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113-562: Other efforts to lose weight may include the use of diuretics , stimulants , water fasting , or excessive exercise. Most people with bulimia are at normal weight. The forcing of vomiting may result in thickened skin on the knuckles , breakdown of the teeth, decreased brain matter, and effects on metabolic rate and caloric intake which cause thyroid dysfunction . Bulimia is frequently associated with other mental disorders such as depression , anxiety , borderline personality disorder , bipolar disorder , and problems with drugs or alcohol. There

226-456: A "secondary narcissism" came as a result of his observation of the peculiar nature of the schizophrenic's relation to themselves and the world. He observed that the two fundamental qualities of such patients were megalomania and withdrawal of interest from the real world of people and things: "the libido that has been withdrawn from the external world has been directed to the ego and thus gives rise to an attitude which may be called narcissism." It

339-419: A certain kind of early environment. Heritability studies using twins have shown that narcissistic traits, as measured by standardized tests, are often inherited. Narcissism was found to have a high heritability score (0.64) indicating that the concordance of this trait in the identical twins was significantly influenced by genetics as compared to an environmental causation. It has also been shown that there

452-694: A certain weight that decide how someone with bulimia nervosa feels. People that associate themselves with thin models get in a positive attitude when they see thin models and people that associate with overweight get in a negative attitude when they see thin models. Moreover, it can be taught to associate with thinner people. The onset of bulimia nervosa is often during adolescence, between 13 and 20 years of age, and many cases have previously experienced obesity, with many relapsing in adulthood into episodic bingeing and purging even after initially successful treatment and remission. A lifetime prevalence of 0.5 percent and 0.9 percent for adults and adolescents, respectively,

565-483: A character trait. He described people with the God complex as being aloof, self-important , overconfident, auto-erotic, inaccessible, self-admiring, and exhibitionistic, with fantasies of omnipotence and omniscience. He observed that these people had a high need for uniqueness. Sigmund Freud (1914) published his theory of narcissism in a lengthy essay titled " On Narcissism: An Introduction ". For Freud, narcissism refers to

678-501: A combination of the antagonistic core with temperamental boldness—defined by positive emotionality, social dominance, reward-seeking and risk-taking. Grandiosity is defined—in addition to antagonism—by a confident, exhibitionistic and manipulative self-regulatory style: Narcissistic vulnerability is thought to arise from a combination of the antagonistic core with temperamental reactivity—defined by negative emotionality, social avoidance, passivity and marked proneness to rage. Vulnerability

791-400: A compound of βοῦς bous , "ox" and λιμός, līmos , "hunger". Literally, the scientific name of the disorder, bulimia nervosa , translates to "nervous ravenous hunger". Although diagnostic criteria for bulimia nervosa did not appear until 1979, evidence suggests that binging and purging were popular in certain ancient cultures. The first documented account of behavior resembling bulimia nervosa

904-514: A generalized lack of empathy and concern for others. On a spectrum, destructive narcissism is more extreme than healthy narcissism but not as extreme as the pathological condition. Extremely high levels of narcissistic behavior are considered pathological . The pathological condition of narcissism is a magnified, extreme manifestation of healthy narcissism. It manifests itself in the inability to love others, lack of empathy, emptiness, boredom, and an unremitting need to search for power, while making

1017-484: A handsome young man, Narcissus, who spurns the advances of many potential lovers. When Narcissus rejects the nymph Echo , who was cursed to only echo the sounds that others made, the gods punish Narcissus by making him fall in love with his own reflection in a pool of water. When Narcissus discovers that the object of his love cannot love him back, he slowly pines away and dies. The concept of excessive selfishness has been recognized throughout history. In ancient Greece,

1130-472: A higher risk to have an affective disorder, such as depression or general anxiety disorder. One study found 70% had depression at some time in their lives (as opposed to 26% for adult females in the general population), rising to 88% for all affective disorders combined. Another study in the Journal of Affective Disorders found that of the population of patients that were diagnosed with an eating disorder according to

1243-434: A label for the self-serving and for all domestic abusers. Some psychologists suggest that a moderate level of narcissism is supportive of good psychological health. Self-esteem works as a mediator between narcissism and psychological health. Elevated self-esteem, in moderation, supports resilience and ambition, but excessive self-focus can distort social relationships. While narcissism, in and of itself, can be considered

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1356-479: A lack of empathy. Narcissism has variously been correlated with both traits, though psychologists such as Delroy Paulhus and Kevin Williams see enough evidence that it is a distinct trait. Collective narcissism is a type of narcissism where an individual has an inflated self-love of their own group. While the classic definition of narcissism focuses on the individual, collective narcissism asserts that one can have

1469-504: A mental illness like narcissistic personality disorder (NPD), where the narcissistic tendency has become pathological, leading to functional impairment and psychosocial disability. The term narcissism is derived from Narcissus , a character in Greek mythology best known from the telling in Roman poet Ovid 's Metamorphoses , written in 8 CE. Book III of the poem tells the mythical story of

1582-417: A normal personality trait, high levels of narcissistic behavior can be harmful to both self and others. Destructive narcissism is the constant exhibition of a few of the intense characteristics usually associated with pathological narcissistic personality disorder such as a "pervasive pattern of grandiosity ", which is characterized by feelings of entitlement and superiority, arrogant or haughty behaviors, and

1695-523: A person to challenge automatic thoughts and engage in behavioral experiments (for example, in session eating of "forbidden foods") has a small amount of evidence supporting its use. By using CBT people record how much food they eat and periods of vomiting with the purpose of identifying and avoiding emotional fluctuations that bring on episodes of bulimia on a regular basis. Barker (2003) states that research has found 40–60% of people using cognitive behaviour therapy to become symptom free. He states in order for

