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A model of eating disorders

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BT with anorexia. Use of reinforcement/punishment to encourage appropriate eating ... BT with anorexia nervosa. Can play a part in initial treatment of anorexia ... – PowerPoint PPT presentation

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Title: A model of eating disorders


1
A model of eating disorders
Restriction of eating
Bulimia Bingeing Purging Maintain weight
Anorexia Continued restriction Reduced
anxiety Excessive weight loss
psychlotron.org.uk
Based on Barlow Durand (1995)
2
Treatments for EDs
  • Behaviour therapy
  • Cognitive behaviour therapy
  • Weight restoration (anorexia only)

psychlotron.org.uk
3
BT with bulimia
  • Attempts to directly manipulate behaviour e.g.
  • Allowing bingeing preventing purging (Exposure
    with Response Prevention)
  • Reinforcement of appropriate eating punishment
    of inappropriate etc.
  • Prescribed alterations in eating patterns

psychlotron.org.uk
4
BT with bulimia
  • Waist cord therapy patients given cord to tie
    around waist
  • Assumed it might provide stimulus to stop
    bingeing.
  • Made bingeing more likely (Boggs et al, 2006)
  • ERT better than no treatment
  • No advantage over other therapies (Carter et al,
    2002 Leitenberg et al, 1988)

psychlotron.org.uk
5
BT with bulimia
  • Patients given eating programme to follow
    (Fairburn et al, 1985)
  • Small, manageable meals
  • 5-6 times a day
  • No more than 3 hours between meals
  • Improvement in about 40 of patients half these
    had relapsed after 4 months

psychlotron.org.uk
6
BT with anorexia
  • Use of reinforcement/punishment to encourage
    appropriate eating
  • Useful for facilitating weight gain
    (reinforceraccess to physical activity Blinder
    et al, 1970)
  • Generally helpful in weight restoration (Bemis,
    1987)
  • Target weight for release from hospital
    facilitates weight restoration (Barlow Durand,
    1995)

psychlotron.org.uk
7
BT with anorexia nervosa
  • Can play a part in initial treatment of anorexia
  • Not a cure and not sufficient to bring about long
    term change
  • May raise ethical questions (patients rights
    consent to treatment see token economy)

psychlotron.org.uk
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