Introduction
Even if anorexia nervosa (AN) is a severe mental illness potentially resulting to serious ongoing psychiatric and physical health issues, there are not many clinical trial studies for treating AN published worldwidely focused on psychotherapeutic interventions (Birmingham et al., 2005; Herzog et al., 2000; Le Grange and Lock, 2005; Rome et al., 2003). According to Ale Grange and Lock (2005), of the interventions investigated for AN only the family therapy based approach developed by Dare and Eisler at the Maudsley Hospital, has been studied more than once in a clinical trial setting. Investigations completed at the end of treatment from the available studies of this approach suggest that it is effective in the short term,
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After discharge it was decided by the medical team in the hospital that Olga has to receive family treatment and she got a referral for it.
Assesment
The family of Olga had to meet for an initial assessment before the beginning of treatment. The initial assesment lasted for about 2-hours for clarifying Olga’s diagnosis and to asses if it could be any other possible comorbid mental health issue and ifs Olga is mentally ready for family treatment based on the Maudsley model. Olga got a diagnosis of anorexia nervosa, binge- eating/purging type without other concurrent psychiatric illness based on DSM-V (American Psychiatric Association, 2013). Parallel with the family based treatment, Olga’s physical health was uninterruptedly examined by her outpatient pediatrician specialist.
Signs and symptoms supporting Olga’s DSM-V diagnosis contain (a) her denial to keep body weight at or above a minimally normal weight for her age and height (85% of her IBW); (b) her constant fear of putting weight and ending up being overweight, albeit she is recently very underweight and malnourished; (c) her biased body image; and (d) the lack of more than three successive menstrual cycles. Olga’s lowest weight was 125 pounds, which is 74% of her ideal body weight.Olga she didn’t get her menstrual cycles for seven times in a row and was binge eating and purging up to eight times per day. As it is common with people having AN her
Incidences of Anorexia Nervosa have appeared to increase sharply in the USA, UK and western European countries since the beginning of the 60s (Gordon, 2001). The increasing prevalence of the disease has led the World Health Organisation to declare eating disorders a global priority area within adolescent mental health (Becker et al. 2011). Anorexia has in many ways become a modern epidemic (Gordon, 2000) and with a mortality rate of 10% per decade (Gorwood et al. 2003), the highest of any mental disorder (Bulik et al. 2006), it is an epidemic that social and biological scientists have been working tirelessly to understand.
Anorexia nervosa, otherwise stated as anorexia, is an eating disorder that occurs when an individual restricts themselves from necessary energy intake which leads to significantly low body weight. Other characteristics of this disorder include: intense fear of becoming fat or gaining weight, persistent behavior that interferes with weight gain, and disturbances of perception and experience of their own body weight and shape (DSM V, 2013). Effective treatments are still trying to be researched for this disorder, as there is not a “one size fits all” for people of all age groups, living situations, etc. Since adolescents with anorexia are such a vulnerable population,
Diagnosing potential Anorexia nervosa is not always easy, and Alicia’s case, based on information given and her representation, is not clear cut. Researchers argue that the diagnosis has to be done carefully and potential ambiguities have to be resolved (Baer & Blais, 2010). For example, some researchers have argued that one criterion, such as a fear of being fat, can decrease significantly when the person actually loses some weight (Surgenor & Maguire, 2013). For reasons like this, selecting the primary question, namely whether or not the patient has Anorexia
They put together questionnaires assessing current and historical eating habits and weight and associated psychological functioning, more commonly known as depression. They also used structured psychiatric history interviews which discussed the patient's first degree relatives to determine lifetime diagnosis of anxiety disorders. The first evaluation session consisted of DSM-IV (a manual of mental disorders) Axis 1 (disorders that need treatment and are the most familiar) psychiatric disorders (including BED) and were determined using the Structured Clinical Interview. The interview assessed the age when BED started in the patient, the age when anxiety started, and the age when any other psychiatric disorders started. Participants completed self-report measures. Their height and weight were measured and their Body Mass Index (BMI) were calculated too. Also in the first evaluation session, they gave an examination called the eating disorder examination. This examination is an investigator-based interview method for assessing eating disorders. It focuses on the previous 28 days and assesses the frequency of different forms of overeating. An interview was also given in the first evaluation session called The Weight and EAting History Interview. This interview assessed the timing and sequencing of current and historical obesity and eating-related variable of interest. It also assessed the participants’ age when they were first overweight, age when they first lost at least 10 pounds dieting, and the age they began binge
Eva symptoms consist with the symptoms of anorexia nervosa. The DSM-5 checklist states that significantly low body weight is a symptom. Eva is 10% less than her ideal weight and is making up excuses over her weight. Behaviors that interfere with gaining weight is another symptom and this can be seen by Eva’s extensive periods of exercise. Also she is only eating one meal per day that does not include any food another than fruits and seeds. Eva also shows denial of her current weight. She claims that she does not feel hungry and says that being underweight is the cause of her growing up. Eva symptoms are consistent with the DSM-5 checklist. To help Eva with this disorder, one should suggest cognitive-behavioral therapy and family therapy. Cognitive therapy can help Eva with her distorted perceptions about herself and body. This can help her change her attitudes and thoughts about her weight, body, and herself. Family therapy can help Eva and her family, learn more about her disorder. This therapy can also
The first article (Goldstein, et al, 2016) aimed to expand the credibility of family-based treatment for anorexia nervosa in a private practice setting. Thirty-four females and three males with either full or partial anorexia nervosa were assessed pre-treatment and post-treatment. The average number of therapy sessions was about fourteen over the duration of a year, with a treatment dropout rate of 27.8%.
