Anorexia and Bulimia Nervosa最新文献

{"title":"Severe and Enduring Eating Disorders: Concepts and Management","authors":"P. Robinson","doi":"10.5772/intechopen.87004","DOIUrl":"https://doi.org/10.5772/intechopen.87004","url":null,"abstract":"The concept of severe and enduring mental illness was introduced in 1999 in order to direct resources to patients suffering from long-term serious disorders, and was suggested for eating disorders in 2009. However, the term is still restricted to patients with long-term psychosis. In this chapter, the concept of severe and enduring eating disorder (SEED) is described and its relevance to anorexia nervosa (AN) and bulimia nervosa (BN) is explored. The recovery curve for anorexia nervosa seems to follow an exponential pattern with an asymptote that approaches but does not meet the horizontal, suggesting that recovery is always possible. Symptoms of AN but not BN seem to worsen after 3 years of illness, perhaps a significant threshold. Symptoms of severe and enduring AN (SEED-AN) are debilitating and longstanding as well as potentially fatal. Symptoms of severe and enduring BN (SEED-BN) are also debilitating, especially in social adjustment. In both conditions, family difficulties are prominent. A clinical approach to SEED is described based on improving quality of life, the recovery approach, (rather than cure) for sufferers and their families is described, although full symptomatic recovery can occur at any stage and clinicians should be alert to the possibility in all patients.","PeriodicalId":404728,"journal":{"name":"Anorexia and Bulimia Nervosa","volume":"231 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115749668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bulimia Nervosa and Body Dissatisfaction in Terms of Self-Perception of Body Image","authors":"L. Anitha, A. Alhussaini, Hessah Ibrahim Alsuwedan, Hessa Faleh Alnefaie, Rehab Abduallah Almubrek, S. Aldaweesh","doi":"10.5772/INTECHOPEN.84948","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.84948","url":null,"abstract":"Bulimia nervosa is characterized by disturbed body image, repetitive binge eating, and compensatory behaviours such as self-induced vomiting, laxative abuse, or fasting. Body image dissatisfaction and eating disordered behaviours (e.g. food restriction, purging, and binge eating) can affect men and women of varied ages, races, and cultural backgrounds. Body dissatisfaction is defined as a negative subjective evaluation of the weight and shape of one’s own body. Body dissatisfaction predicts the onset, severity, and treatment outcomes of eating disorders. A core component of body dissatisfaction is appearance-based social comparisons. In this context a study on self-perception of body image of women in Riyadh in 2018 revealed that a sudden spurt in obesity after marriage is leading to shift of higher percentage of women from positive to negative perception. Overall, an underestimation of body weight in terms of BMI was found among the participants. Such misconceptions should be addressed in view of the high obesity prevalence. It was also evident that positive and negative body image perception will lead to eating disorders in adolescents.","PeriodicalId":404728,"journal":{"name":"Anorexia and Bulimia Nervosa","volume":"109 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116245215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Storytelling as a Therapeutic Tool for Family Support in Bulimia Nervosa","authors":"José Vicente Martínez Quiñones, Marie Gamarra, I. J. Lobera","doi":"10.5772/INTECHOPEN.86195","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.86195","url":null,"abstract":"Telling stories (storytelling) is, above and beyond, a form of communication. It is a natural, universal, and well-known way of interaction among human beings. Storytelling, orally as well as in writing, is the sharing of personal narratives, a sort of story-sharing. With regard to chronic disease self-management, storytelling has been reported to be an exciting approach to patients and families. In this regard, families are considered very important in the management and treatment of eating disorders. Living with an eating disorder is an experience which deserves to be expressed in order to improve emotional support always necessary for patients’ families. Bearing in mind that eating disorders can be chronic illnesses that lead to challenging and troublesome experiences for patients and their families, this chapter aims to think over the everyday interactions that typify family life in the context of eating disorders and specifically in the case of bulimia nervosa. We propose this text as a reflection based on different experiences when working with bulimic patients.","PeriodicalId":404728,"journal":{"name":"Anorexia and Bulimia Nervosa","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131370855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients’ and Carers’ Perspectives of Psychopharmacological Interventions Targeting Anorexia Nervosa Symptoms","authors":"Amabel Dessain, Jessica Bentley, J. Treasure, U. Schmidt, H. Himmerich","doi":"10.5772/INTECHOPEN.86083","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.86083","url":null,"abstract":"In clinical practice, patients with anorexia nervosa (AN), their carers and clinicians often disagree about psychopharmacological treatment. We developed two corresponding questionnaires to survey the perspectives of patients with AN and their carers on psychopharmacological treatment. These questionnaires were distributed to 36 patients and 37 carers as a quality improvement project on a specialist unit for eating disorders at the South London and Maudsley NHS Foundation