In reviewing the major DSM IV-TR categories of eating, substance abuse, sex/gender/sexual, and personality disorders there are various classifications that are analyzed where they are specific to the stages of abnormal psychology.

Under these classifications, how are they examined and how are the components of biology, cognition, behavior and emotion analyzed in perspective of these categories.
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Eating Disorders

Definition and Etiology

Eating disorders are characterized by significant disturbance in eating habits, behaviors and excessive attitudes towards food and/or distorted body image (size, shape and weight). Presentation varies but usually is accompanied by severe psychiatric or medical comorbidity.


The diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM IV-TR) classifies major eating disorders into three categories, anorexia nervosa, bulimia nervosa and eating disorder not otherwise specified. These represent the major categories and classifications, however many patients present with a mixture of both anorexia and bulimia.

DSM IV-TR Criteria for Anorexia Nervosa

  • Unexplained weight loss (medical) accompanied by the refusal to maintain healthy body weight at or above a minimal normal weight for age and height – generally weight loss of body weight less than 85% of expected weight.
  • Food phobias and intense fear of becoming fat or gaining weight even though thin and under weight
  • Distorted body image and the way the individual’s weight or shape are experienced. Denial and refusal to hold a realistic body image
  • Amenorrhea (at least three consecutive cycles) in postmenarchal girls and women

Anorexia Nervosa has two types: Restrictive type in which the patient has not engaged in binging eating or purging (self-induced vomiting, laxative and diuretic abuse, etc.)
Binge eating – purging type in which the patient in the current episode regularly engages in self-induced vomiting, laxative and diuretic abuse, etc.

DSM IV-TR Criteria for Bulimia Nervosa

  • Recurrent episodes of binge eating characterized by both:
  1. Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances
  2. A sense of lack of control over eating during the episode, defined by a feeling that one cannot stop eating or control what or how much one is eating
  • Recurrent inappropriate compensatory behavior to prevent weight gain
  1. Self-induced vomiting
  2. Misuse of laxatives, diuretics, enemas, or other medications
  3. Fasting
  4. Excessive exercise
  • The binge eating and inappropriate compensatory behavior both occur, on average, at least twice a week for 3 months.
  • Self-evaluation is unduly influenced by body shape and weight.
  • The disturbance does not occur exclusively during episodes of anorexia nervosa.

(Taken from the following link:

Bulimia Nervosa has two sub-types: The purging type in which the patient regularly engages in self-induced vomiting, the abuse of laxatives, diuretics, enemas, etc.

The non-purging type in which the patient engages in inappropriate compensatory behavior (excessive exercise for example), without self-induced vomiting and/or the abuse of the afore mentioned types of medication.

DSM IV-TR Criteria for Eating Disorder Not Otherwise Specified

  1. For female patients, all of the criteria for anorexia nervosa are met except that the patient has regular menses.
  2. All of the criteria for anorexia nervosa are met except that, despite significant weight loss, the patient’s current weight is in the normal range.
  3. All of the criteria for bulimia nervosa are met except that the binge eating and inappropriate compensatory mechanisms occur less than twice a week or for less than 3 months.
  4. The patient has normal body weight and regularly uses inappropriate compensatory behavior after eating small amounts of food (e.g., self-induced vomiting after consuming two cookies).
  5. Repeatedly chewing and spitting out, but not swallowing, large amounts of food.

(Taken from the following link:


The diagnostic tools for eating disorders include clinical interviews, Body Shape Questionnaire, the Eating Disorder Inventory, the Eating Attitudes Test and other scales are used for assessment.

Comorbidity and Coexisting Conditions

The list of comorbid conditions include sexual abuse, major depressive disorder, obsessive compulsive disorder, and substance abuse. Medical conditions include obesity and its associated problems, liver damage, heart disease, hormonal imbalance and respiratory problems. Some of these can lead to death.


There are both biological and psychosocial causes in the pathophysiology of eating disorders though the complete cause and origination is not understood and still under research. There is some evidence of genetic causation in that anorexia can run in families at least in female patients. Anorexia may be the result of adolescent pressure to conform, behave more independently (control) or to respond to media and societal pressure to be slender. The constant …

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