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Lifespan Development: Eating Disorders

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Cordelia Snowdon

on 21 March 2015

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Transcript of Lifespan Development: Eating Disorders

minstrel? like the pied piper?
Age 10 - 18
Age 19 - 40
Age 40 <
Age 0 - 9
Infancy and Early Childhood (age 0-9)
Infancy and early childhood differentiate from the other stages in later life.
The disorders that a child experiences could have similar symptoms of those disorders an adult could experience. (Bulimia is an example).
The differences that an infant and an adult would have are the particular reasons and impacts that increased the individual's chances of having the disorder.
Late Age Onset (LAO)
Lifespan Development: Eating Disorders
What is Late Age Onset?

Cognitive Factors
Feeding Disorder:
possibly caused through the child's temperament and/or late development of oral and motor functioning.
What is an eating disorder?

An eating disorder is a "persistent disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning."

Types of Feeding/Eating Disorders
Social Factors
Feeding Disorder:
occurs when mother fails to breastfeed the child for first two years (obesity), mother tries to force feed the baby ( refusal to eat)
- Pressure from culture
• The risk factors for LAO has shown that there is less family history of psychiatric disorders and lower comorbidity. BUT more bereavement
• Women with LAO eating disorders revealed higher rates of denial and increased emotional and behavior over-control compared with TAO

Family & Friends
- perceived pressures from family become more influential than friends or peers. Pressures could include weight related teasing.

Social isolation
- could contribute to or be a result of an eating disorder.

- older women compare themselves to the thin ideal

- habitual body monitoring

Aging Anxiety
- fear of age related changes

Negative affect
- mood states ie. depression, shame, inadequacy and
• Psychological fear of growing up (psychoanalytical perspective)
• Internal image not matching their perspective of their own body
• Most LAO eating disorders present with depression and 65% have anxiety
• Emaciation = an intense fear of gaining weight despite being underweight. Disturbed body image
Quality of life (self report)
Body dissatisfaction (view of self)
Weight and shape concern – age 13 - 15

Neurological Factors
Feeding Disorder
: correlation with feeding problems and medical problems and/or developmental disabilities
Pica Disorder:
children have poor judgment from the association of mental retardation and pervasive developmental disorder. Association with mental retardation and pervasive development
Pica Disorder
: abnormalities in precocity or the infant can show more vulnerability than other children
Pica Disorder
: When associated with other disorders, possible neurological abnormalities such as frontocerebellar dysfunction, atypicality of the cerebellum, and connection disruption in the cerebellum.
Psychological Factors
Psychological Factors
Psychological Factors
Social Factors
Social Factors
Social Factors
Cognitive Factors
Physical Factors
Physical & Cognitive Factors
Conclusion / Discussion

(American Psychiatric Association, Feeding and Eating Disorders)
Anorexia Nervosa
- intentional weight loss initiated by the person
Health risks - hospitalization to restore weight, lethargy, low bone mass density, death from medical complications, suicide.

Bulimia Nervosa
- repeated overeating and purging through vomiting or purgatives to control weight
Health risks - decreased social functioning, elevated risk of suicide

Binge Eating
- Eating a significantly larger amount of food in a short amount of time than similar persons would consume in the same amount of time.
Appears to run in families
Health risks - impaired health related quality of life, weight gain, death.

Rumination disorder
Avoidant/restrictive food intake disorder
Anorexia nervosa
Bulimia nervosa
Binge-eating disorder
(American Psychiatric Association, Feeding and Eating Disorders)
(American Psychiatric Association, Feeding and Eating Disorders)
- Abnormal brain waves
- Low dopamine levels

Developmental Risks:
BN - gastrointestinal disturbances and electrolyte abnormalities
- gastric rupture and esophagus rupture
AN - heart failure
BE - high blood pressure and cholesterol
- high risk for heart failure and type II diabetes
(Boyd, Johnson, & Bee, 2012, pp. 433, 478)
(World Health Organization, 2010)

The International Statistical Classification of Diseases and Related Health Problems (ICD-10) outlines anorexia nervosa as occurring in "older women up to the menopause"

The DSM - states anorexia and bulimia rarely have an age of onset after 40

Cases of late onset anorexia nervosa is rare, but there has been an recent increase in older patients seeking treatment for eating disorders.

