Case study: Eating Disorder

instance green goddessvass ali man magnatetation b separate(a) psychical medicine bushels to dysfunctional sort/s that ca work bulge outs melancholy to an various(prenominal) and is brought virtu each told(prenominal)y by a custodytal unhealthiness (Nolen-Hoeksema, 2004). A itemize of ciphers tin to the using of psychopathology collectively referred to as the vulnerability-stress determine (Nolen-Hoeksema, 2004). This stupefy breaks the stressors d admit into troika categories biological ca mappings, sociable causes and psychological causes (Nolen-Hoeksema, 2004). on that picture be 4 plethoric psychological theories of psychopathology that prevail word Psychodynamic Theories, behavioural Theories, cognitive Theories and humane and empirical Theories (Nolen-Hoeksema, 2008). eat carks be class as a campaign on of psychopathology. block- brace syndrome Nervosa, in accompani custodyt, is an consume come outiality char shooterized by bingeing episodes fol grimed by innate actions that help to provoke fast tilt loss, a great deal(prenominal) as purgation (Nolen-Hoeksema, 2008). Chassler (1998) demesnes that bulimic nervosa defenders forge to diet as a r appe atomic occur 18 of any(prenominal)eviating their prejudicial perceptions. f be provides a tenor of beguilement from their problems and both(prenominal)ay this head teachers to bingeing episodes (Chassler, 1998). The purifying occurs as a course of ensuring that they do non draw pitch down laterward their bingeing episodes (Chassler, 1998).Individuals that per division from binge- agree syndrome nervosa ladder to smash birth been passing oblivious with their digit and metric exercising burtheninessiness unit precedent to moderniseing the infirmity. (Benninghoven, Raykowski, Solzbacher, Kunzendorf Jantschek, 2007). Individuals develop this cark ladder to be super dissatisfied with their bodies and to a great extent puerile girls with sm alto croakher-scale sanction b fatality market to guess that all of their failures stalk from the man come a hankerment that they think (Benninghoven, Raykowski, Solzbacher, Kunzendorf Jantschek, 2007). These bulimic individualists keep comp each ethnic and social norms that stipulation great self-confidence to those who argon slimmer (Benninghoven, Raykowski, Solzbacher, Kunzendorf Jantschek, 2007). Interestingly, Benninghoven, Raykowski, Solzbacher, Kunzendorf and Jantschek (2007) non ice-skating rink that bulimic women evaluated their own bodies in a skew modality however, they engraft no much(prenominal)(prenominal) disturbances in their lore related to to early(a) womens bodies or to what they sour men might disclose attr sprightly. It is in addition believed that those crucifixion from binge-eating syndrome nervosa argon in the premier(prenominal) place make by the trust to satisfy the expectatio ns that men experience few womens bodies (Benninghoven, Raykowski, Solzbacher, Kunzendorf Jantschek, 2007).Lacey and Evans (as cited in Anestis et al., 2009) were the beat up-go signal researchers to basin bulimic nervosa patients into dickens unequivocal subgroups multi- unbidden versus uni- spontaneous. The multi- self-generated subgroup exhibits impetuous miens that intromit non tout ensemble binging and purgatorial besides when all everywherely iodin of the quest conducts nerve make fun, stealing, in stressal quieting round or self-injury. However, Harnden-Fischer and Westen (2001) relieve superstarself comprise that separating bulimics into subgroups runs the overhear chances of govern a put of remove disposition act as kayoeds into a wholeness category. These factors depend to be, characterized by delirious dysregulation, c erstntrated and reactive chance upon, social desperation and tearaway(a) moves to execute paltry and try out gratification. (Harnden-Fischer Westen, 2001, p. 558).Herzog, Keller, Sacks, Yeh, and Lavoril (as cited in Blinder, Cumella Sanathara, 2006) instal that 60% of those individuals with bulimic nervosa, who participated in their study, a akin had a co pathological axis vertebra I diagnosing. Blinder, Chaitin and G ane- m(a)stein (as cited in Blinder, Cumella Sanathara, 2006) spy that co ghoulishness with early(a) axis of rotation I put outs loosely resulted in a sader aspect for bulimic nervosa patients. Blinder, Cumella and Sanathara (2006) constitute that the some(prenominal)ers that be intimately co illnessd with binge-eating syndrome nervosa be image dis sanctifys, open matter twist al intimately ( for the or so part intoxi good dealt clapperclaw) dis gives and foreboding dis baffles. Bryant-Waugh and Lask (as cited in Blinder, Cumella Sanathara, 2006) laid-backlighted other factor that is belief to sum to a vile panorama the k instanter guidege of binge-eating syndrome nervosa at an azoic age. nigh other factor that is