Respond to Emilys post/ What reactions do you have to the ideas Emily has presented? Include examples from your own experience to support your perspective, and raise questions to continue the dialogue.

. please use 7th edition a p a format. Please list references used. Please use up to date/ current scholarly references/sources (within the last 5 years) . cite each paragraph with facts.

Assessment Phase:

On the first observation with Nancy and her family, the application of DSM-5 criteria for bulimia nervosa would be explored for understanding and categorizing Nancy's eating disorder (APA, 2022). The diagnostic criteria provide a framework for evaluating recurrent episodes of binge eating, inappropriate compensatory behaviors, and the impact of body shape on self-evaluation. To determine the severity of Nancy's bulimia nervosa, it is essential to assess the frequency of inappropriate compensatory behaviors, categorizing it as mild, moderate, severe, or extreme (APA, 2022).

In the assessment phase, it is crucial to employ relational codes to comprehensively explore family dynamics influenced by Nancy's eating disorder, particularly considering its impact on her 12-year-old son's eating habits (Nolen-Hoeksema, 2020). This involves evaluating communication patterns (APA, 2022, Z73.1), understanding emotional support levels (APA, 2022, Z63.0), and assessing how Nancy's behaviors may be influencing the family's overall well-being. Exploring family dynamics involves considering relevant diagnostic codes, further enhancing our understanding of the familial context (APA, 2022). Diagnostic codes such as Z codes related to family circumstances (e.g., Z63.0 - Problems in relationship with spouse or partner) and V codes related to psychological and environmental factors (e.g., V61.1 - Family disruption and V62.89 - Other psychological distress) highlight potential stressors within the family that may contribute to or be impacted by Nancy's eating disorder (APA, 2022). This comprehensive approach, incorporating relational codes, enables a thorough understanding of Nancy's situation and informs the development of an effective intervention plan.

Eating Disorder Examination Questionnaire (EDN-5):

In addition to the DSM-5 criteria, employing the Eating Disorder Examination Questionnaire (EDN-5) can offer a more nuanced understanding of Nancy's eating behaviors and potential comorbid psychopathology (APA, 2022). The EDN-5, as a supplementary assessment tool, allows for a detailed exploration of eating patterns, attitudes towards food, and the emotional aspects of the eating disorder (APA, 2022). This additional assessment can aid in differentiating between specific eating disorders, providing valuable insights into whether Nancy may meet criteria for anorexia nervosa binge-eating/purging type, bulimia nervosa, or another specified feeding or eating disorder (APA, 2022). By delving into the intricacies of Nancy's eating behaviors, the EDN-5 contributes to a more comprehensive diagnostic picture, guiding the development of a targeted and effective intervention plan tailored to her specific needs and challenges.

Sociocultural Factors:

Nancy's case demonstrates the impact of sociocultural factors on the development of her eating disorder. The historical and cross-cultural variations in the prevalence of eating disorders are linked to changing standards of beauty for women (Garner & Garfinkel, 1980; Nolen-Hoeksema, 2020). This aligns with findings from a longitudinal study by Herle et al. (2020), which emphasizes the association between childhood overeating and later binge eating, suggesting that increasing rates of childhood overeating could foreshadow later binge eating behaviors (Herle et al., 2020). Nancy's dissatisfaction with her body reflects the influence of societal pressures emphasizing a thin ideal, as seen in the literature on the internalization of thin body ideals (APA, 2022).

Biological Factors:

Biological factors play a significant role in the development of eating disorders, as observed in Nancy's case. Genetic vulnerabilities and familial transmission contribute to the risk of bulimia nervosa (Bulik et al., 2019; Nolen-Hoeksema, 2020). Herle et al. (2020) further support the role of early life eating behaviors, highlighting associations between childhood overeating and later binge eating, indicating a shared genetic vulnerability (Herle et al., 2020). Nancy's childhood obesity and early pubertal maturation align with genetic and physiological factors contributing to the risk of bulimia nervosa, as indicated in the literature (Bulik et al., 2019; Nolen-Hoeksema, 2020; Stice & Shaw, 2017).

Psychological Factors:

Nancy's case underscores the influence of psychological factors on the development of her eating disorder. Cognitive factors, such as body dissatisfaction and perfectionism, are key predictors of eating disorders (Boone et al., 2014; Nolen-Hoeksema, 2020). Herle et al. (2020) support these findings by emphasizing the continuity between childhood eating behaviors and later eating disorder behaviors, particularly for childhood overeating and later binge eating (Herle et al., 2020). Nancy's engagement in binge eating and purging behaviors as maladaptive strategies to cope with emotional difficulties aligns with research on emotion regulation difficulties contributing to eating-disorder behaviors (Fairburn et al., 2009; Nolen-Hoeksema, 2020). The study by Herle et al. (2020) further strengthens this perspective by associating overeating during childhood with an increased risk of binge eating later in adolescence (Herle et al., 2020).

American Psychiatric Association. (2022).Diagnostic and statistical manual of mental disorders(5th ed., text rev.).

Herle, M., Stavola, B. D., Hbel, C., Abdulkadir, M., Ferreira, D. S., Loos, R. J. F., Bryant-Waugh, R., Bulik, C. M., & Micali, N. (2020). A longitudinal study of eating behaviours in childhood and later eating disorder behaviours and diagnoses.British Journal of Psychiatry,216(2), 113-119.https://doi.org/10.1192/bjp.2019.174Links to an external site.

Nolen-Hoeksema, S. (2020).Abnormal psychology(8th ed.). McGraw-Hill.