3.5 Basic Human Needs
Lecture 1 - Introduction and Eating Disorders
Why eating, sex and sleep?
● Basic human needs - survival
○ Built in mechanisms to remind us to engage in them
● They drive behavior
○ We are biologically designed to get pleasure from all these activities and suffer when we are
deprived of them
● Common brain psychology, but it is more complicated than that
● Eating, sexual, and sleep disorders are very common
Diagnostics
● Anorexia Nervosa: a loss of appetite due to nervous reasons
● Boulimia Nervosa: ‘being as hungry as a cow’
● Binge Eating Disorder: binges but no purging
● ARFID (Avoidant Restrictive Food Intake Disorder): patient
tends to avoid certain types of food, most often due to
feeling in their mouth (sensory issues)
○ Regular appearance, no preoccupation with body
image
○ Frequently co-occurs with autism
● Pica: the tendency to consume materials that are not suitable
for consumption, e.g., rocks
● OSFED (other specified feeding- or eating disorder): people who do not fully meet the criteria for a
diagnosis
Treatment: CBT-E
● Making a formulation of the transdiagnostic model
● Start by asking: what is your biggest problem at the
moment?
○ What do you do after a binge?
○ How do you feel after binging?
● The practitioner should ask the patient about their body
and self-image, binge-eating, dietary rules and
compensatory behavior, significant low weight, events
(e.g., coming home after work, being alone) and
associated mood changes
● Bidirectional relationship between binge eating and vomiting/laxative use
Making a transdiagnostic model with the patient allows them to see how their different behaviors and thoughts
turn into a destructive cycle. The value of the transdiagnostic model also lies in its utility for all the major eating
disorders
1
,Stage 1 (sessions 1-7)
● Intensive initial stage, with appointments twice a week
○ Food diary: moments to stop and reflect
○ Weekly weigh-ins
● Therapist and patient together set up the formulation of the underlying
maintaining factors, which will be used as a base for the remainder of the
treatment
● Aims: engage the patient in treatment
Stage 2 (sessions 8-9)
● Weekly appointments
● The therapist and patient take stock, review progress, identify any emerging
barriers to change, modify the formulation and plan stage 3
● Is important to identify problems with the therapy, to
remove barriers and adjust treatment if needed
● After this stage, the treatment will become more
personalized
Stage 3 (sessions 10-17)
● Main body of treatment
● Weekly appointments
● Aim: address the main mechanisms that are supposed
to maintain the patient’s eating disorder
○ How this is done varies from patient to patient
● Therapist can choose to pay attention to one or more defined
maintaining factors
● Often the over-evaluation of shape and weight is an important
maintaining mechanism that will be addressed in this stage
Stage 4 (sessions 18-20)
● Final stage of treatment
● Focus shifts to the future
● Appointments are scheduled at two-week intervals
● Two aims
1) Ensure that the changes are maintained (over the
subsequent 20 weeks until a review appointment is held)
2) Minimize the risk of relapse in the long term
● Personalized maintenance plan is made
→ After 20 weeks a review session is (sometimes?) planned
2
, Lecture 2 - Introduction to sexology
Why do psychologists need to know about sexuality?
● Mental illness can cause sexual dysfunctions or problems
● Sexual complaints are sometimes a symptom of mental illness
● Sexual problems are not only psychological in nature
● Sexual problems are treatable
● Sexual problems as a result of treatment
● A satisfying sex life is healthy: better prognosis, good prevention, better patient compliance
Disease and sex
● Sexual problems directly caused by disease (e.g., depression)
● Sexual problems indirectly caused by disease (e.g., impaired body image because of a disorder)
● Sexual problems as a result of treatment (e.g., medication)
Sexual dysfunction by age groep, %
Dysfunction = problem + distress
Explanation for high percentage in young females: lack of stimulation and lack of knowing your body
% of sexual activity with a partner, last 6 months
Grading of sexlife
3
Lecture 1 - Introduction and Eating Disorders
Why eating, sex and sleep?