(first step, 2013)
(ABC News, 2012)
(Bayer, n.d.)
Battling Eating Disorders 8:32 – 9:31
The risks associated with eating disorders increases in later years as maintaining a healthy lifestyle becomes more important to prevent chronic diseases and disabilities.
ie - "Being significantly underweight or overweight were linked to increased risk of death"

Body mass index
- As BMI increases , older adults are likely to be dissatisfied with their weight and may contribute to unhealthy eating practices.

- hormone changes during menopause can lead to increased weight gain
Often times multiple diagnoses (psychiatric comorbidity)
Social Anxiety Disorders
Obsessive-compulsive Disorders
Theory of Mind deteriorates due to damage done in brain
(Bühren et al, 2013, p. 39)
(Ruther et al, 2012, p. 839)
(Ferguson, 2014, p. 3)
Relationship between influence of media and social pressure
Social competition
Theory of Mind deteriorates – unable to consider other’s thoughts
Social withdrawal

(Ruther et al, 2012, p. 832)
(DiSantis, Hodges & Fisher, 2013).
(Fish, Shapero, Halpern & Wile, 1965).
(Fish, Shapero, Halpern & Wile, 1965).
(Schiffman et al., 2009)
(American Psychiatric Association, 2013)
(Slevec & Tiggemann, 2010, pp. 517-518)

ABC News. (2012). Eating disorders ‘common’ in older women. [Photograph]. Retrieved from http://abcnews.go.com/blogs/health/2012/06/21/eating-disorders-common-in-older-womenhttpabcnews-go-comblogshealthwp-adminpost-phppost114081actioneditmessage10/

Ackard, D. M., Richter, S., Frisch, M. J., Mangham, D., & Cronemeyer, C. L. (2013). Eating disorder treatment among women forty and older: Increases in prevalence over time and comparisons to young adult patients. Journal of Psychosomatic Research, 74(2), 175-178. http://dx.doi.org /10.1016/j.jpsychores.2012.10.014

American Psychiatric Association. (2013) Diagnostic and statistical manual of mental disorders: Fifth edition: DSM-5. (5th ed.). Retrieved from dsm.psychiatryonline.org

Ammaniti, M., Lucarelli, L., Cimino, S., D'Olimpio, F., & Chatoor, I. (2012). Feeding disorders of infancy: A longitudinal study to middle childhood. International Journal Of Eating Disorders, http://dx.doi.org/ 10.1002/eat.20925

Bayer, R. (n.d.) Portrait of an attractive middle aged woman looking into a mirror, with focus set on the mirror image. [Photograph]. Retrieved from http://www.livescience.com/27303-aging-woman-old-talk.html

Bischoff-Grethe, A., McCurdy, D., Grenesko-Stevens, E., Irvine, L. E., Wagner, A., Yau, W. W., … Kaye, W. (2013). Altered brain response to reward and punishment in adolescents with anorexia nervosa. Psychiatry Research: Neuroimaging, 214(3), 331-340. http://dx.doi.org/10.1016 /j .pscychresns.2013.07.004

Blomquist, K. K., Roberto, C. A., Barnes, R. D., White, M. A., Masheb, R. M., & Grilo, C. M. (2014). Development and validation of the eating loss of control scale. Psychological Assessment: A Journal of Counsulting and Clinical Psychology, 26(1), 77-89.

Boyes, A. D., Fletcher, G. J. O., & Latner, J. D. (2007). Male and female body image and dieting in the context of intimate relationships. Journal of Family Psychology, 21(4), 764-768.

