AP Psychology 5.7-5.8: Eating and Personality Disorders

Eating disorder

A mental disorder involving abnormal eating behaviors that negatively affect physical health, mental health, or both. Behaviors may involve eating too much or too little, compensating for food intake, or having disturbed body-image beliefs.

Anorexia nervosa

A disorder involving restriction of energy intake that leads to significantly low body weight, intense fear of gaining weight, and disturbance in how body weight or shape is experienced or evaluated.

What distinguishes the two major anorexia nervosa subtypes?

In the restricting type, weight loss is achieved through dieting, fasting, and/or excessive exercise without recurrent binge-eating or purging. In the binge-eating/purging type, recurrent binge eating or compensatory behaviors also occur.

Why is amenorrhea no longer required for diagnosing anorexia nervosa in DSM-5?

Amenorrhea excludes people who do not menstruate because they are male, postmenopausal, or have another reason for absent periods. Therefore, DSM-5 removed it as a required criterion.

Bulimia nervosa

A disorder marked by recurrent binge-eating episodes followed by inappropriate compensatory behaviors such as self-induced vomiting, laxative or diuretic misuse, fasting, or excessive exercise. Body weight is often maintained at or above the minimally normal range.

How is bulimia nervosa severity commonly determined?

Severity is based primarily on the number of episodes of inappropriate compensatory behavior per week.

Binge-eating disorder

A disorder involving recurrent binge-eating episodes without the inappropriate compensatory behaviors typical of bulimia nervosa. The episodes cause marked distress and occur, on average, at least once per week for three months.

What behaviors or feelings can characterize a binge-eating episode?

Examples include eating unusually rapidly, eating until uncomfortably full, eating large amounts without physical hunger, eating alone due to embarrassment, and experiencing guilt, depression, disgust, or distress afterward.

How is binge-eating disorder severity determined?

Severity is determined by the number of binge-eating episodes per week.

What is the central psychopathology shared by many eating disorders?

It often centers on body-image disturbance, excessive concern with weight or shape, self-worth that depends heavily on appearance, fear of weight gain, denial of illness severity, and distorted perception of the body.

Why is overvaluation of weight or shape clinically important in anorexia nervosa and bulimia nervosa?

Overvalued beliefs about weight or shape are a key diagnostic feature of both disorders. General body dissatisfaction alone is not sufficient because it can occur without an eating disorder.

What is the pro-ana subculture?

It refers to online or social communities that promote or normalize anorexia-related behaviors. Such communities may share restrictive diet or exercise strategies and can reinforce illness rather than recovery.

What is attentional bias in eating disorders?

Attentional bias is preferential attention to certain environmental information while other information is ignored. In eating disorders, attention may be disproportionately captured by food, weight, body-size, or shape-related cues, reinforcing maladaptive thoughts and behaviors.

How can attentional bias interfere with eating-disorder recovery?

When food- or body-related cues receive excessive attention, they can trigger restrictive, bingeing, or compensatory behaviors and make it harder to focus on recovery-related information.

Which personality traits are associated with increased vulnerability to eating disorders?

Perfectionism, neuroticism, a fragile sense of self, and difficulties with mentalization have been associated with eating-disorder development. These traits may be intensified during adolescence by biological, social, and cultural pressures.

Are eating disorders caused by a single factor?

No. They arise from interacting biological, genetic, psychological, developmental, interpersonal, environmental, and sociocultural influences.

What evidence supports a genetic contribution to eating disorders?

Twin and family studies indicate inherited vulnerability, and first-degree relatives of someone with an eating disorder have substantially elevated risk. One cited estimate attributes about half of eating-disorder cases to genetic factors, although estimates vary.

How can epigenetics contribute to eating-disorder risk?

Environmental experiences can alter gene expression through mechanisms such as DNA methylation without changing the DNA sequence. These changes may be heritable, can occur throughout life, and may be reversible.

Which environmental and sociocultural influences can increase eating-disorder risk?

Cultural idealization of thinness, media pressure, bullying, social isolation, peer or parental influence, trauma, and sexual abuse may contribute. Participation in activities emphasizing body size or leanness, such as dance or gymnastics, is also associated with increased risk.

How can food insecurity relate to eating disorders?

Limited or unreliable access to food can contribute to disordered eating patterns and complicate diagnosis and treatment. ARFID, however, is not diagnosed when inadequate intake is better explained simply by lack of available food.

What medical conditions may be associated with disordered eating?

Gastrointestinal disorders, including celiac disease and other illnesses affecting digestion or swallowing, may increase risk or mimic eating-disorder symptoms. Medical causes must therefore be considered during diagnosis.

Which psychiatric conditions commonly co-occur with eating disorders?

Anxiety disorders, depression, obsessive-compulsive disorder, substance-use disorders, attention-deficit/hyperactivity disorder, and some personality disorders commonly co-occur.

What is the relationship between obesity and eating disorders?

Obesity itself is not classified as an eating disorder in the cited diagnostic framework. However, binge-eating disorder and other eating disorders can occur in people across a wide range of body weights.

What serious cardiovascular and metabolic complications can result from eating disorders?

Complications include electrolyte abnormalities such as hypokalemia or hyponatremia, arrhythmias, low blood pressure, heart failure, cardiac arrest, and increased risk of death.

How can recurrent self-induced vomiting damage the body?

It can expose the esophagus, throat, and teeth to gastric acid, contributing to acid reflux, hoarseness, tooth erosion, cavities, and tooth loss. It can also promote dangerous fluid and electrolyte disturbances.