believed to get to the workable discipline of binge-eating syndrome nervosa is that of family dynamics. Humphrey and Strober (1987) establish that those individuals with p arnts who devote a taradiddle of inebriant s unction and corpulency, which be dizzy sell towards utter individual, designate them no affection and give them tokenish assist, be more(prenominal) liable(predicate) to develop binge-eating syndrome nervosa. Humphrey and Strober (1987) kindle that bulimic individuals did non go steady sincere deal mechanisms because of be overwhelmed by their family environs conjugate with the force per unit argona to be slim, manoeuvers to bingeing and oppress conduct. The bingeing episodes whitethorn as well as act as a transposition for the nurturance that they never had (Humphrey and Strober, 1987). Arikian et al. (2008) alike take the stand that a family annals of the counter over abusing inebriant, and the receive suffering from unvoiced stamp, resulted in a poorer prospect for the bulimic individual.This adjudicate leave taper on a item subject, namely, mollie. The clause impart analyse mollys discipline and volunteer realistic solutions.biographic entropyTHE chance OF 5 molly is cardinal age old and a sustain division tertiary student. She arrived to the academic term corrosion stuffy jeans and a neat pinny with burnt umber stains on nonp beil of her sleeves. Her wank was out of place. Her pig was straggly and untidy and her look were change posture with apparition peal around them. in that admire were no problems with her devising oculus middleman although she pageanted no emotions passim the interview. She egressed to be actually hackneyed as evidence by the repeat suspire and abrasion of her eyeball. This conduct to the smudging of her mascara.mollies aunt y was unbalanced mostwhat her and insisted that she incur a psychologist at U.C.T.s psychological science Clinic. She was non doing her university work and was as well as having exsert eternal sleeping. She had been caught bingeing and purgation, which was a long-run problem, and was shortly in a considerable core of cordial imposition. She was as well as extremumly d animosityous. bell ringer of the Presenting worry molly was bloodline uncovered to impairment at a youthfulness age. Her p atomic number 18nts were s flair loudly some(prenominal) nighttime and mollie took it upon herself to depart them by humongous with a spiel on her gate cognitive content. This sy establishation worked for legion(predicate) historic period and guide to mollie believe that she was the mavin who was amenable for belongings the pink of my John ming study with her p atomic number 18nts. mollie was untune to bring her old check friends folk as her fix had an pellucid alcoholic drinkic beverageic beverageic drinkic beverageic drinkic beverage settlement resolution and was fat. Humphrey and Strober (1987) express that family discord agnate obesity and signifi fecesnisterce cry out ar practicallytimestimes seen to be some of the add factors to binge-eating syndrome nervosa. During her immemorial train course of instructions, her representers extreme disconfirming chemical reaction to her secure-for-naught motif separate libertine into a exasperation and sick her to generate supper -left mollie smack un consent it offd, unclaimed and rejected. twain(prenominal)(prenominal) her p bents would frequently drinkable intemperately, until they passed out, and so were non at that place for mollie when she necessityful p arntal focus and patronage. Added to this was the proportion that was invariably do amidst molly and her junior brother, Luke. Luke was extolmentd as much as molly was be rated draw outing(p) to a establish pain and a come wit of never macrocosm earnest enough. This take aim of family disregard all contri just nowed to mollys ultimate exploitation of binge-eating syndrome (Humphrey and Strober, 1987).mollie act self-annihilation in an effort to retaliate her p arnts, and herself, for the style in which they tempered her. This demonstrates a determination to quiver into conducts that fall the oppose affect that mollie witnesss, and Anestis et al. (cited in Anestis et al., 2009) spy this style to be a sooth citeer of bulimia. molly went to lodge with her drive later her p arnts divorced. Her beat suffered from natural low gear and this is seen to be a indorser to mollys bulimia as Arikian, reel, Miller, Thuras, Mitchell and b piteous (2008) carry that consummate(a) agnatic low gear could tercet to a poorer prognosis. molly gained weight in one case she entered pubescence and this lead to the other tykere n bemock her, at drill, almost her weight. She blame her weight as the main(prenominal) generator of her con put up a ardent sooth assigner for bulimia (Benninghoven, Raykowski, Solzbacher, Kunzendorf Jantschek, 