The average age was 16.6 years. All women had a diagnosis of Anorexia Nervosa as indicated by DSM-IV and never received FT prior to the study. Patients and family were informed of the study when admitted to impatient care. Unfortunately, the sample size is quite small and there is a gender bias. This study only generalizes its results to females in their teens and early twenties who are hospitalized in inpatient care. Randomization does not occur in the sample selection.
Society has a big role in America and sometimes they do not use their power in a good way. One of the things society has failed in doing is promoting a healthy body size for all women. According to the National Eating Disorder Association, Society has a large impact on women's body image in the United States. Society has created an thin unobtainable image of how women should look. By doing this they have created an influx of eating disorders, one of those, is anorexia nervosa. Anorexia Nervosa is when someone starves themselves and causes extreme weight loss to the point where this disorder can become life-threatening. Anorexia nervosa is a very serious problem specifically in the United States about 30 million people of all ages and genders
Similar to the form of group therapy in the previous case study, the use of family therapy is a common treatment for coping with an eating disorder. In a controlled study on the effects of family therapy as a source of treatment for adolescents with anorexia nervosa, an observational study was conducted comparing two forms of family therapy. In addition to observing the patients in treatment they also examined the five-year follow-up of 40 patients who utilized conjoined group family therapy and separate family therapy (Eisler, Simic, Russell and Dare. 2007). The study included interviewing 40 patients who received either separate or conjoint family therapy. In addition to the interviews with the families, all participants also took part in 6-question surveys. The data collected measured the relationship between symptomatic outcome and psychosocial
A second diagnosis for Kathie is Mild Binge Eating Disorder (BED) (F50.8). BED is characterized by recurrent episodes of binge eating in which the client eats a large amount of food in a two-hour period that most people would consume in a similar situation. There is sense of lack of control over the eating. The binge episodes one to three times a week for three months. The client must meet three of the five criteria listed in the DSM-V for BED which include eating more rapidly than normal, feeling uncomfortably full after binge eating (BE), eating when not hungry, feeling embarrassed, and feeling guilty, disgusted, or depressed after the binge eating episode. Additionally, there is a feeling of marked distress over the binge eating episode. There are no compensatory behaviors such as vomiting, using laxatives, medications or excessive exercise (APA, 2013). Kathie has been secretly struggling with an eating disorder (ED) for the last six months. She has meets 3 of the 5 criteria listed in the DSM-V including eating excessively until she feels uncomfortably full. After binge eating, she feels ashamed and helpless, which makes her more depressed. She feels a loss of control over her eating. She eats alone and feels guilty after binge
Fairborn (2005) points out that there is a range of treatment options and a variety of treatment settings for anorexia nervosa, however there is inadequate empirical support for this abundance of options as what minimal research on the treatment has been inconclusive. One reasoning behind this is that anorexia nervosa has been an uncommon disorder and sample sizes for studies have been low. Furthermore, the lack of evidence based treatment research can be attributed to the individual’s avoidance of treatment and dropping out of treatment. Many individuals with anorexia nervosa are unwilling to change as their identity and self-worth are intertwined with their distorted body image; they tend to deny that anything is wrong with their weight and are ambivalent on changing (Abbate-Daga, Amianto, Delsedime, De-Bacco & Fassino,
This patient had been asked to leave school where she was completing a masters degree and was currently
When people are surrounded by images of young celebrities who are painfully thin-or very slender with large breasts- girls growing up in todays world feel the pressure of having to meet the standards. While trying hard to look just like their famous idols, a lot of those people will fall prey to an eating disorder, and some will even abuse drugs that will help them lose weight. Also it may lead to self-doubt, depression, extreme dieting and even at the worst an eating disorder. Everywhere you go there is something around them that is advertising weight loss such as TV ads, weightloss ads, shakes, diet pills, weight loss apps are popping up like crazy. Statistics stats that 5 million or more girls and women in America are estimated to suffer from anorexia and other eating disorders. Anorexia affects up to 3.7 percent of the female population at some point in their life. Just because they want to look like all the famous models. According to the American Society for Aesthetic Plastic Surgery, 11,326 girls aged 18 and under got breast implants last year-which tripled the number from 2010. Most board-certified plastic surgeons say they usually won’t preform implant surgery on girls under 18 unless one breast is smaller then the other. However, a lot of girls want this surgery as a graduation gift. Shows just how much young women will do to be perfect in society eyes.
Brandy is a 21-year-old from Oklahoma City, Oklahoma. She is the oldest of four children and her parents have been married for the past twenty-two years. After suffering for the past seven years in silence, Brandy has finally sought out treatment for bulimia nervosa. Brandy is a textbook case of a patient suffering from bulimia. The Diagnostic and Statistical Manual of Mental Disorders (5th ed., DSM-5; American Psychiatric Association, 2013) diagnostic criteria includes: Persisting binge eating episodes, reoccurring behaviors to prevent weight gain, both harmful purging behaviors and binge eating episodes occurring at least once a week for a minimum for three months, evaluating oneself solely or predominantly influenced by one’s body shape and weight, and finally the patient must not exhibit the aforementioned symptoms during an episode of anorexia nervosa. Her difficulty with her weight started in high school with binge eating. Soon after starting to binge eat, she starting purging by forcing herself to puke. The roots of her disorder is in her persistent stress and anxiety as a result of her trying to strive to success.
Eating Disorder Case Study Mother is concerned that daughter is not eating enough, restricting food intake for 8 months because she feels fat, feels she needs to lose ten pounds, feels that her thighs and stomach are to large, reporting 35 lb weight loss over last 8 months, denies any eating problems, began menarche at age 16 periods normally regular, stop three months ago, exercises daily 20 min. to 2 hours, experiences low energy, chronic constipation and lightheadedness, favorite TV show is “America’s Next Top Model” and reports “feeling down in the dumps” for about nine months, college student, good grades, finding it difficult to concentrate, admits to feeling worthless and having no