What are important long-term physical consequences of severe eating disorders?

Possible consequences include osteoporosis, kidney failure, organ failure, brain atrophy or damage, infertility, growth failure, amenorrhea, severe dehydration, gastrointestinal problems, and stroke.

Which physical symptoms may suggest an eating disorder?

Weakness, fatigue, cold sensitivity, weight loss, impaired growth, reduced libido, and endocrine or reproductive changes may occur. Vomiting-related hoarseness, swollen parotid glands, dry lips, and dental damage are also possible.

What are the main components of eating-disorder treatment?

Treatment may include psychotherapy or counseling, nutritional rehabilitation and dietary guidance, reducing excessive exercise, stopping purging or other compensatory behaviors, and medication for selected symptoms or conditions. Severe medical instability may require hospitalization.

Why can hospitalization be necessary for an eating disorder?

Hospitalization may be required when malnutrition, dehydration, electrolyte imbalance, cardiovascular instability, organ complications, or other risks cannot be safely managed in outpatient care.

What are approximate five-year recovery figures cited for anorexia nervosa and bulimia nervosa?

Approximately 70% of people with anorexia nervosa and 50% of people with bulimia nervosa were reported to recover within five years, although outcomes vary and recovery is not always linear.

What is known about recovery from binge-eating disorder?

Recovery estimates are less certain and have been reported in a broad range of roughly 20% to 60%, reflecting differences in definitions, follow-up, and study methods.

How common is eating-disorder treatment among affected people?

The cited material reports that only about 10% of people with eating disorders receive treatment, and many treated individuals do not receive adequate or appropriately long care.

Which eating disorders are associated with increased mortality risk?

Both anorexia nervosa and bulimia nervosa increase the risk of death. Causes may include medical complications, severe physiological disruption, and suicide.

What demographic patterns are reported for eating disorders?

Onset commonly occurs from late childhood through early adulthood. Anorexia nervosa and bulimia nervosa are reported much more often in females than males, although eating disorders can affect people of any sex, age, culture, or body size.

What approximate annual prevalence figures are cited for young women in developed countries?

The cited estimates are about 0.4% for anorexia nervosa and 1.3% for bulimia nervosa. Estimates vary substantially depending on diagnostic criteria and methods.

What approximate annual prevalence is cited for binge-eating disorder?

The cited estimates are about 1.6% of women and 0.8% of men in a given year in the referenced populations.

How should prevalence comparisons among cultures and countries be interpreted?

Reported prevalence varies with age, sex, culture, diagnostic criteria, and measurement methods. Lower reported rates in less developed countries may reflect true differences, underdiagnosis, limited access to care, or differences in detection.

What is a personality disorder?

A personality disorder is an enduring, inflexible pattern of thinking, feeling, and behaving that deviates from cultural expectations, begins by adolescence or early adulthood, and causes significant distress or impairment.

What are the three clusters of personality disorders?

Cluster A disorders are odd or eccentric; Cluster B disorders are dramatic, emotional, or erratic; and Cluster C disorders are anxious or fearful.

Which personality disorders are in Cluster A?

Cluster A includes paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder. These disorders are characterized broadly by odd or eccentric patterns.

What characterizes paranoid personality disorder?

A pervasive distrust and suspiciousness of others, leading the person to interpret others' motives as malevolent even without adequate evidence.

What characterizes schizoid personality disorder?

A pervasive pattern of detachment from social relationships and limited emotional expression. The person often prefers solitude and appears indifferent to praise, criticism, or close relationships.

What characterizes schizotypal personality disorder?

A pattern involving social and interpersonal deficits, discomfort with close relationships, eccentric behavior, unusual perceptual experiences, and odd beliefs or magical thinking.

Which personality disorders are in Cluster B?

Cluster B includes antisocial, borderline, histrionic, and narcissistic personality disorders. These disorders are characterized broadly by dramatic, emotional, or erratic behavior.

What characterizes antisocial personality disorder?

A pervasive disregard for and violation of the rights of others, including deceitfulness, impulsivity, aggression, irresponsibility, and lack of remorse. The person must be at least 18 and have evidence of conduct-disorder symptoms before age 15.

What characterizes borderline personality disorder?

A pattern of instability in relationships, self-image, emotions, and behavior, often involving fear of abandonment, impulsivity, intense mood shifts, recurrent self-harm or suicidal behavior, and chronic feelings of emptiness.

What characterizes histrionic personality disorder?

A pervasive pattern of excessive emotionality and attention seeking, including discomfort when not the center of attention, rapidly shifting or shallow emotions, and behavior that may appear dramatic or theatrical.

What characterizes narcissistic personality disorder?

A pattern of grandiosity, need for admiration, and lack of empathy. The person may have an exaggerated sense of importance, entitlement, and sensitivity to criticism.

Which personality disorders are in Cluster C?

Cluster C includes avoidant, dependent, and obsessive-compulsive personality disorders. These disorders are characterized broadly by anxious or fearful behavior.

What characterizes avoidant personality disorder?

A pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. The person often avoids social or occupational activities because of fear of criticism, rejection, or embarrassment.

What characterizes dependent personality disorder?

A pervasive and excessive need to be cared for, leading to submissive and clinging behavior, difficulty making independent decisions, and intense fears of separation or abandonment.

What characterizes obsessive-compulsive personality disorder?

A pattern of preoccupation with orderliness, perfectionism, and control at the expense of flexibility and openness. It differs from OCD because it primarily involves enduring personality traits rather than unwanted intrusive obsessions and compulsive rituals.