PSYC 134 Lecture Notes - Lecture 5: Emotional And Behavioral Disorders, Harm Avoidance, Anxiety Disorder
PSYC 134 Lecture 5
5/2/2018
• AN and BN have highest mortality rate of all psychiatric disorders
• Relatively low funding to treatment and research when compared to others behavioral
disorders
• While a lot of people in society diet, not a lot develop into an ED
• AN temperament
o Anxious, risk avoidant, perfectionistic, obsessive, oversensitive to
mistakes/loss/criticism change/uncertainty
o Issue that contributes to high death rate and problems with treatment: not
seeing that they have a problem; denial; resistance to treatment; lack insight
• No proven treatments that reverse core symptoms of EDs
• Course:
o 50% recover
o 30% chronically ill
o 5-10+% die/ severely ill for most of life
• Because not all who diet develop an ED, why do some?
o So, are there susceptibility factors that make some women vulnerable to
dieting/weight loss?
• Why do’t poerful hoeostati ehaiss related to ody eight kik i i EDs?
• New understandings of EDs
o Family studies
▪ Increased rates in first degree relatives
o Twin studies
▪ 50-80% heritable risk
▪ Genes more powerful than culture
o Genes cause childhood pre-morbid traits, which suggests powerful neurobiology
▪ It’s ee hard to find these contributing genes→assue there’s o sigle
gene, but a lot that contribute a relatively small effect that sum into a
behavioral disorder
• Childhood traits
o Perfectionism
o Achievement oriented
o Obsessionality (e.g. symmetry, exactness)
o Sensitivity of criticism, punishment, mistakes
o Anxiety, worry about what might happen and consequences
o Harm avoidance, difficulty with uncertainty, novelty, change, social situations
o Inflexible and rule-bound
o Impulsive, over-reactive, over-emotional
▪ All is more likely to be encoded in brain circuitry
• So why do these traits lead to an ED?
• When good traits go bad: temperament, personality, and course of AN
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o
• AD before ED
o Results similar across continents
o Roughly the anxiety disorder preceded the ED in 2/3 of patients
o Childhood Ads: OCD and social phobia
• Evidence that harm-avoidance persists even into recovery
• The neurobiology of the ED is important in the development and maintenance of the
disorder
o All attribute to appetite dysregulation and disordered eating
• Inadequate treatment: 50% remain chronic
• New understanding of how behavior is encoded in the brain
• Hard to come up with an effective treatment before you understand the underlying
mechanisms→a need to find and target these mechanisms so that recovery rates
increase
• Appetite regulation
o Systems determining food and weight regulation:
▪ CNS factors (limbic, cognitive circuits, hypothalamic-brain stem system)
▪ BBB
▪ Metabolic signals
▪ Peripheral factors (adipose tissue, pancreas, and GI tract)
o Energy balance signals come mainly from the hypothalamus
▪ Know less about the higher-brain circuits because the brain is relatively
inaccessible
▪ Could lead to overlap between emotions and appetite
• Why pathological eating behaviors?
o Healthy people: when hungry, get irritable, tense; there is then a
pleasure/reward when eating
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Increased rates in first degree relatives: twin studies, 50-80% heritable risk, genes more powerful than culture, genes cause childhood pre-morbid traits, which suggests powerful neurobiology. Anxiety reducing character to dietary restraint: ed people (cid:271)e(cid:272)o(cid:373)e (cid:862)(cid:449)ired(cid:863) differe(cid:374)tly, limbic circuits involved in rewards/punishments play a critical role. Is pathological eating related to altered modulation of reward and inhibition in n: under-consumption of food, drugs, money, diminished reward sensitivity, could lead to denial, lack of motivation to engage in treatment. In combo with the other circuits, provides emotional salience for ed behaviors: salience circuit: evaluates interceptive cues and integrates cues with motivational/emotional processes, critical in eds, aka gustatory cortex. Is this specific to food, or broader: seen altered limbic and cognitive reward processing for wins and losses in an, could legitimize as a true biological disorder, and explains that these are general circuits that are disrupted.