Boyd, D., Johnson, P., & Bee, H. (2012). Lifespan development (4th ed.). Toronto, Ontario: Pearson Canada Inc.

Bryant-Waugh, R., Markham, L., Kreipe, R. E., & Walsh, B. (2010). Feeding and eating disorders in childhood. International Journal Of Eating Disorders. Retrieved from http://library.mtroyal.ca:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,url,cookie,uid&db=psyh&AN=2010-04191-002&site=ehost-live

Bueno, B., Krug, I., Bulik, C. M., Jiménez-Murcia, S., Granero, R., Thornton, L., … Fernández-Aranda, F. (2014). Late onset eating disorders in Spain: Clinical characteristics and therapeutic implications. Journal of Clinical Psychology, 70(1), 1-17. http://dx.doi.org/ 10.1002/jclp.22006

Bühren, K., Schwarte1, R., Fluck, F., Timmesfeld, N., Krei, M., Egberts, K.,... Herpertz-Dahlmann, B. (2013). Comorbid psychiatric disorders in female adolescents with first-onset anorexia nervosa. European Eating Disorders Review, 22(1), 39-44. http://dx.doi.org/10.1002/erv.2254

DiSantis, K., Hodges, E. A., & Fisher, J. (2013). The association of breastfeeding duration with later maternal feeding styles in infancy and toddlerhood: A cross-sectional analysis. The International Journal Of Behavioral Nutrition And Physical Activity. http://dx.doi.org/ 10.1186/1479-5868-10-53

Ferguson, C., Muñoz, M., Garza, A., & Galindo, M. (2014). Concurrent and prospective analyses of peer, television and social media influences on body dissatisfaction, eating disorder symptoms and life satisfaction in adolescent girls. Journal of Youth and Adolescence, 43(1), 1-14. http://dx.doi.org /10.1007/s10964-012-9898-9

First Step. (2013). eating-disorders2. [image of teenager with a bigger shadow]. [Photograph]. Retrieved from http://firststeprecovery.com/?page_id=48

Fish, B., Shapero, T., Halpern, F., & Wile, R. (1965). The prediction of schizophrenia in infancy: III. a ten- year follow-up repot of neurological and psychological development. Retrieved from http://ajp.psychiatryonline.org/article.aspx?articleid=149842

Hughes, E. K., Goldschmidt, A. B., Labuschagne, Z., Loeb, K. L., Sawyer, S. M., & Le Grange, D. (2013). Eating disorders with and without comorbid depression and anxiety: Similarities and differences in a clinical sample of children and adolescents. European Eating Disorders Review, 21(5), 386-394). http://dx.doi.org/10.1002/erv.2234

Jenkins, P. E., Hoste, R. R., Doyle, A. C., Eddy, K., Crosby, R. D., Hill, L., … Le Grange, D. (2014). Health-related quality of life among adolescents with eating disorders. Journal of Psychosomatic Research, 76(1), 1-5. http://dx.doi.org/10.1016/j.jpsychores.2013.11.006

Linna, M. S., Raevuori, A., Haukka, J., Suvisaari, J. M., Suokas, & J. T., Gissler, M. (2013). Reproductive health outcomes in eating disorders. International Journal of Eating Disorders, 46(8), 826-833.http://dx.doi.org/10.1002/eat.22179

ohde, J., Claussen, M., Kuechenhoff, B., Seifritz, E., & Schuepbach, D. (2013). Combined symptomatology of psychosis, pica syndrome, and hippocampal sclerosis: A case report. International Journal Of Eating Disorders. http://dx.doi.org/ 10.1002/eat.22064

Schiffman, J., Sorensen, H. J., Maeda, J., Mortensen, E. L., Victoroff, J., Hayashi, K., & ... Mednick, S. (2009). Childhood motor coordination and adult schizophrenia spectrum disorders. The American Journal Of Psychiatry. http://dx.doi.org/ 10.1176/appi.ajp.2009.08091400

Scholtz, S., Hill, L. S., & Lacey, H. (2010). Eating disorders in older women: Does late onset anorexia nervosa exist?. International Journal of Eating Disorders, 43(5), 393-397.

