Case Study 145 Anorexia Case Study (Winningham’s) Answer Key 1.Using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) criteria, how is the diagnosis of anorexia nervosa determined? 2.Identify eight clinical signs or symptoms of anorexia nervosa. Place a star or asteris...
Case Study 145 Anorexia Case Study (Winningham’s) Answer Key
1.Using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) criteria, how is the
diagnosis of anorexia nervosa determined?
• Restriction of energy intake relative to requirements leading to a significantly low body weight in the
context of age, sex, developmental trajectory, and physical health
• Intense fear of gaining weight or becoming fat, even though underweight
• Disturbance in the way in which one's body weight or shape is experienced, undue influence of body
weight or shape on self-evaluation, or denial of the seriousness of the current low body weight
2.Identify eight clinical signs or symptoms of anorexia nervosa. Place a star or asterisk next to those that J.M.
has.
• Emaciated and malnourished appearance*
• Hypotension (She has been blacking out, which can indicate hypotension. No vital signs were provided,
but students might star this item.)
• Obese or overweight person: electrolyte imbalance, hypothermia, weight loss
of more than 2 pounds per week, perception of being obese despite weight
loss
3. What other disorders might occur along with anorexia nervosa? Name at least
four.
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• Major depression
, • Bulimia nervosa
• Obsessive-compulsive disorder (OCD)
• Eating disorders not otherwise specified
• Binge-eating disorder
• Cardiac dysrhythmias
4. How does bulimia nervosa differ from anorexia nervosa?
• Anorexia nervosa is refusal to maintain body weight at a minimum level for
age and height or failure to gain weight during a period of growth, resulting in
body weight less than 85% of what is expected. The person has an intense fear
of gaining weight or becoming fat, even though the person is underweight.
The person may have a persistent inability to recognize the seriousness of the
very low body weight and extreme weight loss. Some types of anorexia
nervosa involve periods of binging and purging behaviors.
• Bulimia is characterized by recurrent periods of binge eating and recurrent,
inappropriate behaviors to prevent weight gain (such as self-induced vomiting;
use of laxatives, enemas, and diuretics to lose weight; fasting; or excessive
exercise). This cycle occurs, on average, at least once a week for 3 months.
Psychiatric Disorders
5. Name five behaviors that J.M. or any other patient with anorexia may engage in
other than self-starvation.
• Excessive daily exercise
• Binging and purging
15
• Intense food rituals
• Use of diuretics
• Laxative or enema abuse
• Denial
• Wearing loose clothing
• Withdrawal from social activities
6. What common family dynamics are associated with anorexia nervosa?
• Middle- or upper-class background
• Passive father and dominant mother
• Expectations of perfection
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• Overly dependent child
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