try to have the person to commit to get help n
stop from doing the behavior (if the intent
is serious), will call 911,
-if u fantisise about it n occupying ur thought daily it more dangerous
1/3 make a plan
and half of those 1/3 make an attempt to kill themselves
Why african american have low rate of depression because:
-social support ncluding religious participation
-psychological sources(high self-esteem)
-RESILIENCE (GOOD JOB VANESSA!!)
-63% of blacks believe depression is a personal weekness
-blacks were more likely to believe to believe that depression was normal' norma
l part of aging
-can effect whehter they recceive treatment
-WILL POST NEW SLIDES
-MUST WATCH THE VIDEO (DYING TO BE THIN)
WWW://VIDEO.PBS.ORG/VIDEO/1865661292 (ALL LOWERCASE)
--------------------------------------------------------------------------------
----------------------------
Eating disorders
-Anorexia nervosa
-both have intenste fear of being fat n they have persuit ti be thin, afraid obs
eesional fear of being weight
-n want to maintain normal weight
-a person who is
DSM 5, if below healthy weight u could be anerxioa nervosa,
-its also not fasting or eating, it also involves in bingde n purging, excessive
exerssice n this is all for anerexia
nervosa
-in builimia nervosa are normal weight or above weight, for aneroxia they ned to
stay in control , worring about
calories,
-slide 5 (even though they are skinny they see themselves as overweight)
-a women skips her mentrual cylcle (this criteria is no longer a critieria for D
SM 5)
-its common for people who suffer from anorexia to switch to bulemia
-bulemia: frequent binge eating n lack of control over eating n they dont stop u
ntil a full bindge, laxatives, diet pills,
vomit n purge, use of diaretics, excessice extercise n even when they dont binge
, they dont want to gain weight they
want to maintain their weiht.
-in DSM 4 binge eating 2 times a week in binge eating in DSM 5 is 1 monthly
-they see themselves n are fine with they dont have a disorderd
-they are the purging type: vomiting, laxitivesm diuretics
-nonpurging type: fasting n exercise
-binges: are 3,000 calories,
-people cna be bindging in this daily or several times a day
-*builimia n anoria people think about food and are never satisfied
-eating disorder EDNOS, in DSM 5 we weill see the classification of bindge disod
er (not with the rest of the disorder)
its focused on a person lack of control of what they eat n excessive precupation
in their body image
-bulemia is the less common of the 3 disorders
-not as stron of gender difference in bulimea in contrast to anorexia
-also engage in competitve envrionments( ex: college)
-most likely to develop in 15-19 years old in anorexia
-bulemia 20-24
-anorexia is th more dealy disease, body stops working, kidnety failure, heart a
ttack, death reate 5-15%
-body is in emergency mode all the time, it does nto have the nutrinets to opera
te properly,
bulemia, does not have these death rates, body not getting proper nutrients, dam
age to troat for vomiting n teeth
low potassium n damage to hands
-calisis as well (look up)
-not able to think right, blood presurre, hormonal problems, hair thins, kidney
failure, bruising esily, cold easily,
look 1t slide 13
-anorexia is one of the most difficult treatment to treat, after 21 years 51% FU
LLY RECOVERED, 20% PARTIALLY RECOVERED
-have high risk of sucides (anorexia)
-BULEMIA PATIENTS SHOW GREATER RECOVERY
-commorbidies we see , clinical dression, ocd, substance disorder, various perso
nalities disorders
-found of detail making lists, ridgid, more stubnorn, more frugal, dont disgard
things easily that perfectionsim makes
ocd,
-an eating disoder maybe related to borderline disorder(the core of this is not
being able to regulte emotions)
*perfectionism a key charatiristic for both illness
-sexual abuse (can be controlled), but having a eating disorder allows u to have
control
-binge eating is a temporary escape
-causual factors
SLIDE 21
bio factors: runs in family, heritable componets (range of .5% .80%), monozygoti
c twing is 56%, other tins 50%,
not as much as a heritibale component in bulemia nervosa, Dizigoc twins : 9%
-set point theory:people trying to lose wight, going against their set point tha
t creates a cyclical process
were they become hungry, want to be under their ideal weight which has them thin
king about food n eating more
because u want to go against ur biology-> creting a cylce to stay in weight whic
h will increase binge eating n food
-seretonin disregulation: people with bulemia have low rates of seretonin n eat
food to stimulate reward center
-n anorexis n bulemic recover they have an overactive seretonin
*seretonin is implicated in eating disoders
-people with bulemia nervosa have a disturbance in statisfation levels after the
y eat food, some research suggest their feedback
loop does not work as weel n dont receive the signal or a weak signal that their
stomach is full
-how statisfied they are in the feedback loop
sociocultural facors
-they influence how we sjhould look like n be which leads to eating disorders, a
dvertisment tell us thin is valued,
its what we want to be, for some people that stressors or predisposed to a illne
ss this is not good sociocultural values
-obesity is not a disorder n is not in DSM 4 or 5 (it may comrbid with another i
llness such as depression)
-eating disorders are becoming a worldwide problem we see this in western civiza
tions higher, using food as a mechanism
to feel better, more common in whites n asians then african american.
-overtime eating disorders increase over time n are at higher risks
-the stressor is that there has been a change in ideals n expectation n this pla
ys a role in the having the disorders
-a bigger distance between what u think u are n what u should be
-ex: the more they see beuty magazines the more disatisfied with how they are
-Family influences:
-more emphasis in weight n looking good, body image is a sign of self-esteem,
-parental overinvolment, being overly dependednt n not allowing children to be t
heir own people
-they find cotnrol by what they eat
-food to help u feel bettwe BULEMIA
-LOOK AT SLIDE 29: BEING AN ADOLECENT A WOMEN, BELIEVING THAT BEING THIN IS ATTR
ACTIVE, NOT BEING STATISFIED N A PATTERNS
OF DIETIING, PERFECTISONST (MORE PRONE OR UNSTABLE) N MOOD STATES CAN LEAD TO BI
NDGE
-some support for sexual abuse
-fdiathesis: biological disposition perfectionist personaluty n family histry
stress triggers:competative environment
-treatment can be challenging with anorexia (17% end up being hospitalizied, res
istance n disorders, u have to forcebly
feed them n make sure theydint use laxatives
-for anorexia antidepressants are not as effective as in bulemia n CBT not effec
tive, what works is a family
theraphy-maudsley model, careful monotoring, n see what they are eating, n issue
s with family or in second phase once
a person has gained weight they fix family problemns n in third phase we try to
prevent replase
-for bulimia good response for CBT: planning meals, proviging eucation eating, c
hange irrational percetions
about being thin or beuty n medications are more sucessuful, change congition so
they dont feel lik ethat or think