Schulte-Rüther, M., Mainz, V., Flink, G. R., Herpertz-Dahlmann, B., & Konrad, K. (2012). Theory of mind and the brain in anorexia nervosa: Relation to treatment outcome. Journal of the American Academy of Child & Adolescent Psychiatry, 51(8), 832-841. http://dx.doi.org /10.1016 j.jaac.2012.06.007

Slevec, J. H., & Tiggemann, M. (2011). Predictors of body dissatisfaction and disordered eating in middle-aged women. Clinical Psychology Review, 31(4), 515-524. http://dx.doi.org /10.1016 /j.cpr.2010.12.002

Wade, T. D., Hansell, N. K., Crosby, R. D., Bryant-Waugh, R., Treasure, J., Nixon, R.,…Martin, N. (2013). A study of changes in genetic and environmental influences on weight and shape concern across adolescence. Journal of Abnormal Psychology, 122(1), 119-130.

Williams, K. E., Riegel, K., & Kerwin, M. (2009). Feeding disorder of infancy or early childhood: How often is it seen in feeding programs?. Children's Health Care. http://dx.doi.org/ 10.1080/02739610902813302

World Health Organization. (2010). ICD-10 version: 2010. Retrieved March 16, 2014, from http://apps.who.int /classifications/icd10/browse/2010/en#/F50.0

- eating nonfood substances consistently for at least 1 month
Health risks - intestional obstruction, poisoning

Rumination Disorder
- repeated regurgitation of food for at least 1 month
Health risks - malnutrition, growth delay, lowered developmental and learning potential

Avoidant/Restrictive Food Intake Disorder
- An extension of the feeding disorders found in infancy/childhood. i.e. an apparent lack of interest in eating or food or avoidance due to the appearance of food
Health risks - impairment of physical development and social difficulties

(American Psychiatric Association, Feeding and Eating Disorders)
(Jenkins et al, 2014, p. 4)
(Wade et al, 2013, p. 128)
(Ackard et al, 2012, p 175)
(Slevec & Tiggemann, 2010, p. 521)
(Ackard et al, 2012, p 175) , (Scholtz et al, 2010, p. 393) , (Slevec & Tiggemann, 2010, p. 521)
Rumination Disorder:
most commonly caused by developmental disorders and mental retardation. (Later correlation with depression, anxiety and obsessive-compulsive behavior)
(Scholtz, Hill, & Lacey, 2010, p. 396)
(Bryant-Waugh, Markham, Kreipe & Walsh, 2010)
Rumination Disorder:
increases in distress, decreases in interaction with others, and abnormal patterns during sleep
(Bryant-Waugh, Markham, Kreipe & Walsh, 2010)
Rumination Disorder:
possible structural or biochemical abnormalities and link with gastrointestinal disorder.
(Bryant-Waugh, Markham, Kreipe & Walsh, 2010).
Eating Disorders & Pregnancy
• Eating disorders can cause women’s menstrual cycle to become irregular
• Despite irregular cycles women can usually still conceive a child
• Slight correlation between women with a lifelong eating disorder and fertility problems
• Pregnant women with eating disorders need to be heavily monitored because having an eating disorder can strongly affect the mind, organ functioning, and the endocrine system.
• During the pre-natal period women with anorexia and bulimia are at a high risk for miscarriage and induced abortions
• Binge eating is associated with high risk for miscarriage

(Slevec & Tiggemann, 2010, pp. 519-520)

- LAO is defined as someone who has an eating disorder and they are over the age of 25
What are the main differences between LAO and TAO?
- less vomiting
- less self-harm
- less drug abuse
- response to age related triggers
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