Do you know about - Pathological Eating Disorders and Poly-Behavioral Addiction
Trs Recovery Services! Again, for I know. Ready to share new things that are useful. You and your friends.When inspecting that pathological eating disorders and their related diseases now afflict more population globally than malnutrition, some experts in the healing field are presently purporting that the world’s number one condition problem is no longer heart disease or cancer, but obesity. according to the World condition organization (June, 2005), “obesity has reached epidemic proportions globally, with more than 1 billion adults overweight - at least 300 million of them clinically obese - and is a major contributor to the global burden of chronic disease and disability. Often coexisting in developing countries with under-nutrition, obesity is a complicated condition, with serious collective and psychological dimensions, affecting virtually all ages and socioeconomic groups.” The U.S. Centers for Disease operate and stoppage (June, 2005), reports that “during the past 20 years, obesity among adults has risen significantly in the United States. The most recent data from the National center for condition Statistics show that 30 percent of U.S. Adults 20 years of age and older - over 60 million population - are obese. This growth is not little to adults. The ration of young population who are overweight has more than tripled since 1980. Among children and teens aged 6-19 years, 16 percent (over 9 million young people) are determined overweight.”
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Morbid obesity is a condition that is described as being 100lbs. Or more above ideal weight, or having a Body Mass Index (Bmi) equal to or greater than 30. Being obese alone puts one at a much greater risk of suffering from a compound of several other metabolic factors such as having high blood pressure, being insulin resistant, and/ or having abnormal cholesterol levels that are all related to a poor diet and a lack of exercise. The sum is greater than the parts. Each metabolic problem is a risk for other diseases separately, but together they multiply the chances of life-threatening illness such as heart disease, cancer, diabetes, and stroke, etc. Up to 30.5% of our Nations’ adults suffer from morbid obesity, and two thirds or 66% of adults are overweight measured by having a Body Mass Index (Bmi) greater than 25. inspecting that the U.S. population is now over 290,000,000, some estimation that up to 73,000,000 Americans could advantage from some type of schooling awareness and/ or medicine for a pathological eating disorder or food addiction. Typically, eating patterns are determined pathological problems when issues concerning weight and/ or eating habits, (e.g., overeating, under eating, binging, purging, and/ or obsessing over diets and calories, etc.) come to be the focus of a persons’ life, causing them to feel shame, guilt, and embarrassment with related symptoms of depression and anxiety that cause indispensable maladaptive collective and/ or occupational impairment in functioning.
We must consider that some population originate dependencies on certain life-functioning activities such as eating that can be just as life threatening as drug addiction and just as socially and psychologically damaging as alcoholism. Some do suffer from hormonal or metabolic disorders, but most obese individuals simply consume more calories than they burn due to an out of operate overeating Food Addiction. Hyper-obesity resulting from gross, habitual overeating is determined to be more like the problems found in those ingrained personality disorders that involve loss of operate over appetite of some kind (Orford, 1985). Binge-eating Disorder episodes are characterized in part by a feeling that one cannot stop or operate how much or what one is eating (Dsm-Iv-Tr, 2000). Lienard and Vamecq (2004) have proposed an “auto-addictive” hypothesis for pathological eating disorders. They report that, “eating disorders are related with abnormal levels of endorphins and share clinical similarities with psychoactive drug abuse. The key role of endorphins has recently been demonstrated in animals with regard to certain aspects of normal, pathological and experimental eating habits (food restriction combined with stress, loco-motor hyperactivity).” They report that the “pathological management of eating disorders may lead to two extreme situations: the absence of ingestion (anorexia) and inordinate ingestion (bulimia).”
