Lecture 6: Eating

and Sleeping

https://emotiondashboard.web.app/

Comment: how would you describe the

RCT? What did it ask you to do? What did
you get out of it (if anything)?

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 RCT Debrief
• By now you should have finished your
‘post-surveys’
• The RCT assignment is now available on
Quercus, due by start of class next
week!

3
 RCT Debrief
• RCT: Randomized Control Trial

• How many conditions?

• What were the conditions?

4
 RCT Debrief
• The thing(s) we measure in a study are
called the dependent variable(s)

• What were the dependent variable(s) in

this RCT?

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 RCT Debrief
• The thing(s) we manipulate or control in
a study are called the independent
variable(s)

• What was the independent variable in

this RCT?

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 RCT Debrief
• New updates to the in-class web app-
let’s try a poll:
https://emotiondashboard.web.app/

7
 RCT Debrief
• What do you expect we will find,
especially linking the independent and
dependent variables?

• What did you like / dislike the most

about it?

8
Chapter 9
Eating

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World Obesity Rates

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What is Considered Obese?

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Overview of Eating
Disorders

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 Overview of Eating Disorders
• Bulimia nervosa
– Binging (out-of-control) eating episodes
followed by self-induced vomiting
• Anorexia nervosa
– Person eats minimal amounts or exercises
vigorously
• Binge-eating disorder

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 Overview of Eating Disorders
• An increase in the cases
of eating disorders over
last few decades
– Increase is culturally
specific; going global
– Young females in a socially
competitive environment

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 Overview of Eating Disorders
Bulimia Nervosa
Clinical Description
• Large amounts of food consumed
• Eating out of control
• Several purging techniques to compensate
– Self-induced vomiting
– Using laxatives and diuretics
– Excessive exercising
– Fasting

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 Overview of Eating Disorders
Bulimia Nervosa
Medical Consequences
• Enlargement of salivary glands
• Erosion of dental enamel
• Electrolyte imbalance
• Disrupted heartbeat, kidney failure
• Intestinal problems
• Marked calluses on fingers or back of hand

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 Overview of Eating Disorders
Bulimia Nervosa
Associated Psychological Disorders
• Anxiety and mood disorders, GAD
• Depression, borderline personality
disorder
• Impulsivity (compulsive shoplifting)

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 Overview of Eating Disorders
Anorexia Nervosa
Clinical Description
• Fear of obesity: severe caloric
restriction
• Two subtypes:
– Restricting type
– Binge eating/purging type

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 Overview of Eating Disorders
Anorexia Nervosa
Clinical Description
• About half of anorexics engage in binge eating and
purging
• Comorbidity with anxiety disorders
• Body mass index (BMI) close to 16 when treatment is
sought
• Disturbance in body image

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 Overview of Eating Disorders
Anorexia Nervosa
Medical Consequences
• Cessation of menstruation (amenorrhea)
• Dry skin, brittle hair or nails, and sensitivity to or
intolerance of cold temperatures
• Lanugo, downy hair on the limbs and cheeks
• Cardiovascular problems
• Electrolyte imbalance

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 Overview of Eating Disorders
Anorexia Nervosa - Comorbidity
• Anxiety disorder
• Mood disorders
• OCD
• Substance abuse
• Suicide

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 Overview of Eating Disorders
Binge-Eating Disorder
• Associated with obesity
• Males; later age of onset
• 20% of individuals in weight-loss programs engage in
binge eating
• 50% of those in stomach surgery (bariatric surgery)
• Many cross over to bulimia
• Binge to alleviate bad moods

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 Overview of Eating Disorders
Statistics
• 90%–95% of bulimics are women
• The rest male: predominantly minority sexual
orientation
• Age of onset: 16–19 years; girls at most risk
• Urban areas
• Becomes chronic if left untreated

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 Overview of Eating Disorders
Statistics
Cross-Cultural Considerations
• Immigrants who recently moved to Western
countries
• Higher social class
• Acculturating to the Western majority
• Eastern cultures deny having eating disorders

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 Overview of Eating Disorders
Statistics
Developmental Considerations
• Girls have concerns of gain
weight gain at puberty
• Found in children and older
adults too
• Concerns about body image
• ARFID
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Causes of Eating Disorders

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 Social Dimensions of Eating
Disorders
• Magazines, beauty
pageants glorify
“slenderness”
• Collision between
culture and physiology
• Increase in exercise
programs
• Dieting produces
stress-related
withdrawal symptoms
in brain
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 Male/Female Differences
• On average,
males and
females
view body
weight
differently
• But in the
end it
depends on
the person
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 Dieting

• Are you dieting (trying to change your

weight through diet) right now?
https://emotiondashboard.web.app/
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 Prevalence of Weight-Related
Problems and Concerns
Are you dieting?
• Eating disorders and eating-
related concerns are much more
common among women and
girls than men and boys.
• In a survey conducted by the
World Health Organization,
almost 75% of Grade 10 girls
indicated they were on a diet or
needed to lose weight.
• A Canadian study found that
almost one in four adolescent
females is actively dieting to lose
weight (Jones et al., 2001).