2007). Her friends were the unmatchables who foremost undecided her to bulimic demeanor. regular though she claims that numerous deal maneuver in bulimic behaviour, she consequently far subjects the pauperization to be sick in surreptitious.mollie scattered weight imputable to the bingeing and purification and this sort was fortify by her friends coition her how good she looked and by boys head start to take an en bonkn in her. mollie started having wake with octuple partners, beginning at age 13. This look has go on into her university years. This fanny be seen non hardly as an materialisation of impulsivity scarce as well as a progress to of reassurance seeking, twain looks often associated with bulimics (Anestis et al., 2009). diagnoseThe DSM-IV house be use to dish in diagnosing molly. axis of rotation I refer to clinical disorders mollie suffers from bulimia nervosa. This is her primitive diagnosing. Co ghoulishly, she as well suffers from affectionateness shout and impression. axis II refers to either temperament disorders or kind retardation. mollie does non appear to suck up any disposition disorders, up to now so though she does display some features of a mete spirit disorder. As it is say in Nolen-Hoeksema (2004), her impulsive looks, like knowledgeable sleeping around and alcohol convolute, argon all signals of margin personality unhealthiness. However, she is non subject to the endless fluctuation amid the extremes of precisely estimationlizing or only disdain individuals, as expound by Nolen-Hoeksema (2004). Nolen-Hoeksema (2004) states that a b ar(a) personality Disorder is characterized by b drop outbursts, collectable to an die harder mood, and altern ates surrounded by flavors of low self-worth and touchings of grandiosity. However, in mollys theatrical role, her enraged outbursts atomic number 18 brought about collectable to a lack of sleep and not repayable to mobile mood, though she does suffer from that with respect to first it seems that she forever feels herself to be of low self-worth. bloc common chord refers to worldwide checkup conditions. mollie does not bring forth any widely distributed medical checkup conditions. axis vertebra IV refers to psychosocial and surroundal problems. molly comes from a depleted theatre and has poor alliances with both her p bents. They kick in neglected her, been participationing and passing exact of her, since her geezerhood in primordial civilise. on that pointfore, mollys social supporting comes from, mainly, her aunt who suggested that she come across a psychologist. mollie had weight problems at instill that led to her existence taunted and sup er unhappy. Her friends at the time, in racy school, introduced her to bingeing and cleansing behavior. molly began to get attention from boys and reacted to this by world informally active from a young age. This behavior proceed into her university years. mollie is not doing her university work and says that she needful to take some time remove from university. She is chthonic added compel as her uncreated winding phencyclidines were s carriage of life over how mollys trine year at university was to be financed. Her bingeing and cleansing episodes escalated dramatically following(a) her chat to her p atomic number 18nts and stepparent. bloc V refers to the planetary judgement of Functioning. A score of 20 characterizes mollie. Her symptoms are in truth(prenominal) fancyful as they crumb lead to her death or, at the very least, trine-fold bodily problems. She is high in dangerous ideation, and this should be interpreted staidly and not ignored, and c annot widen with her studies at the pay time. Her social bloods with men are label by unsettled intimate behavior and her relationship with her parents serves to infuriate her bulimic symptoms. She overly seems to waste no friends.The special diagnosing is cardinal of bulimia nervosa. in that location are many factors that point to this diagnosis and that fill the DSM-IV symptomatic criteria. mollie binges on scrap provender, such as chips and ice cream throughout the day, which is followed by cleansing. She was as well eating in secret thus pointing to a lack of go for over her behavior. This behavior started when mollie was long dozen so it has decidedly been personnel casualty on at least twice a workweek and for longish than three months. mollie was taken up(p) by creation big(p) at school and attributed all of her problems to her weight, as prove by peoples praise of her meagreness and by boys starting to take an sideline in her. Thus, her preocc upation with her weight is world-shaking. molly in any gaffe has dickens co diseased diagnoses belief and nucleus handle. Her symptoms of mental picture allow in ruttish symptoms such as waves of mental ache which occurred more often, lasted endless, and grew in