Trust. Although most patients did not believe that medication could help with AN, the majority thought that medication for AN should help with anxiety (61.1%), concentration (52.8%), sleep problems (52.8%) and anorexic thoughts (55.6%). Most of the carers shared the view that drug treatment for AN should help with anxiety (54%) and anorexic thoughts (64.8%). Most patients had concerns about potential weight gain, increased appetite, changes in body shape and metabolism during psychopharmacological treatment. By contrast, the majority of carers were not concerned about these specific side effects. Some of the concerns expressed by the patients seem to be AN-related. However, their desire for help with anxiety and anorexic thoughts, which is shared by their carers, should be taken seriously by clinicians when choosing a medication or planning psychopharmacological studies.","PeriodicalId":404728,"journal":{"name":"Anorexia and Bulimia Nervosa","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125207223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bulimia Nervosa: Is Body Dissatisfaction a Risk Factor?","authors":"N. Solano-Pinto, Miriam Valles-Casas, R. Fernández-Cézar","doi":"10.5772/INTECHOPEN.84169","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.84169","url":null,"abstract":"Eating disorder studies are often carried out with adolescents. However, having a normal weight and the appearance of a seemingly healthy body makes many young people wait for years before seeking out professional consultation with a specialist. Therefore, after a review of the literature we will reflect on the role of body dissatisfaction in the development and persistence that occur in bulimia nervosa. It will be linked to the data found by our research group, both in samples of adolescents and adult women. Results on risk scores in purgative behaviors associated with bulimia nervosa, dieting, eating habits, physical activity, self-esteem, social skills, and body dissatisfaction will be described. They will be contrasted in a descriptive way with data from clinical study participants diagnosed with bulimia nervosa, leading to a predictive model of the role body dissatisfaction plays as a risk factor in the development of bulimia nervosa.","PeriodicalId":404728,"journal":{"name":"Anorexia and Bulimia Nervosa","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116636597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysbiosis of the Microbiota in Anorexia Nervosa: Pathophysiological Implications","authors":"M. Sjögren, S. Frostad, K. Barfod","doi":"10.5772/INTECHOPEN.85253","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.85253","url":null,"abstract":"Anorexia nervosa (AN) is a severe and often enduring condition of which the etiology is unknown. Studies on the gut microbiota in AN have found deviations from that of healthy individuals, which may imply a relation to pathophysiology, development and maintenance of the disorder via the gut-brain axis, which has been shown in other disorders. A narrative review of the gut microbiota studies in AN is presented. Several studies point to a dysbiosis in AN which may have implications for maintenance of a low body weight, immunological changes and a severely reduced food intake. An association may be found to clinical symptoms in AN. A pathophysiological model for disease is presented implying a role of the microbiota in maintenance of AN. Dysbiosis in AN may play an important role in the development and maintenance of AN.","PeriodicalId":404728,"journal":{"name":"Anorexia and Bulimia Nervosa","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127802779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reclaiming the Lost Self in the Treatment of Bulimia Nervosa: A Neurobiological Approach to Recovery That Integrates Mind, Brain, and Body","authors":"A. Natenshon","doi":"10.5772/INTECHOPEN.83844","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.83844","url":null,"abstract":"The pathology of bulimia nervosa reflects the ‘dis-integration’ of the structure of the self within the distributed nervous system, resulting in the patient’s impaired sense of self and incapacity to sense self-experience. The twenty-first century defi-nition of self as ‘an embodied, sensory-based process grounded in kinesthetic expe-rience’ not only refutes the long-held myth of mind-body dualism, but also sheds light on the influence of neurobiological factors in disease onset and on how people make recovery changes within psychotherapy. The capacity to create, or reinstate, self-integration is built into the nervous system through the neuroplastic brain’s ability to change its structure and function in response to thought, sensation, feeling, and motor activity. The introduction of neurophysiological (sensorimotor) and neurobiological (interpersonal, attachment-based) interventions into mainstream clinical treatment for bulimia nervosa increases exposure to embodied experience, fostering mind, brain, and body connectivity. By stimulating integrative neuronal firing and synaptic activity, top-down and bottom-up transactions enhance acuity in self-sensing, self-perception, and body image coherence, supporting the unifica-tion of the disparate self. The current focus of mainstream clinical eating disorder treatment on symptom reduction alone neglects the neurological underpinnings of the disease. This chapter describes a range of treatment options for bulimia nervosa designed to support sustainable changes at the brain level. differentiated, and ultimately re-integrated through her movement experiences she became more adept at differentiating and reintegrating her emotions as well, becoming calmer and increasingly