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Dieting Prevalence

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 Why diet?
• Health concerns
– Obesity is related to the development of
type II diabetes, high blood pressure, heart
disease, stroke, and some forms of cancer
(Arslanian, 2002, Serdula et al., 1993).

• Attractiveness
– Western culture values thin ideal
– Belief that being thin will increase self-
worth
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 Dieting Consequences
• Failure and cycling
– Dieting is hard and often ends in failure (Wing
& Phelan, 2005).

• Eating regulation issues

– Chronic dieters forget how to use hunger as
a cue for eating.

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 Historical Perspective
• Eating disorders such as bulimia and anorexia have
been described for hundreds of years.
• In the 1960s and 1970s, Western societies became
more enamored with thin physiques for women.
• Increase in prevalence of eating disorders
• Not always so:

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36
 Causes of Eating Disorders
Social Dimensions
• Dieting produces stress-related withdrawal
symptoms in brain
– Result in more eating than without dieting
• Fighting biology
• Pressure from family
– Anorexia leads to deteriorating relationships with family
• Chronic dieting leads to preoccupation with food
– Athletes, dancers, models

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 Causes of Eating Disorders
Biological Dimensions
• Biological and genetic vulnerabilities
• Heritability is estimated at 0.56
• Low levels of serotonergic activity
• High levels of postovulatory hormones lead to
impulsive eating

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 Causes of Eating Disorders
Psychological Dimensions
• Young women with eating disorders have
– Diminished sense of personal control
– Lack of confidence in their own abilities and
talents
– Perfectionist attitudes
– Low self-esteem
– Intense negative emotional reactions
– Distorted body image
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41
 Treatment of
Eating Disorders

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 Treatment of Eating Disorders
Drug Treatments
• Antidepressants, Prozac
Psychosocial Treatments
• Short-term CBT
• CBT-E (cognitive-behavioural therapy-
enhanced)

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 Treatment of Eating Disorders
Psychosocial Treatments
Bulimia Nervosa
• CBT-E: alter dysfunctional thoughts, attitudes about
body shape, weight, eating
• IPT: improve interpersonal functioning
• CBT: change eating habits and attitudes about food
• Behaviour therapy: change eating habits
• Family therapy

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 Treatment of Eating Disorders
Psychosocial Treatments
Binge-Eating Disorder
• CBT
• Weight-loss programs
• Self-help procedures
• Treatment to be directed toward bingeing

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 Treatment of Eating Disorders
Psychosocial Treatments
Anorexia Nervosa
• Hospitalization for weight gain
• Fear of relapse
• CBT-E
• Outpatient CBT: nutritional counselling
• Motivational enhancement techniques
• Family therapy

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 Treatment of Eating Disorders
Preventing Eating Disorders
• Eliminating exaggerated focus on body shape, weight
• Educating about food and eating habits
• Promoting a healthy body image
• Countering the effects of the media portrayals of
desirability of being thin

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https://emotiondashboard.web.app/

Comment: are you sleeping

enough? How would you describe
your sleep quality these days?

48
Chapter 10
Sleeping

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50
 Sleeping
• About one-third of our lives spent sleeping
• Many do not meet the recommended hours
• Sleep energizes mentally and physically
• Poor sleep leads to social, psychological, and
health problems
• See Figure 10.1

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Sleeping

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 An Overview of Sleep-Wake
Disorders
• Two broad states of sleep:
– Slow-wave (deep) sleep
– Rapid eye movement (REM), brain is active
• Four stages of sleep: stages 1–4
• Sleep follows 90-minute cycles
• Normal sleepers spend 20% in deep
sleep, 30% dreaming, 50% light sleep
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 An Overview of Sleep-Wake
Disorders
• Sleep problems contribute to psychological
disorders
• Limbic system involved with anxiety and sleep
– Mutual neurobiological connection suggests
anxiety and sleep may be interrelated
– Poor sleep can raise cortisol
– Sleep deprivation has temporary antidepressant
effects

55
 An Overview of Sleep-Wake
Disorders
• Sleep-wake disorders categorized into:
– Dyssomnias: difficulty getting enough sleep
– Parasomnias: abnormal events that occur during
sleep
• Polysomnographic (PSG) evaluation includes
EEG, EOG, EMG, ECG
• Sleep efficiency: percentage of time actually
spent sleeping

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 An Overview of Sleep-Wake
Disorders
Insomnia Disorder
– Microsleeps of several seconds or longer
– Fatal familial insomnia (rare)
– Insomnia “not sleeping”
– Difficulty falling asleep or maintaining sleep

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 An Overview of Sleep-Wake
Disorders
Insomnia Disorder
Clinical Description
• Insomnia disorder (primary insomnia)
– Trouble initiating or maintaining sleep
– Inability to concentrate on daily activities
– Fear of falling asleep doing activities requiring
concentration

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 An Overview of Sleep-Wake
Disorders
Insomnia Disorder
Statistics
• Approximately one-fourth of population
– 15% of older adults report daytime sleepiness
– Associated with other disorders (depression,
anxiety disorders, dementia)
– Women twice as likely: hormonal differences?