Co-morbidity & Mortality
Addictions and other thinking disorders as a rule do not originate in isolation. The National Co-morbidity gawk (Ncs) that sampled the whole U.S. population in 1994, found that among non-institutionalized American male and female adolescents and adults (ages 15-54), almost 50% had a diagnosable Axis I thinking disorder at some time in their lives. This survey’s results indicated that 35% of males will at some time in their lives have abused substances to the point of qualifying for a thinking disorder diagnosis, and nearly 25% of women will have suited for a serious mood disorder (mostly major depression). A indispensable looking of note from the Ncs study was the broad occurrence of co-morbidity among diagnosed disorders. It specifically found that 56% of the respondents with a history of at least one disorder also had two or more further disorders. These persons with a history of three or more co-morbid disorders were estimated to be one-sixth of the U.S. Population, or some 43 million population (Kessler, 1994).
McGinnis and Foege, (1994) report that, “the most prominent contributors to mortality in the United States in 1990 were tobacco (an estimated 400,000 deaths), diet and activity patterns (300,000), alcohol (100,000), microbial agents (90,000), toxic agents (60,000), firearms (35,000), sexual behavior (30,000), motor vehicles (25,000), and illicit use of drugs (20,000). Acknowledging that the prominent cause of preventable morbidity and mortality was risky behavior lifestyles, the U.S. stoppage Services Task Force set out to research behavioral counseling interventions in condition care settings (Williams & Wilkins, 1996).
Poor Prognosis
We have come to perceive today more than any other time in history that the medicine of lifestyle diseases and addictions are often a difficult and frustrating task for all concerned. Repeated failures abound with all of the addictions, even with utilizing the most sufficient medicine strategies. But why do 47% of patients treated in inexpressive medicine programs (for example) relapse within the first year following medicine (Gorski,T., 2001)? Have addiction specialists come to be conditioned to accept failure as the norm? There are many reasons for this poor prognosis. Some would proclaim that addictions are psychosomatically- induced and maintained in a semi-balanced force field of driving and restraining multidimensional forces. Others would say that failures are due simply to a lack of self-motivation or will power. Most would agree that lifestyle behavioral addictions are serious condition risks that deserve our attention, but could it possibly be that patients with many addictions are being under diagnosed (with a singular dependence) simply due to a lack of diagnostic tools and resources that are incapable of resolving the complexity of assessing and treating a patient with many addictions?
Diagnostic Delineation
Thus far, the Dsm-Iv-Tr has not delineated a prognosis for the complexity of many behavioral and substance addictions. It has reserved the Poly-substance Dependence prognosis for a person who is repeatedly using at least three groups of substances during the same 12-month period, but the criteria for this prognosis do not involve any behavioral addiction symptoms. In the Psychological Factors Affecting healing Condition’s section (Dsm-Iv-Tr, 2000); maladaptive condition behaviors (e.g., overeating, unsafe sexual practices, inordinate alcohol and drug use, etc.) may be listed on Axis I only if they are significantly affecting the course of medicine of a healing or thinking condition.
Since prosperous medicine outcomes are dependent on accepted assessments, precise diagnoses, and broad individualized medicine planning, it is no wonder that repeated restoration failures and low success rates are the norm instead of the irregularity in the addictions field, when the most recent Dsm-Iv-Tr does not even include a prognosis for many addictive behavioral disorders. medicine clinics need to have a medicine planning theory and referral network that is qualified to thoroughly collate many addictive and thinking condition disorders and related medicine needs and comprehensively furnish education/ awareness, stoppage strategy groups, and/ or specific addictions medicine services for individuals diagnosed with many addictions. Written medicine goals and objectives should be specified for each detach addiction and dimension of an individuals’ life, and the desired operation outcome or completion criteria should be specifically stated, behaviorally based (a visible activity), and measurable.