1808-601: A person's teeth due to the acid passed through the mouth from frequent vomiting causing acid erosion, mainly on the posterior dental surface. Research has shown that there is a relationship between bulimia and narcissism . According to a study by the Australian National University , eating disorders are more susceptible among vulnerable narcissists . This can be caused by a childhood in which inner feelings and thoughts were minimized by parents, leading to "a high focus on receiving validation from others to maintain

1921-731: A positive sense of self". The medical journal Borderline Personality Disorder and Emotion Dysregulation notes that a "substantial rate of patients with bulimia nervosa" also have borderline personality disorder . A study by the Psychopharmacology Research Program of the University of Cincinnati College of Medicine "leaves little doubt that bipolar and eating disorders—particularly bulimia nervosa and bipolar II disorder—are related." The research shows that most clinical studies indicate that patients with bipolar disorder have higher rates of eating disorders, and vice versa. There

2034-506: A psychiatric facility for depression, Ellen ate ravenously yet lost weight, presumably due to self-induced vomiting. However, while these patients may have met modern criteria for bulimia nervosa, they cannot technically be diagnosed with the disorder, as it had not yet appeared in the Diagnostic and Statistical Manual of Mental Disorders at the time of their treatment. An explanation for the increased instances of bulimic symptoms may be due to

2147-403: A quarter of the overeating cases they examined actually vomited after the binges. There was no evidence of deliberate vomiting or an attempt to control weight. Globally, bulimia was estimated to affect 3.6 million people in 2015. About 1% of young women have bulimia at a given point in time and about 2% to 3% of women have the condition at some point in their lives. The condition is less common in

2260-540: A range of potential leadership problems ranging from poor motivational skills to risky decision making, and in extreme cases, white-collar crime. High-profile corporate leaders that place an extreme emphasis on profits may yield positive short-term benefits for their organizations, but ultimately it drags down individual employees as well as entire companies. Subordinates may find everyday offers of support swiftly turn them into enabling sources, unless they are very careful to maintain proper boundaries. Studies examining

2373-729: A relatively low rate of excretion of calcium . The reduced concentration of calcium in the urine can lead to an increased rate of calcium in serum. The sparing effect on calcium can be beneficial in hypocalcemia , or unwanted in hypercalcemia . The thiazides and potassium-sparing diuretics are considered to be calcium-sparing diuretics. By contrast, loop diuretics promote a significant increase in calcium excretion. This can increase risk of reduced bone density. Osmotic diuretics (e. g., mannitol ) are substances that increase osmolarity, but have limited tubular epithelial cell permeability. They work primarily by expanding extracellular fluid and plasma volume, therefore increasing blood flow to

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2486-455: A result of a life of asceticism) may also have displayed bulimic behaviors. Saint Mary Magdalen de Pazzi (1566–1607) and Saint Veronica Giuliani (1660–1727) were both observed binge eating—giving in, as they believed, to the temptations of the devil. Saint Catherine of Siena (1347–1380) is known to have supplemented her strict abstinence from food by purging as reparation for her sins. Catherine died from starvation at age thirty-three. While

2599-406: A retention of water in the urine, as water normally follows penetrating solutes. Frequent urination is due to the increased loss of water that has not been retained from the body as a result of a concomitant relationship with sodium loss from the convoluted tubule. The short-term anti-hypertensive action is based on the fact that thiazides decrease preload, decreasing blood pressure. On the other hand,

2712-430: A significant role in shaping and amplifying narcissistic behaviors in recent years. Platforms such as Instagram and TikTok encourage users to share content that emphasizes their personal achievements and appearance, often rewarding those who gain the most likes and followers. Narcissistic individuals are more likely to use these platforms for self-promotion and validation. The trend of posting selfies and curated images

2825-502: A similar excessively high opinion of a group, and that a group can function as a narcissistic entity. Collective narcissism is related to ethnocentrism ; however, ethnocentrism primarily focuses on self-centeredness at an ethnic or cultural level, while collective narcissism is extended to any type of ingroup beyond just cultures and ethnicities. Some commentators contend that the American populace has become increasingly narcissistic since

2938-454: A slim physique, such as dance, gymnastics, modeling, cheerleading , running, acting, swimming, diving, rowing and figure skating . Bulimia is thought to be more prevalent among whites ; however, a more recent study showed that African-American teenage girls were 50 percent more likely than white girls to exhibit bulimic behavior, including both binging and purging. The term bulimia comes from Greek βουλιμία boulīmia , "ravenous hunger",

3051-401: A substantial diuresis – up to 20% of the filtered load of NaCl (salt) and water. This is large in comparison to normal renal sodium reabsorption which leaves only about 0.4% of filtered sodium in the urine. Loop diuretics have this ability, and are therefore often synonymous with high-ceiling diuretics. Loop diuretics, such as furosemide , inhibit the body's ability to reabsorb sodium at

3164-405: A toll on mental health. Women frequently reported an onset of anxiety at the same time of the onset of bulimia nervosa. The approximate female-to-male ratio of diagnosis is 10:1. In addition to cognitive, genetic, and environmental factors, childhood gastrointestinal problems and early pubertal maturation also increase the likelihood of developing bulimia nervosa. Another concern with eating disorders

3277-419: A tyrannical father, was repulsed by her weight and would fast for a few days, rapidly losing weight. Ellen West , a patient described by Ludwig Binswanger in 1958, was teased by friends for being fat and excessively took thyroid pills to lose weight, later using laxatives and vomiting. She reportedly consumed dozens of oranges and several pounds of tomatoes each day, yet would skip meals. After being admitted to

