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NEDA TOOLKIT for Parents Cognitive Orientation Therapy (COT) A type of cognitive therapy that uses a systematic procedure to understand the meaning of a patient’s behavior by exploring certain themes such as aggression and avoidance. The procedure for modifying behavior then focuses on systematically changing the patient’s beliefs related to the themes and not directly to eating behavior Comorbid Conditions Multiple physical and/or mental conditions existing in a person at the same time. (See Dual Diagnosis.) Crisis Residential Treatment Services Short-term, round-the-clock help provided in a nonhospital setting during a crisis. The purposes of this care are to avoid inpatient hospitalization, help stabilize the individual in crisis, and determine the next appropriate step. Cure The treated condition or disorder is permanently gone, never to return in the individual who received treatment. Not to be confused with “remission.” (See Remission.) Dental Caries Tooth cavities. The teeth of people with bulimia who using vomiting as a purging method may be especially vulnerable to developing cavities because of the exposure of teeth to the high acid content of vomit. Depression (also called Major Depressive Disorder) A condition that is characterized by one or more major depressive episodes consisting of two or more weeks during which a person experiences a depressed mood or loss of interest or pleasure in nearly all activities. It is one of the mood disorders listed in the DSM-IV-R. (See Mood Disorders.) Diabetic Omission of Insulin A nonpurging method of compensating for excess calorie intake that may be used by a person with diabetes and bulimia. Dialectical Behavior Therapy (DBT) A type of behavioral therapy that views emotional deregulation as the core problem in bulimia nervosa. It involves teaching people with bulimia nervosa new skills to regulate negative emotions and replace dysfunctional behavior. A typical course of treatment is 20 group sessions lasting 2 hours once a week. (See Behavioral Therapy.) Disordered Eating Term used to describe any atypical eating behavior. Drunkorexia Behaviors that include any or all of the following: replacing food consumption with excessive alcohol consumption; consuming food along with sufficient amounts of alcohol to induce vomiting as a method of purging and numbing feelings. DSM-IV The fourth (and most current as of 2006) edition of the Diagnostic and Statistical Manual for Mental Disorders IV published by the American Psychiatric Association (APA). This manual lists mental diseases, conditions, and disorders, and also lists the criteria established by APA to diagnose them. Several different eating disorders are listed in the manual, including bulimia nervosa. DSM-IV Diagnostic Criteria A list of symptoms in the Diagnostic and Statistical Manual for Mental Disorders IV published by APA. The criteria describe the features of the mental diseases and disorders listed in the manual. For a particular mental disorder to be diagnosed in an individual, the individual must exhibit the symptoms listed in the criteria for that disorder. Many health plans require that a DSM-IV diagnosis be made by a qualified clinician before approving benefits for a patient seeking treatment for a mental disorder such as anorexia or bulimia. DSM-IV-R Diagnostic Criteria Criteria in the revised edition of the DSM-IV used to diagnose mental disorders. Dual Diagnosis Two mental health disorders in a patient at the same time, as diagnosed by a clinician. For example, a patient may be given a diagnosis of both bulimia nervosa and obsessive-compulsive disorder or anorexia and major depressive disorder. Eating Disorders Anonymous (EDA) A fellowship of individuals who share their experiences with each other to try to solve common problems and help each other recover from their eating disorders. Eating Disorders Not Otherwise Specified (ED-NOS) Any disorder of eating that does not meet the criteria for anorexia nervosa or bulimic nervosa. Eating Disorder Inventory (EDI) A self-report test that clinicians use with patients to diagnose specific eating disorders and determine the severity of a patient’s condition. Page | 88