New Proposed Diagnosis
To sustain in resolving the little Dsm-Iv-Trs’ diagnostic capability, a multidimensional prognosis of “Poly-behavioral Addiction,” is proposed for more precise prognosis prominent to more sufficient medicine planning. This prognosis encompasses the broadest category of addictive disorders that would include an private manifesting a compound of substance abuse addictions, and other obsessively-compulsive behavioral addictive behavioral patterns to pathological gambling, religion, and/ or sex / pornography, etc.). Behavioral addictions are just as damaging - psychologically and socially as alcohol and drug abuse. They are comparative to other life-style diseases such as diabetes, hypertension, and heart disease in their behavioral manifestations, their etiologies, and their resistance to treatments. They are progressive disorders that involve obsessive thinking and compulsive behaviors. They are also characterized by a preoccupation with a continuous or periodic loss of control, and continuous irrational behavior in spite of adverse consequences.
Poly-behavioral addiction would be described as a state of periodic or chronic physical, mental, emotional, cultural, sexual and/ or spiritual/ religious intoxication. These discrete types of intoxication are produced by repeated obsessive thoughts and compulsive practices complicated in pathological relationships to any mood-altering substance, person, organization, trust system, and/ or activity. The private has an overpowering desire, need or obligation with the nearnessy of a tendency to intensify their adherence to these practices, and evidence of phenomena of tolerance, abstinence and withdrawal, in which there is all the time corporeal and/ or psychic dependence on the effects of this pathological relationship. In addition, there is a 12 - month duration in which an private is pathologically complicated with three or more behavioral and/ or substance use addictions simultaneously, but the criteria are not met for dependence for any one addiction in singular (Slobodzien, J., 2005). In essence, Poly-behavioral addiction is the synergistically integrated chronic dependence on many physiologically addictive substances and behaviors (e.g., using/ abusing substances - nicotine, alcohol, & drugs, and/or acting impulsively or obsessively compulsive in regards to gambling, food binging, sex, and/ or religion, etc.) simultaneously.
New Proposed Theory
The Addictions salvage estimation System’s (Arms) theory is a nonlinear, dynamical, non-hierarchical model that focuses on interactions between many risk factors and situational determinants similar to catastrophe and chaos theories in predicting and explaining addictive behaviors and relapse. many influences trigger and operate within high-risk situations and work on the global multidimensional functioning of an individual. The process of relapse incorporates the interaction between background factors (e.g., family history, collective support, years of potential dependence, and co-morbid psychopathology), physiological states (e.g., corporeal withdrawal), cognitive processes (e.g., self-efficacy, cravings, motivation, the abstinence violation effect, outcome expectancies), and coping skills (Brownell et al., 1986; Marlatt & Gordon, 1985). To put it simply, small changes in an individual’s behavior can corollary in large qualitative changes at the global level and patterns at the global level of a theory emerge solely from numerous little interactions.
The Arms hypothesis purports that there is a multidimensional synergistically negative resistance that individual’s originate to any one form of medicine to a singular dimension of their lives, because the effects of an individual’s addiction have dynamically interacted multi-dimensionally. Having the traditional focus on one dimension is insufficient. Traditionally, addiction medicine programs have failed to adapt for the multidimensional synergistically negative effects of an private having many addictions, (e.g. Nicotine, alcohol, and obesity, etc.). Behavioral addictions interact negatively with each other and with strategies to enhance broad functioning. They tend to encourage the use of tobacco, alcohol and other drugs, help growth violence, decrease functional capacity, and promote collective isolation. Most medicine theories today involve assessing other dimensions to identify dual prognosis or co-morbidity diagnoses, or to collate contributing factors that may play a role in the individual’s traditional addiction. The Arms’ theory proclaims that a multidimensional medicine plan must be devised addressing the potential many addictions identified for each one of an individual’s life dimensions in addition to developing specific goals and objectives for each dimension.
The Arms acknowledges the complexity and unpredictable nature of lifestyle addictions following the commitment of an private to accept assistance with changing their lifestyles. The Stages of change model (Prochaska & DiClemente, 1984) is supported as a model of motivation, incorporating five stages of readiness to change: pre-contemplation, contemplation, preparation, action, and maintenance. The Arms theory supports the constructs of self-efficacy and collective networking as outcome predictors of hereafter behavior over a wide collection of lifestyle risk factors (Bandura, 1977). The Relapse stoppage cognitive-behavioral advent (Marlatt, 1985) with the goal of identifying and preventing high-risk situations for relapse is also supported within the Arms theory.