● Basic human needs - survival
○ Built in mechanisms to remind us to engage in them
● They drive behavior
○ We are biologically designed to get pleasure from all these activities and suffer when we are
deprived of them
● Common brain psychology, but it is more complicated than that
● Eating, sexual, and sleep disorders are very common
Diagnostics
● Anorexia Nervosa: a loss of appetite due to nervous reasons
● Boulimia Nervosa: ‘being as hungry as a cow’
● Binge Eating Disorder: binges but no purging
● ARFID (Avoidant Restrictive Food Intake Disorder): patient
tends to avoid certain types of food, most often due to
feeling in their mouth (sensory issues)
○ Regular appearance, no preoccupation with body
image
○ Frequently co-occurs with autism
● Pica: the tendency to consume materials that are not suitable
for consumption, e.g., rocks
● OSFED (other specified feeding- or eating disorder): people who do not fully meet the criteria for a
diagnosis
Treatment: CBT-E
● Making a formulation of the transdiagnostic model
● Start by asking: what is your biggest problem at the
moment?
○ What do you do after a binge?
○ How do you feel after binging?
● The practitioner should ask the patient about their body
and self-image, binge-eating, dietary rules and
compensatory behavior, significant low weight, events
(e.g., coming home after work, being alone) and
associated mood changes
● Bidirectional relationship between binge eating and vomiting/laxative use
Making a transdiagnostic model with the patient allows them to see how their different behaviors and thoughts
turn into a destructive cycle. The value of the transdiagnostic model also lies in its utility for all the major eating
disorders
1
,Stage 1 (sessions 1-7)
● Intensive initial stage, with appointments twice a week
○ Food diary: moments to stop and reflect
○ Weekly weigh-ins
● Therapist and patient together set up the formulation of the underlying
maintaining factors, which will be used as a base for the remainder of the
treatment
● Aims: engage the patient in treatment
Stage 2 (sessions 8-9)
● Weekly appointments
● The therapist and patient take stock, review progress, identify any emerging
barriers to change, modify the formulation and plan stage 3
● Is important to identify problems with the therapy, to
remove barriers and adjust treatment if needed
● After this stage, the treatment will become more
personalized
Stage 3 (sessions 10-17)
● Main body of treatment
● Weekly appointments
● Aim: address the main mechanisms that are supposed
to maintain the patient’s eating disorder
○ How this is done varies from patient to patient
● Therapist can choose to pay attention to one or more defined
maintaining factors
● Often the over-evaluation of shape and weight is an important
maintaining mechanism that will be addressed in this stage
Stage 4 (sessions 18-20)
● Final stage of treatment
● Focus shifts to the future
● Appointments are scheduled at two-week intervals
● Two aims
1) Ensure that the changes are maintained (over the
subsequent 20 weeks until a review appointment is held)
2) Minimize the risk of relapse in the long term
● Personalized maintenance plan is made
→ After 20 weeks a review session is (sometimes?) planned
2
, Lecture 2 - Introduction to sexology
Why do psychologists need to know about sexuality?
● Mental illness can cause sexual dysfunctions or problems
● Sexual complaints are sometimes a symptom of mental illness
● Sexual problems are not only psychological in nature
● Sexual problems are treatable
● Sexual problems as a result of treatment
● A satisfying sex life is healthy: better prognosis, good prevention, better patient compliance
Disease and sex
● Sexual problems directly caused by disease (e.g., depression)
● Sexual problems indirectly caused by disease (e.g., impaired body image because of a disorder)
● Sexual problems as a result of treatment (e.g., medication)
Sexual dysfunction by age groep, %
Dysfunction = problem + distress
Explanation for high percentage in young females: lack of stimulation and lack of knowing your body
% of sexual activity with a partner, last 6 months
Grading of sexlife
3