regulated. Lana spoke of her Feldenkrais experience as “clearing out the cobwebs in my brain.” At the end of one Feldenkrais session, in response to my lifting her leg off the treatment table in order to assess her degree of neuro-skeletal integration, Lana described feeling a sense of “overwhelm-ing relief and gratitude” for the now seemingly apparent weightlessness in her leg, in contrast with her own self-perception. “This is the first time I can remember feeling good about living inside this body of mine”].","PeriodicalId":404728,"journal":{"name":"Anorexia and Bulimia Nervosa","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115486016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impulsivity and Compulsivity in Anorexia Nervosa: Cognitive Systems Underlying Variation in Appetite Restraint from an RDoC Perspective","authors":"Samantha J. Brooks, H. Schiöth","doi":"10.5772/INTECHOPEN.83702","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.83702","url":null,"abstract":"Contemporary nomenclature for anorexia nervosa (AN) describes the eating disorder as transdiagnostic, with overlapping facets of impulsivity and compulsivity contributing to variations in binge-purge, restrictive eating and maladaptive cognitions. It is important to understand how these facets interact, given that those diagnosed with AN often fluctuate and relapse–as opposed to maintaining a stable diagnosis—between Diagnostic and Statistical Manual version 5 (DSM-5) categories, over the life course. The National Institute of Health’s Research Domain Criteria (NIH RDoC) subscribes to the transdiagnostic view of mental disorders and provides progressive guidelines for neuroscience research. As such, using the RDoC guidelines may help to pinpoint how impulsivity and compulsivity contribute to the cognitive mechanisms underlying variations in appetite restraint in eating disorders and common psychiatric comorbidities such as anxiety and obsessive-compulsive disorder. Exploring impulsivity and compulsivity in AN from the perspective of the RDoC cognitive systems domain is aided by measures of genetic, molecular, cellular, neural, physiological, behavioural and cognitive task paradigms. Thus, from the standpoint of the RDoC measures, this chapter will describe some of the ways in which impulsivity and compulsivity contribute to the cognitive systems associated with appetite restraint in AN, with the aim of further clarifying a model of appetite restraint to improve treatment interventions.","PeriodicalId":404728,"journal":{"name":"Anorexia and Bulimia Nervosa","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130043625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Possible Dysregulation of Orexin and Dopamine Systems in Anorexia Nervosa","authors":"M. Morales-Mulia, S. Morales-Mulia","doi":"10.5772/INTECHOPEN.83843","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.83843","url":null,"abstract":"Anorexia nervosa (AN) is a psychiatric illness characterized by a lack of motivation and a taste for rewarding food consumption. Mood disorders such as depression and stress are frequently associated with this condition. Abnormalities in several neural systems have been identified in patients with AN, including serotonin, dopamine (DA), appetite-related neuropeptides, and other neurochemical systems. Moreover, the changes that occur between the mesolimbic dopaminergic pathway and the orexin neurons in the lateral hypothalamus (LH) in response to the reduction in food consumption are key in the development of AN. Several studies suggest a functional relationship between orexin and dopaminergic circuits. LH orexin neurons project dense fibers on dopaminergic neurons, potently activating these neurons. DA and orexin neurons regulate negative and positive motivational states, such as drug and food seeking behavior. For this reason, it is important to extend the study of the functional and emotional interactions that exist between both neuronal systems to design new drugs that act at a behavioral and molecular level to treat AN. This chapter provides an overview of the evidence from literature implicating dopamine-orexin systems in AN and discusses recent advances that have contributed to our current understanding of the mechanisms underlying the molecular bases of AN.","PeriodicalId":404728,"journal":{"name":"Anorexia and Bulimia Nervosa","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121921182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Neurobiology of Anorexia Nervosa","authors":"Ashley Higgins","doi":"10.5772/INTECHOPEN.82751","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.82751","url":null,"abstract":"Anorexia nervosa is considered the most deadly psychological illness. Individuals with and recovered from anorexia nervosa experience numerous physical and mental health difficulties, and treatment outcomes remain unpromising. Anorexia nervosa is rare in the general population, but common among individuals with a first-degree relative with the disorder. In addition, the onset of anorexia nervosa is developmentally specific, which suggests a partly biological etiology. A better understanding of the biological and neurobiological etiology of anorexia nervosa is direly needed to inform new therapies and to identify individuals at risk for the disorder. This paper summarizes the research related to neurotransmitter abnormalities, aberrant brain activity, and genetic and epigenetic mechanisms that may contribute to the etiology of this deadly disorder.","PeriodicalId":404728,"journal":{"name":"Anorexia and Bulimia Nervosa","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127055796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}