3390-744: Is a compulsion of some professionals to constantly assert their competence, even when they are wrong. Professional narcissism can lead otherwise capable, and even exceptional, professionals to fall into narcissistic traps. "Most professionals work on cultivating a self that exudes authority, control, knowledge, competence and respectability. It's the narcissist in us all—we dread appearing stupid or incompetent." Executives are often provided with potential narcissistic triggers. Inanimate triggers include status symbols like company cars, company-issued smartphone , or prestigious offices with window views; animate triggers include flattery and attention from colleagues and subordinates. Narcissism has been linked to

3503-570: Is a continuum or spectrum of narcissistic traits ranging from normal to a pathological personality. Furthermore, evidence suggests that individual elements of narcissism have their own heritability score. For example, intrapersonal grandiosity has a score of 0.23, and interpersonal entitlement has a score of 0.35. While the genetic impact on narcissism levels is significant, it is not the only factor at play. Two primary expressions of narcissism have been identified: grandiose ("thick-skinned") and vulnerable ("thin-skinned"). Recent accounts posit that

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3616-420: Is a secondary narcissism because it is not a new creation but a magnification of an already existing condition (primary narcissism). In 1925, Robert Waelder conceptualized narcissism as a personality trait. His definition described individuals who are condescending, feel superior to others, are preoccupied with admiration, and exhibit a lack of empathy. Waelder's work and his case study have been influential in

3729-511: Is also a higher risk of suicide and self-harm . Bulimia is more common among those who have a close relative with the condition. The percentage risk that is estimated to be due to genetics is between 30% and 80%. Other risk factors for the disease include psychological stress , cultural pressure to attain a certain body type, poor self-esteem, and obesity . Living in a culture that commercializes or glamorizes dieting , and having parental figures who fixate on weight are also risks. Diagnosis

3842-431: Is based on a person's medical history; however, this is difficult, as people are usually secretive about their binge eating and purging habits. Further, the diagnosis of anorexia nervosa takes precedence over that of bulimia. Other similar disorders include binge eating disorder , Kleine–Levin syndrome , and borderline personality disorder . Bulimia typically involves rapid and out-of-control eating, which may stop when

3955-484: Is believed to be more common in men than in women, it occurs in both males and females who compensate for feelings of sexual inadequacy by becoming overly proud or obsessed with their masculinity or femininity. The controversial condition referred to as " sexual addiction " is believed by some experts to be sexual narcissism or sexual compulsivity, rather than an addictive behavior. Narcissistic parents often see their children as extensions of themselves and encourage

4068-411: Is certainly reductionist. Every one differs from another, and taking such a complex behavior like bulimia and applying the same one theory to everyone would certainly be invalid. In addition, the cognitive-behavioral model of bulimia nervosa is very culturally bound in that it may not be necessarily applicable to cultures outside of Western society. To evaluate, Fairburn et al. .'s model and more generally

4181-424: Is defined—in addition to antagonism—by a shy, vindictive and needy self-regulatory style: Sexual narcissism has been described as an egocentric pattern of sexual behavior that involves an inflated sense of sexual ability or sexual entitlement, sometimes in the form of extramarital affairs. This can be overcompensation for low self-esteem or an inability to sustain true intimacy. While this behavioral pattern

4294-492: Is developing a coexisting substance use disorder . There is little data on the percentage of people with bulimia in general populations. Most studies conducted thus far have been on convenience samples from hospital patients, high school or university students; research on bulimia nervosa among ethnic minorities has also been limited. Existing studies have yielded a wide range of results: between 0.1% and 1.4% of males, and between 0.3% and 9.4% of females. Studies on time trends in

4407-856: Is estimated among the United States population. Bulimia nervosa may affect up to 1% of young women and, after 10 years of diagnosis, half will recover fully, a third will recover partially, and 10–20% will still have symptoms. Adolescents with bulimia nervosa are more likely to have self-imposed perfectionism and compulsivity issues in eating compared to their peers. This means that the high expectations and unrealistic goals that these individuals set for themselves are internally motivated rather than by social views or expectations. Bulimia nervosa can be difficult to detect, compared to anorexia nervosa , because bulimics tend to be of average or slightly above average weight. Many bulimics may also engage in significantly disordered eating and exercise patterns without meeting

4520-410: Is evidence that sex hormones may influence appetite and eating in women and the onset of bulimia nervosa. Studies have shown that women with hyperandrogenism and polycystic ovary syndrome have a dysregulation of appetite, along with carbohydrates and fats. This dysregulation of appetite is also seen in women with bulimia nervosa. In addition, gene knockout studies in mice have shown that mice that have

4633-415: Is for the purposes of invalidating drug tests . Diuretics increase the urine volume and dilute doping agents and their metabolites. Another use is to rapidly lose weight to meet a weight category in sports like boxing and wrestling . Narcissism Narcissism is a self-centered personality style characterized as having an excessive preoccupation with oneself and one's own needs, often at

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4746-475: Is higher among those with bulimia nervosa than anorexia nervosa. When exploring the etiology of bulimia through a socio-cultural perspective, the "thin ideal internalization" is significantly responsible. The thin-ideal internalization is the extent to which individuals adapt to the societal ideals of attractiveness. Studies have shown that young women that read fashion magazines tend to have more bulimic symptoms than those women who do not. This further demonstrates

4859-406: Is indistinguishable from narcissistic personality disorder , differing only in its late onset and its environmental support by large numbers of fans. "The lack of social norms, controls, and of people centering them makes these people believe they're invulnerable", so that the person may suffer from unstable relationships, substance abuse or erratic behaviors. Social media Social media has played