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 An Overview of Sleep-Wake
Disorders
Insomnia Disorder
Causes
• Pain, physical discomfort, physical inactivity,
problems with biological clock, light exposure
• Drug use, noise, temperature rhythm
• Psychological stresses, cognitions (thoughts)
• Cultural factors: co-sleeping
• Biological vulnerability (being a light sleeper)

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 An Overview of Sleep-Wake
Disorders
Insomnia Disorder
An Integrative Model
• Biological vulnerability interacts
with sleep stress
• Extrinsic influences (poor sleep
habits, daily activities, jet lag)
• Rebound insomnia
• Daytime naps disrupt night sleep;
anxiety

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 An Overview of Sleep-Wake
Disorders
Hypersomnolence Disorders
• Disorders involve sleeping too much
– Less successful academically, complain of
tiredness; personally upsetting
• Sleep apnea: difficulty breathing at night
• Genetic factors, viral infections could be
causes

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 An Overview of Sleep-Wake
Disorders
Narcolepsy
• Daytime sleepiness: 0.03%–0.16% population
• Cataplexy: sudden loss of muscle tone
• Caused by sudden onset of REM sleep
– Sleep paralysis
– Hypnagogic hallucinations
• Genetic, recessive trait; cluster of genes on
chromosome 6

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 An Overview of Sleep-Wake
Disorders
Breathing-Related Sleep Disorders
• Breathing disrupted during sleep
• Experience brief arousals throughout night
• Hypoventilation: laboured breathing
– Sleep apnea; 6% Canadians; men twice as likely
– Sleep attacks during the day
– Three types: obstructive sleep apnea hypopnea syndrome,
central sleep apnea, sleep-related hypoventilation

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 An Overview of Sleep-Wake
Disorders
Circadian Rhythm Sleep-Wake Disorders
• Brain unable to synchronize sleep patterns
• Our internal clock is in the suprachiasmatic nucleus
in the hypothalamus; connect to eyes
– Jet lag type: difficulty falling asleep at the proper time
– Shift-work type: working odd hours interferes with sleep
cycles
– Delayed sleep phase: sleep later than normal bedtime
– Irregular sleep-wake type, and 24-hour sleep-wake type

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 Treatment of
Sleep-Wake Disorders

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 Treatment of
Sleep-Wake Disorders
Medical Treatments
• 10% Canadian adults use medication for sleep
• Benzodiazepine medications
– Short-acting drugs
• Newer medications work with melatonin system
• Stimulants prescribed for narcolepsy
• Weight loss recommended for breathing-related
sleep disorders
– Continuous positive air pressure (CPAP) machine improves
breathing
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 Treatment of
Sleep-Wake Disorders
Environmental Treatments
• Phase delays (moving the bedtime later)
easier than phase advances (moving bedtime
earlier)
• Bright light used to trick the brain into
readjusting the internal clock

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Psychological Treatment of
Sleep-Wake Disorders

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 Treatment of
Sleep-Wake Disorders
Preventing Sleep
Disorders
• Sleep hygiene:
changes in lifestyle to
avoid insomnia
• Educating young
parents to prevent
later difficulties
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 Treatment of
Sleep-Wake Disorders
Parasomnias and Their Treatment
• DSM-5 identifies a number of parasomnias:
– Sleep terrors
– Sleepwalking
– Nightmares (nightmare disorder)
• Genes implicated, trauma, medication
– Treatment: psychological intervention (CBT) and
medication
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 Treatment of
Sleep-Wake Disorders
Parasomnias and Their Treatment
• Nocturnal eating syndrome: individuals rise from
their beds and eat while they are still asleep
(Yamada, 2015)
• Sexsomnia: acting out sexual behaviours, such as
masturbation and sexual intercourse, with no
memory of the event (Béjot et al., 2010)
• REM sleep behaviour disorder: the individual talks or
moves while sleeping, sometimes acting out a dream
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 Next Week
• If you haven’t, do the RCT Post Survey
ASAP!
• Do the RCT Report on Quercus before
next class
• Textbook Section Quizzes and Case
Studies
• Start listing symptoms for the case study
assignment…
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