The Arms continues to promote Twelve Step salvage Groups such as Food Addicts and Alcoholics Anonymous along with spiritual and religious salvage activities as a indispensable means to voice outcome effectiveness. The useful effects of Aa may be attributable in part to the change of the participant's collective network of drinking friends with a fellowship of Aa members who can furnish motivation and retain for maintaining abstinence (Humphreys, K.; Mankowski, E.S, 1999) and (Morgenstern, J.; Labouvie, E.; McCrady, B.S.; Kahler, C.W.; and Frey, R.M., 1997). In addition, Aa's advent often results in the development of coping skills, many of which are similar to those taught in more structured psychosocial medicine settings, thereby prominent to reductions in alcohol consumption (Niaaa, June 2005).
Treatment develop Dimensions
The American community of Addiction Medicine’s (2003), “Patient Placement Criteria for the medicine of Substance-Related Disorders, 3rd Edition”, has set the accepted in the field of addiction medicine for recognizing the totality of the private in his or her life situation. This includes the internal interconnection of many dimensions from biomedical to spiritual, as well as external relationships of the private to the family and larger collective groups. Life-style addictions may work on many domains of an individual's functioning and often require multi-modal treatment. Real develop however, requires accepted interventions and motivating strategies for every dimension of an individual’s life.
The Addictions salvage estimation theory (Arms) has identified the following seven medicine develop areas (dimensions) in an endeavor to: (1) sustain clinicians with identifying further motivational techniques that can growth an individual’s awareness to make progress: (2) measure within medicine progress, and (3) measure after medicine outcome effectiveness:
Pd- 1. Abstinence/ Relapse: develop Dimension
Pd- 2. Bio-medical/ Physical: develop Dimension
Pd- 3. Mental/ Emotional: develop Dimension
Pd- 4. Social/ Cultural: develop Dimension
Pd- 5. Educational/ Occupational: develop Dimension
Pd- 6. Attitude/ Behavioral: develop Dimension
Pd- 7. Spirituality/ Religious: develop Dimension
Considering that addictions involve unbalanced life-styles operating within semi-stable equilibrium force fields, the Arms doctrine promotes that certain medicine effectiveness and prosperous outcomes are the corollary of a synergistic association with “The Higher Power,” that spiritually elevates and connects an individuals’ many life functioning dimensions by reducing chaos and addition resilience to bring an private harmony, wellness, and productivity.
Addictions salvage estimation - Subsystems
Since chronic lifestyle diseases and disorders such as diabetes, hypertension, alcoholism, drug and behavioral addictions cannot be cured, but only managed - how should we effectively manage poly-behavioral addiction?
The Addiction salvage estimation theory (Arms) is proposed utilizing a multidimensional integrative assessment, medicine planning, medicine progress, and medicine outcome estimation tracking theory that facilitates rapid and precise recognition and estimation of an individual’s broad life-functioning develop dimensions. The “Arms”- systematically, methodically, interactively, & spiritually combines the following five versatile subsystems that may be utilized individually or incorporated together:
1) The Prognostication theory – composed of twelve screening instruments industrialized to rate an individual’s total life-functioning dimensions for a broad bio-psychosocial estimation for an objective 5-Axis prognosis with a point-based Global estimation of Functioning score;
2) The Target Intervention theory - that includes the Target Intervention measure (Tim) and Target develop Reports (A) & (B), for individualized goal-specific medicine planning;
3) The develop Point theory - a standardized performance-based motivational salvage point theory utilized to furnish in-treatment develop reports on six life-functioning private dimensions;
4) The Multidimensional Tracking theory – with its Tracking Team Surveys (A) & (B), along with the Arms dismissal criteria guidelines utilizes a multidisciplinary tracking team to sustain with dismissal planning; and
5) The medicine Outcome estimation theory – that utilizes the following two estimation instruments: (a) The medicine Outcome measure (Tom); and (b) the Global estimation of develop (Gap), to sustain with aftercare medicine planning.