4972-495: Is limited. However, people with bulimia nervosa may share dopamine D2 receptor-related vulnerabilities with those with substance use disorders . Dieting, a common behaviour in bulimics, is associated with lower plasma tryptophan levels. Decreased tryptophan levels in the brain, and thus the synthesis of serotonin, such as via acute tryptophan depletion , increases bulimic urges in currently and formerly bulimic individuals within hours. Abnormal blood levels of peptides important for

5085-456: Is most prevalent amongst girls from middle-class families; however, in a 2009 study girls from families in the lowest income bracket studied were 153 percent more likely to be bulimic than girls from the highest income bracket. According to a study conducted in 2022 by Silen et al., which conglomerated statistics using various methods such as SCID, MRFS, EDE, SSAGA, and EDDI, the US, Finland, Australia, and

5198-503: Is overlap in phenomenology, course, comorbidity, family history, and pharmacologic treatment response of these disorders. This is especially true of "eating dysregulation, mood dysregulation, impulsivity and compulsivity, craving for activity and/or exercise." Studies have shown a relationship between bulimia's effect on metabolic rate and caloric intake with thyroid dysfunction . Scientific research has shown that people suffering from bulimia have decreased volumes of brain matter, and that

5311-436: Is particularly prevalent among individuals who seek external approval to boost their self-esteem. The constant feedback from social media algorithms, which prioritize highly engaging content, further fuels narcissistic tendencies. While this can lead to increased attention and admiration, it can also create emotional instability. Narcissists often experience negative feelings, such as anxiety or depression, when they do not receive

5424-617: Is sometimes colloquially called a water tablet . There are several categories of diuretics. All diuretics increase the excretion of water from the body, through the kidneys . There exist several classes of diuretic, and each works in a distinct way. Alternatively, an antidiuretic , such as vasopressin ( antidiuretic hormone ), is an agent or drug which reduces the excretion of water in urine. In medicine , diuretics are used to treat heart failure , liver cirrhosis , hypertension , influenza , water poisoning , and certain kidney diseases . Some diuretics, such as acetazolamide , help to make

5537-512: Is still debated. Media portrayals of an 'ideal' body shape are widely considered to be a contributing factor to bulimia. In a 1991 study by Weltzin, Hsu, Pollicle, and Kaye, it was stated that 19% of bulimics undereat, 37% of bulimics eat an average or normal amount of food, and 44% of bulimics overeat. A survey of 15- to 18-year-old high school girls in Nadroga , Fiji , found the self-reported incidence of purging rose from 0% in 1995 (a few weeks after

5650-482: Is the primary treatment for bulimia. Antidepressants of the selective serotonin reuptake inhibitor (SSRI) or tricyclic antidepressant classes may have a modest benefit. While outcomes with bulimia are typically better than in those with anorexia, the risk of death among those affected is higher than that of the general population. At 10 years after receiving treatment about 50% of people are fully recovered. Cognitive behavioral therapy (CBT), which involves teaching

5763-533: Is triggered and supported by the celebrity-obsessed society. Fans, assistants and tabloid media all play into the idea that the person really is vastly more important than other people, triggering a narcissistic problem that might have been only a tendency, or latent, and helping it to become a full-blown personality disorder. " Robert Millman says that what happens to celebrities is that they get so used to people looking at them that they stop looking back at other people." In its most extreme presentation and symptoms, it

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5876-742: The Mayo Clinic from 1917 to 1929 were compiled. Fifty-five to sixty-five percent of these patients were reported to be voluntarily vomiting to relieve weight anxiety. Records show that purging for weight control continued throughout the mid-1900s. Several case studies from this era reveal patients with the modern description of bulimia nervosa. In 1939, Rahman and Richardson reported that out of their six anorexic patients, one had periods of overeating, and another practiced self-induced vomiting. Wulff, in 1932, treated "Patient D", who would have periods of intense cravings for food and overeat for weeks, which often resulted in frequent vomiting. Patient D, who grew up with

5989-402: The kidney , particularly the peritubular capillaries. This reduces medullary osmolality and thus impairs the concentration of urine in the loop of Henle (which usually uses the high osmotic and solute gradient to transport solutes and water). Further, the limited tubular epithelial cell permeability increases osmolality and thus water retention in the filtrate. It was previously believed that

6102-435: The urine more alkaline , and are helpful in increasing excretion of substances such as aspirin in cases of overdose or poisoning. Diuretics are sometimes abused by people with an eating disorder , especially people with bulimia nervosa , with the goal of losing weight. The antihypertensive actions of some diuretics ( thiazides and loop diuretics in particular) are independent of their diuretic effect. That is,

6215-425: The 20th century's new ideals of thinness. The shame of being fat emerged in the 1940s when teasing remarks about weight became more common. The 1950s, however, truly introduced the trend of aspiration for thinness. Diuretic A diuretic ( / ˌ d aɪ j ʊ ˈ r ɛ t ɪ k / ) is any substance that promotes diuresis , the increased production of urine . This includes forced diuresis . A diuretic tablet

6328-566: The DSM-V guidelines about 27% also suffered from bipolar disorder. Within this article, the majority of the patients were diagnosed with bulimia nervosa, the second most common condition reported was binge-eating disorder. Some individuals with anorexia nervosa exhibit episodes of bulimic tendencies through purging (either through self-induced vomiting or laxatives) as a way to quickly remove food in their system. There may be an increased risk for diabetes mellitus type 2 . Bulimia also has negative effects on