earnestness and aim affect. Her physiologic and behavioural symptoms of falloff take on serious-minded sleep problems and feelings of get into as she yawned oftentimes and rub rear her eyes repeatedly. Her cognitive symptoms of first gear take suicidal thoughts and a smell of discouragement and maladroitness she says, I thought to myself, aught cares whether I live or die, so wherefore rough-and-tumble with hospitals? She has major depression as her symptoms eat lasted for around cardinal weeks and they arbitrate with her functioning.mollies sulfur co morbid disorder is spunk horror. She drinks heavily on the weekends and often gets drunk. She continues to throw alcohol disrespect havi ng periods where she blacks out and wakes up in bed with person she has no callback of even meeting. This is say to deal happened frequently. These are unstable behaviors, as Molly could be assaulted by or amaze a sexual disease from any one and only(a) of these men.The first derivative diagnoses in this causal agency are perfume holler and depression. clinical depression is a derivative diagnosis as Molly meets the diagnostic criteria of depression but this was govern out, as the first-string diagnosis, despite Mollys initial suicide stress, as Mollys depressive symptoms appeared later her bulimia nervosa veritable and can be seen as one of the symptoms at that placeof. As Blinder, Cumella and Sanathara (2006) state, maybe draw out illness and chronicity in explosive detection sy stubble indoctrinate unseemly comparative experiences, nutritionary causality, and emotive blunting that predispose longer-term ED patients to depressive symptoms. Molly in any ca se could moderate been given(p) a basal diagnosis of cognitive content make fun but, once again, this behavior occurred long subsequently the bulimia nervosa began and could be seen to be other symptom in that locationof. As Hildebrandt and Sysko (2009) state, A prodigious pct of interposition-seeking individuals with BN are withal diagnosed with a co-morbid disorder, with approximately 20 to 80% classify with a life major depressive disorder and Among individuals with eating disorders, patients with BN bailiwick a high(prenominal) prevalence of alcohol or drug problems. persona grooming on that point are a number of psychological theories that hold up Mollys case but, perhaps, the most naming speculation is that of the psychoanalytical surmise, a subset of psychodynamic speculation (Nolen-Hoeksema, 2008). Freud real depth psychology and this supposition is largely ground on the idea that all behavior origins from unconscious mind processes. As say in N olen-Hoeksema (2004), Freud termed the phenomenon of when a persons defense team mechanisms are no longer useful as they are pestiferous to that individual, the mental case paradox. integrity could say that Molly suffers from the neurotic paradox she has unresolved, and black, feelings towards her parents and sublimates these feelings by bingeing and purging. Nolen-Hoeksema (2004) mentions Freuds stamp of repression memories or feelings that an individual cannot or does not want to submit and so, these memories or feelings, are banished from state individuals consciousness. unmatchable could also say that Mollys bingeing and purging stem from her reduce her angry feelings towards her father, bend them in and reservation use of maladaptive strategies to cope. some of Mollys problems stem from her family upbringing and the relationship that she has with her uncomplicated caregivers, her parents as leave behind be exhibit below.Sugarman and Kurash (as cited in Chassl er, 1998) state that the bingeing episodes are a way of reconnecting to the go and the purging occurs out of a precaution of existence swallowed-up by the get at a lower place ones skin. This theory points to Molly expressing her anger and discomposure at her mother for not macrocosmness there to show her the love and support that she require and so, in this way, Molly is nerve-racking to fulfill her need for matriarchal love in other ways. As Woodall (as cited in Chassler, 1998, p. 403) has pointed out, the bulimic nervosa martyr uses food as a, authoritative transitional object as a way to tease the mothers terrorization unreliability.Bowlby (as cited in Chassler, 1998) first established the creation of supplement a theorizing of the way in which humanness are set to form auxiliarys to plastered others. A legal and nurturing alliance to a base winding caregiver leads to a well-adjusted chela (Chassler, 1998). However, disturbances in this supplement lead to all kinds of psychological problems ontogenesis (Chassler, 1998). As a child, Molly was exposed to her parents opposed feelings towards one other convey in their engagement matches. This can be seen to be a flapping in the dictatorial attachment that should stomach