National Movement
With the end of the Cold War, the threat of a world nuclear war has diminished considerably. It may be hard to fantasize that in the end, comedians may be exploiting the humor in the fact that it wasn’t nuclear warheads, but “French fries” that annihilated the human race. On a more serious note, lifestyle diseases and addictions are the prominent cause of preventable morbidity and mortality, yet brief preventive behavioral assessments and counseling interventions are under-utilized in condition care settings (Whitlock, 2002).
The U.S. Preventive Services Task Force complete that sufficient behavioral counseling interventions that address personal condition practices hold greater promise for improving broad condition than many secondary preventive measures, such as disposition screening for early disease (Uspstf, 1996). base health-promoting behaviors include wholesome diet, regular corporeal exercise, smoking cessation, accepted alcohol/ medication use, and responsible sexual practices to include use of condoms and contraceptives.
350 national organizations and 250 State collective health, thinking health, substance abuse, and environmental agencies retain the U.S. Group of condition and Human Services, “Healthy population 2010” program. This national initiative recommends that traditional care clinicians use clinical preventive assessments and brief behavioral counseling for early detection, prevention, and medicine of lifestyle disease and addiction indicators for all patients’ upon every healthcare visit.
Partnerships and coordination among assistance providers, government departments, and community organizations in providing medicine programs are a necessity in addressing the multi-task solution to poly-behavioral addiction. I encourage you to retain the thinking condition and addiction programs in America, and hope that the (Arms) resources can sustain you to personally fight the War on pathological eating disorders within poly-behavioral addiction.
For more info see:
Poly-Behavioral Addiction and the Addictions salvage estimation System,
By James Slobodzien, Psy.D., Csac at:
[http://www.geocities.com/drslbdzn/Behavioral-Addictions.html]
Food Addicts Anonymous: http://www.foodaddictsanonymous.org/
Alcoholics Anonymous: http://www.alcoholics-anonymous.org/
References
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Treatment of Substance-Related Disorders, 3rd Edition,. Retrieved, June 18, 2005, from:
http://www.asam.org/
Bandura, A. (1977), Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review,
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Kessler, R.C., McGonagle, K.A., Zhao, S., Nelson, C.B., Hughes, M., Eshleman, S., Wittchen, H. H,-U, & Kendler, K.S. (1994). Lifetime and 12-month prevalence of Dsm-Iii-R psychiatric disorders in the United
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Morgenstern, J.; Labouvie, E.; McCrady, B.S.; Kahler, C.W.; and Frey, R.M (1997). Affiliation with Alcoholics Anonymous after treatment: A study of its therapeutic effects and mechanisms of action. J Consult Clin Psychol 65(5):768-777.
Orford, J. (1985). inordinate appetites: A psychological view of addiction. New York: Wiley.
Prochaska, J. O., & DiClemente, C. C. (1984). The transtheoretical approach: Crossing the boundaries of therapy. Malabar, Fl: Krieger.
Slobodzien, J. (2005). Poly-behavioral Addiction and the Addictions salvage estimation theory (Arms), Booklocker.com, Inc., p. 5.
Whitlock, E.P. (1996). Evaluating traditional Care Behavioral Counseling Interventions: An Evidence-based Approach. Am J Prev Med 2002;22(4): 267-84.Williams & Wilkins. U.S. Preventive Services Task Force. Guide to Clinical Preventive Services. 2nd ed. Alexandria, Va.
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World condition Organization, (Who). Retrieved June 18, 2005, from: http://www.who.int/topics/obesity/en/
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