6441-640: The Maudsley Hospital in London for the treatment of anorexia, has been shown promising results in bulimia. The use of CBT has been shown to be quite effective for treating bulimia nervosa (BN) in adults, but little research has been done on effective treatments of BN for adolescents. Although CBT is seen as more cost-efficient and helps individuals with BN in self-guided care, Family Based Treatment (FBT) might be more helpful to younger adolescents who need more support and guidance from their families. Adolescents are at

6554-572: The Netherlands had an estimated 2.1%, 2.4%, 1.0%, and 0.8% prevalence of bulimia nervosa among females under 30 years of age. This demonstrates the prevalence of bulimia nervosa in developed, Western, first-world countries, indicating an urgency in treating adolescent women. Additionally, these statistics may be misrepresentative of the true population affected with bulimia nervosa due to potential underreporting bias. There are higher rates of eating disorders in groups involved in activities which idealize

6667-410: The abnormalities are reversible after long-term recovery. As with anorexia nervosa , there is evidence of genetic predispositions contributing to the onset of this eating disorder. Abnormal levels of many hormones, notably serotonin , have been shown to be responsible for some disordered eating behaviors. Brain-derived neurotrophic factor (BDNF) is under investigation as a possible mechanism. There

6780-442: The appropriate time while eating, and are prone to eating more calories in a short period of time as a result of this decreased sensitivity. Examining from a neural basis also connects elements of interoception and emotion; notable overlaps occur in the medial prefrontal cortex , anterior and posterior cingulate , and anterior insula cortices , which are linked to both interoception and emotional eating. People with bulimia are at

6893-400: The ascending loop in the nephron , which leads to an excretion of water in the urine, whereas water normally follows sodium back into the extracellular fluid. Other examples of high-ceiling loop diuretics include ethacrynic acid and torasemide . Thiazide -type diuretics such as hydrochlorothiazide act on the distal convoluted tubule and inhibit the sodium-chloride symporter leading to

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7006-667: The behaviors of others in the workplace as abusive and threatening than individuals who are low in narcissism. Relationships Narcissism can have a profound impact on both personal and professional relationships, often creating toxic dynamics. In romantic relationships, narcissistic individuals typically demand attention and admiration from their partner while offering little in return. They often fail to show empathy or concern for their partner’s emotional needs, focusing instead on fulfilling their own desires. The narcissist’s behavior can shift dramatically, alternating between idealizing their partner—viewing them as perfect—and devaluing them when

7119-485: The blood. However, in certain conditions, such as diabetes mellitus , the concentration of glucose in the blood ( hyperglycemia ) exceeds the maximum reabsorption capacity of the kidney. When this happens, glucose remains in the filtrate, leading to the osmotic retention of water in the urine. Glucosuria causes a loss of hypotonic water and Na , leading to a hypertonic state with signs of volume depletion, such as dry mucosa, hypotension, tachycardia , and decreased turgor of

7232-450: The children to act in ways that support the parents' emotional and self-esteem needs. Due to their vulnerability, children may be significantly affected by this behavior. To meet the parents' needs, the child may sacrifice their own wants and feelings. A child subjected to this type of parenting may struggle in adulthood with their intimate relationships. In extreme situations, this parenting style can result in estranged relationships with

7345-414: The children, coupled with feelings of resentment, and in some cases, self-destructive tendencies. Origins of narcissism in children can often come from the social learning theory. The social learning theory proposes that social behavior is learned by observing and imitating others' behavior. This suggests that children are anticipated to grow up to be narcissistic when their parents overvalue them. There

7458-472: The cognitive explanation of bulimia nervosa is more descriptive than explanatory, as it does not necessarily explain how bulimia arises. Furthermore, it is difficult to ascertain cause and effect, because it may be that distorted eating leads to distorted cognition rather than vice versa. A considerable amount of literature has identified a correlation between sexual abuse and the development of bulimia nervosa. The reported incident rate of unwanted sexual contact

7571-516: The concept was understood as hubris . Some religious movements such as the Hussites attempted to rectify what they viewed as the shattering and narcissistic cultures of recent centuries. It was not until the late 1800s that narcissism began to be defined in psychological terms. Since that time, the term has had a significant divergence in meaning in psychology. It has been used to describe: In 1889, psychiatrists Paul Näcke and Havelock Ellis used

7684-556: The contention that American culture has become more narcissistic is an analysis of US popular song lyrics between 1987 and 2007. This found a growth in the use of first-person singular pronouns, such as I, me, my, and mine, reflecting a greater focus on the self, and also of references to antisocial behavior; during the same period, there was a diminution of words reflecting a focus on others, positive emotions, and social interactions. References to narcissism and self-esteem in American popular print media have experienced vast inflation since

7797-408: The core of narcissism is self-centred antagonism (or "entitled self-importance"), namely selfishness, entitlement, lack of empathy, and devaluation of others. Grandiosity and vulnerability are seen as different expressions of this antagonistic core, arising from individual differences in the strength of the approach and avoidance motivational systems. Narcissistic grandiosity is thought to arise from

7910-591: The developing world. Bulimia is about nine times more likely to occur in women than men. Among women, rates are highest in young adults. Bulimia was named and first described by the British psychiatrist Gerald Russell in 1979. At the turn of the century, bulimia (overeating) was described as a clinical symptom, but rarely in the context of weight control. Purging, however, was seen in anorexic patients and attributed to gastric pain rather than another method of weight control. In 1930, admissions of anorexia nervosa patients to