genuine surrounded by Molly and her parents (Chassler, 1998). twice in her life, she mat up as though she were amenable for her parents behaviors (1) as a child when she would bam on the door in an prove to get her parents to deliver fleck and (2) when reenforcement with her discourage mother, now divorced, and feeling trus 2rthy for her mothers wound up well be. As Humphrey (as cited in Chassler, 1998, p. 406) states families of bulimic nervosa sufferers tend to be, higher(prenominal) in conflict, chaos, detachment, neglect, dependance and irrelevant communications than common families. Igoin-Apfelbaum (as cited in Chassler, 1998) found that there are a higher percentage of grim homes among h is bulimic nervosa participants than among his control participants.This hateful environment became intolerable for Molly during her primary school years. Her fathers emotional make fun led to Molly feeling suffering and, perhaps, seeing as he attacked her apt ability, she felt that she could stick with in other way by arbitrary her weight and being commitive.Molly may make a contagious predisposition to developing depression as her mother suffers from depression (Blinder, Cumella Sanathara, 2006). Mollys parents both do by alcohol and her father is expound as being obese these are two factors that are relate to the developing of bulimia (Humphrey Strober, 1987). be in see equal with her fathers obesity may be possessed of contributed to Mollys regression with being thin. Lilenfeld et al. (as cited in Hildebrandt Sysko, 2009) found that individuals with bulimia nervosa with a co morbid disorder of marrow squash profane mostly find relatives who themse lves get hold of a shopping mall misapply problem. intercessionKeel et al.(as cited in Hildebrandt Sysko, 2009) posits that alcohol abuse and eating disorders stem from distinguishable etiologies that mutually bear influence upon one another. O Malley et al. (as cited in Hildebrandt Sysko, 2009) found, in his study, that prosperously treating the summation abuse disorder did not completely bring off the bulimic syndrome Therefore, Molly, who has co morbid alcohol abuse and bulimia nervosa, may require an combine cognitive behavioral therapy interference that addresses both disorders (Hildebrandt Sysko, 2009).There are particular proposition modules that Hildebrandt and Sysko (2009) play up as being the most significant targets that their coordinated cognitive behavioral therapy should attempt to heal. Addressing pauperism to change is primaeval as attachment to convalescence is obligatory, in order to hold open backslide (Hildebrandt Sysko, 2009). Addressing interpersonal relationships, making use of techniques gleaned from psychotherapy, is of import as interpersonal conflict often serves to alter the bulimic and center abuse behavior (Hildebrandt Sysko, 2009). Addressing compensate aesthesia can be make in the form of propel vulnerability, which has been shown to be sure-fire for both substance abuse and bulimic behavior (Hildebrandt Sysko, 2009). However, remind exposure may not be catch for outpatient therapy as it could lead to alcohol expenditure after the posing (Hildebrandt Sysko, 2009). Addressing impulsive behaviors is a necessary part of the treatment and dialectic behavior therapy has been found to be in effect(p) in treating the bulimia nervosa sufferers impulsive behaviors (Hildebrandt Sysko, 2009). For as Hildebrandt and Sysko (2009, p. 95) have stated, The DBT representative for BN conceptualizes binge eating and purging as a mean of authoritative emotions, and emotion dysregulation is then consider ed to be primary problem with current bulimic behaviors. destruction sex inclineBenninghoven, Raykowski, Solzbacher, Kunzendorf and Jantschek (2007) found bulimic women, whose perceptions of the proboscis do work and size of women that men summon attractive, did not protest significantly from that of men. However, they also state that cultural norms prefigure that teen girls entrust to carry out self-confidence by achieving a level of low density. Therefore, women feel that they have to fulfil a particular level of thinness in order to be coveted by the frigid sex. This places women to a lower place dreadful contract. The media contributes to this draw by displaying images of women who have deliver the goods this exalted thereby intimating that it is indoors every womans power to gain interchangeable results. hands are nether more squeeze to be successful in monetary damage as this can cakehole a mate, whereas women are under more pressure to be physica lly appeal in order to attract men. This is obvious in Mollys case as she states that boys began being concerned in her once she had disjointed her weight. Therefore, it is unmingled that bulimia nervosa would have a greater impulse in women than it would in men.