8023-482: The distinctiveness and uniqueness of the person; whereas advertising in South Korean stressed the importance of social conformity and harmony. These cultural differences were greater than the effects of individual differences within national cultures. There has been an increased interest in narcissism and narcissistic personality disorder (NPD) in the last 10 years. There are areas of substantial debate that surround

8136-425: The drive for thinness was the major cause of purging as a way of controlling weight. In turn, Byrne and Mclean argued that this makes the individual vulnerable to binging, indicating that it is not a binge-purge cycle but rather a purge-binge cycle in that purging comes before bingeing. Similarly, Fairburn et al. ' s cognitive-behavioral model of bulimia nervosa is not necessarily applicable to every individual and

8249-446: The end of World War II . According to sociologist Charles Derber , people pursue and compete for attention on an unprecedented scale. The profusion of popular literature about "listening" and "managing those who talk constantly about themselves" suggests its pervasiveness in everyday life. The growth of media phenomena such as " reality TV " programs and social media is generating a "new era of public narcissism". Also supporting

8362-556: The episodes of compensatory behaviors and binge eating to happen a minimum of once a week for a consistent time period of 3 months. The diagnosis is made only when the behavior is not a part of the symptom complex of anorexia nervosa and when the behavior reflects an overemphasis on physical mass or appearance. Purging often is a common characteristic of a more severe case of bulimia nervosa. There are two main types of treatment given to those with bulimia nervosa; psychopharmacological and psychosocial treatments. Cognitive behavioral therapy

8475-534: The expense of others. Narcissism, rooted in Greek mythology, has evolved into a psychological concept studied extensively since the early 20th century, highlighting its relevance across various societal domains. Narcissism exists on a continuum that ranges from normal to abnormal personality expression. While many psychologists believe that a moderate degree of narcissism is normal and healthy in humans, there are also more extreme forms, observable particularly in people who are excessively self-absorbed, or who have

8588-646: The full diagnostic criteria for bulimia nervosa. Recently, the Diagnostic and Statistical Manual of Mental Disorders was revised, which resulted in the loosening of criteria regarding the diagnoses of bulimia nervosa and anorexia nervosa. The diagnostic criteria utilized by the DSM-5 includes repetitive episodes of binge eating (a discrete episode of overeating during which the individual feels out of control of consumption) compensated for by excessive or inappropriate measures taken to avoid gaining weight. The diagnosis also requires

8701-484: The gene encoding estrogen receptors have decreased fertility due to ovarian dysfunction and dysregulation of androgen receptors. In humans, there is evidence that there is an association between polymorphisms in the ERβ ( estrogen receptor β) and bulimia, suggesting there is a correlation between sex hormones and bulimia nervosa. Bulimia has been compared to drug addiction, though the empirical support for this characterization

8814-458: The general workforce. For example, individuals high in narcissism inventories are more likely to engage in counterproductive behavior that harms organizations or other people in the workplace. Aggressive (and counterproductive) behaviors tend to surface when self-esteem is threatened. Individuals high in narcissism have fragile self-esteem and are easily threatened. One study found that employees who are high in narcissism are more likely to perceive

8927-497: The impact of media on the likelihood of developing the disorder. Individuals first accept and "buy into" the ideals, and then attempt to transform themselves in order to reflect the societal ideals of attractiveness. J. Kevin Thompson and Eric Stice claim that family, peers, and most evidently media reinforce the thin ideal, which may lead to an individual accepting and "buying into" the thin ideal. In turn, Thompson and Stice assert that if

9040-447: The individual's direction of libidinal energy toward themselves rather than objects and others. He postulated a universal "primary narcissism", that was a phase of sexual development in early infancy – a necessary intermediate stage between auto-eroticism and object-love, love for others. Portions of this 'self-love' or ego-libido are, at later stages of development, expressed outwardly, or "given off" toward others. Freud's postulation of

9153-407: The introduction of television in the province) to 11.3% in 1998. In addition, the suicide rate among people with bulimia nervosa is 7.5 times higher than in the general population. When attempting to decipher the origin of bulimia nervosa in a cognitive context, Christopher Fairburn et al. ' s cognitive-behavioral model is often considered the golden standard. Fairburn et al.'s model discusses

9266-419: The largest circulation Norwegian newspaper found that the use of self-focused and individualistic terms increased in frequency by 69 per cent between 1984 and 2005 while collectivist terms declined by 32 per cent. One study looked at differences in advertising between an individualistic culture, United States, and a collectivist culture, South Korea and found that in the US there was a greater tendency to stress

9379-406: The late 1980s. Between 1987 and 2007 direct mentions of self-esteem in leading US newspapers and magazines increased by 4,540 percent while narcissism, which had been almost non-existent in the press during the 1970s, was referred to over 5,000 times between 2002 and 2007. Similar patterns of change in cultural production are observable in other Western states. For example, a linguistic analysis of

9492-463: The long-term effect is due to an unknown vasodilator effect that decreases blood pressure by decreasing resistance. Carbonic anhydrase inhibitors inhibit the enzyme carbonic anhydrase which is found in the proximal convoluted tubule. This results in several effects including bicarbonate accumulation in the urine and decreased sodium absorption. Drugs in this class include acetazolamide and methazolamide . These are diuretics which do not promote

9605-427: The media's control of the societal ideal of attractiveness, the thin ideal internalization significantly dropped. In other words, less thin ideal images portrayed by the media resulted in less thin-ideal internalization. Therefore, Thompson and Stice concluded that media greatly affected the thin ideal internalization. Papies showed that it is not the thin ideal itself, but rather the self-association with other persons of

9718-455: The narcissist no longer feels validated. This inconsistency can cause emotional confusion and distress for the partner, leaving them feeling undervalued and emotionally drained. Celebrity narcissism (sometimes referred to as acquired situational narcissism ) is a form of narcissism that develops in late adolescence or adulthood, brought on by wealth, fame and the other trappings of celebrity . Celebrity narcissism develops after childhood, and

9831-468: The person is interrupted by another person or the stomach hurts from over-extension, followed by self-induced vomiting or other forms of purging. This cycle may be repeated several times a week or, in more serious cases, several times a day and may directly cause: These are some of the many signs that may indicate whether someone has bulimia nervosa: As with many psychiatric illnesses, delusions can occur, in conjunction with other signs and symptoms, leaving

9944-424: The person unavailable to others. The clinical theorists Kernberg , Kohut , and Theodore Millon all saw pathological narcissism as a possible outcome in response to unempathetic and inconsistent early childhood interactions. They suggested that narcissists try to compensate in adult relationships. German psychoanalyst Karen Horney (1885–1952) also saw the narcissistic personality as a temperament trait molded by

10057-541: The person with a false belief that is not ordinarily accepted by others. People with bulimia nervosa may also exercise to a point that excludes other activities. People with bulimia exhibit several interoceptive deficits, in which one experiences impairment in recognizing and discriminating between internal sensations, feelings, and emotions. People with bulimia may also react negatively to somatic and affective states. Regarding interoceptive sensation, hyposensitive individuals may not detect normal feelings of fullness at

10170-434: The practical application of scientific knowledge. Karen Horney (1939) postulated that narcissism was on a spectrum that ranged from healthy self-esteem to a pathological state. The term entered the broader social consciousness following the publication of The Culture of Narcissism by Christopher Lasch in 1979. Since then, social media, bloggers, and self-help authors have indiscriminately applied "narcissism" as

10283-406: The prevalence of bulimia nervosa have also yielded inconsistent results. According to Gelder, Mayou and Geddes (2005) bulimia nervosa is prevalent between 1 and 2 percent of women aged 15–40 years. Bulimia nervosa occurs more frequently in developed countries and in cities, with one study finding that bulimia is five times more prevalent in cities than in rural areas. There is a perception that bulimia

10396-400: The primary mechanism of osmotic diuretics such as mannitol is that they are filtered in the glomerulus , but cannot be reabsorbed. Thus their presence leads to an increase in the osmolarity of the filtrate and to maintain osmotic balance, water is retained in the urine. Glucose , like mannitol, is a sugar that can behave as an osmotic diuretic. Unlike mannitol, glucose is commonly found in

10509-417: The process in which an individual falls into the binge-purge cycle and thus develops bulimia. Fairburn et al. argue that extreme concern with weight and shape coupled with low self-esteem will result in strict, rigid, and inflexible dietary rules. Accordingly, this would lead to unrealistically restricted eating, which may consequently induce an eventual "slip" where the individual commits a minor infraction of

10622-725: The proximal tubule via the organic anion transporter-1 and exert their diuretic action by binding to the Na(+)-K(+)-2Cl(-) co-transporter type 2 in the thick ascending limb and the Na(+)-Cl(-) co-transporter in the distal convoluted tubule, respectively. Caffeine when initially consumed in large quantities is both a diuretic and a natriuretic , but this effect disappears with chronic consumption. The main adverse effects of diuretics are hypovolemia , hypokalemia , hyperkalemia , hyponatremia , metabolic alkalosis , metabolic acidosis , and hyperuricemia . A common application of diuretics

10735-430: The psychological disorder "bulimia nervosa" is relatively new, the word "bulimia", signifying overeating, has been present for centuries. The Babylon Talmud referenced practices of "bulimia", yet scholars believe that this simply referred to overeating without the purging or the psychological implications bulimia nervosa. In fact, a search for evidence of bulimia nervosa from the 17th to late 19th century revealed that only

10848-418: The reduction in blood pressure is not due to decreased blood volume resulting from increased urine production , but occurs through other mechanisms and at lower doses than that required to produce diuresis . Indapamide was specifically designed with this in mind, and has a larger therapeutic window for hypertension (without pronounced diuresis) than most other diuretics. High-ceiling diuretics may cause

10961-427: The regulation of appetite and energy balance are observed in individuals with bulimia nervosa, but it remains unknown if this is a state or trait. In recent years, evolutionary psychiatry as an emerging scientific discipline has been studying mental disorders from an evolutionary perspective. If eating disorders, Bulimia nervosa in particular, have evolutionary functions or if they are new modern "lifestyle" problems

11074-756: The role of personality in the rise to leadership have shown that individuals who rise to leadership positions can be described as inter-personally dominant, extraverted, and socially skilled. When examining the correlation of narcissism in the rise to leadership positions, narcissists who are often inter-personally dominant, extraverted, and socially skilled, were also likely to rise to leadership but were more likely to emerge as leaders in situations where they were not known, such as in outside hires (versus internal promotions). Paradoxically, narcissism can present as characteristics that facilitate an individual's rise to leadership, and ultimately lead that person to underachieve or even to fail. Narcissism can also create problems in

11187-407: The secretion of potassium into the urine; thus, potassium is retained and not lost as much as with other diuretics. The term "potassium-sparing" refers to an effect rather than a mechanism or location; nonetheless, the term almost always refers to two specific classes that have their effect at similar locations: The term "calcium-sparing diuretic" is sometimes used to identify agents that result in

11300-513: The situation in the beginning and gradually letting the adolescent become more autonomous when they have learned healthier eating habits. Antidepressants of the selective serotonin reuptake inhibitors (SSRI) class may have a modest benefit. This includes fluoxetine , also known as prozac, which is FDA approved, for the treatment of bulimia, other antidepressants such as sertraline may also be effective against bulimia. Topiramate may also be useful but has greater side effects. Compared to placebo,

11413-537: The skin. Use of some drugs , especially stimulants , may also increase blood glucose and thus increase urination. . The term "low-ceiling diuretic" is used to indicate a diuretic has a rapidly flattening dose effect curve (in contrast to "high-ceiling", where the relationship is close to linear). Certain classes of diuretic are in this category, such as the thiazides . Diuretics are tools of considerable therapeutic importance. First, they effectively reduce blood pressure . Loop and thiazide diuretics are secreted from

11526-531: The stage where their brains are still quite malleable and developing gradually. Therefore, young adolescents with BN are less likely to realize the detrimental consequences of becoming bulimic and have less motivation to change, which is why FBT would be useful to have families intervene and support the teens. Working with BN patients and their families in FBT can empower the families by having them involved in their adolescent's food choices and behaviors, taking more control of

11639-544: The strict and inflexible dietary rules. Moreover, the cognitive distortion due to dichotomous thinking leads the individual to binge. The binge subsequently should trigger a perceived loss of control, promoting the individual to purge in hope of counteracting the binge. However, Fairburn et al. assert the cycle repeats itself, and thus consider the binge-purge cycle to be self-perpetuating. In contrast, Byrne and Mclean's findings differed slightly from Fairburn et al. ' s cognitive-behavioral model of bulimia nervosa in that

11752-420: The subject including: This extent of the controversy was on public display in 2010–2013 when the committee on personality disorders for the 5th Edition (2013) of the Diagnostic and Statistical Manual of Mental Disorders recommended the removal of Narcissistic Personality from the manual. A contentious three-year debate unfolded in the clinical community with one of the sharpest critics being John G. Gunderson ,

11865-490: The term "narcissism", independently of each other, to describe a person who treats their own body in the same way in which the body of a sexual partner is ordinarily treated. Narcissism, in this context, was seen as a perversion that consumed a person's entire sexual life. In 1911 Otto Rank published the first clinical paper about narcissism, linking it to vanity and self-admiration. In an essay in 1913 called "The God complex ", Ernest Jones considered extreme narcissism as

11978-490: The therapy to work, all parties must work together to discuss, record and develop coping strategies. Barker (2003) claims by making people aware of their actions they will think of alternatives. People undergoing CBT who exhibit early behavioral changes are most likely to achieve the best treatment outcomes in the long run. Researchers have also reported some positive outcomes for interpersonal psychotherapy and dialectical behavior therapy . Maudsley family therapy , developed at

12091-449: The thin ideal internalization as a factor of bulimia nervosa is Thompson's and Stice's research. Their study aimed to investigate how and to what degree media affects the thin ideal internalization. Thompson and Stice used randomized experiments (more specifically programs) dedicated to teaching young women how to be more critical when it comes to media, to reduce thin-ideal internalization. The results showed that by creating more awareness of

12204-609: The thin ideal is accepted, one could begin to feel uncomfortable with their body shape or size since it may not necessarily reflect the thin ideal set out by society. Thus, people feeling uncomfortable with their bodies may result in body dissatisfaction and may develop a certain drive for thinness. Consequently, body dissatisfaction coupled with a drive for thinness is thought to promote dieting and negative effects, which could eventually lead to bulimic symptoms such as purging or bingeing. Binges lead to self-disgust which causes purging to prevent weight gain. A study dedicated to investigating

12317-637: The use of a single antidepressant has been shown to be effective. Combining medication with counseling can improve outcomes in some circumstances. Some positive outcomes of treatments can include: abstinence from binge eating, a decrease in obsessive behaviors to lose weight and in shape preoccupation, less severe psychiatric symptoms, a desire to counter the effects of binge eating, as well as an improvement in social functioning and reduced relapse rates. Some researchers have also claimed positive outcomes in hypnotherapy . The first use of hypnotherapy in Bulimic patients

12430-419: The validation they expect. This pressure to maintain an idealized online persona can lead to emotional distress, especially when their real-world interactions do not match the image they present online. Narcissism is one of the three traits in the dark triad model. The dark triad of personality traits – narcissism, Machiavellianism, and psychopathy – shows how narcissism relates to manipulative behaviors and

12543-475: The way narcissism and the clinical disorder narcissistic personality disorder are defined today. His patient was a successful scientist with an attitude of superiority, an obsession with fostering self-respect, and a lack of normal feelings of guilt. The patient was aloof and independent from others, had an inability to empathize with others, and was selfish sexually. Waelder's patient was also overly logical and analytical and valued abstract intellectual thought over

12656-445: Was in 1981. When it comes to hypnotherapy, Bulimic patients are easier to hypnotize than Anorexia Nervosa patients. In Bulimic patients, hypnotherapy focuses on learning self-control when it comes to binging and vomiting, strengthening stimulus control techniques, enhancing ones ego, improving weight control, and helping overweight patients see their body differently (have a different image). Being female and having bulimia nervosa takes

12769-738: Was recorded in Xenophon's Anabasis around 370 B.C, in which Greek soldiers purged themselves in the mountains of Asia Minor . It is unclear whether this purging was preceded by binging. In ancient Egypt, physicians recommended purging once a month for three days to preserve health. This practice stemmed from the belief that human diseases were caused by the food itself. In ancient Rome, elite society members would vomit to "make room" in their stomachs for more food at all-day banquets. Emperors Claudius and Vitellius both were gluttonous and obese, and they often resorted to habitual purging. Historical records also suggest that some saints who developed anorexia (as

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