Anorexia Nervosa
- Created by: Natalie867
- Created on: 29-04-15 14:18
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- Anorexia Nervosa (AN)
- Clinical character-isitics
- Anxiety and dissatisfact-ion with body weight and/or shape
- A body weight 85% or less than normal weight for age.
- Loss of 3 consecutive menstrual cycles (amenorroea)
- Distorted perception of body weight.Do not see their own thinness
- Prevalence
- 0.9% of females
- 0.3% of males
- Over 90% of cases are female.
- Most cases are in early teens to late 20's.
- More people in their 30's, 40's and children are being diagnosed.
- Prognosis
- AN often develops into Bulimia Nervosa.
- Very resistant to treatment.
- 30-40% show no improvemnt over 5 years
- 1/3 live with the condition all their lives and learn to manage it.
- mortality rate: 8% (often through suicide).
- Biologiclal explanation
- Evolutionary explanations
- Adapted to Flee Famine Hypothesis (AFFH). Guisinger (2003)
- In the EEA, hunter-gatherers had to move on regularly as food supplies in the local area were exhausted
- Key character-istics of people with AN include restlessness and high levels of activity.
- A normal reaction to starvation/we-ight loss would be depression and inactivity.
- High levels of activity and denial of hunger help the individual to migrate in reponse to famine.
- AO2
- doesnt explain why it affects women more than men.
- Explains why AN sufferers deny their hunger and have increased activity levels.
- Men with these characteristics get called 'sportsmen' and women get called 'anorexics'.
- Post-hoc
- Unscientific
- Deterministic
- Doesnt account for the 'westernisat-ion' of AN.
- Treatment Implications
- Removes the 'control' issue.
- Aids understand-ing of the sufferer, it removes blame.
- Adapted to Flee Famine Hypothesis (AFFH). Guisinger (2003)
- Genetic explanations
- Dizygotic (DZ): share 50% of their genes. Monozygotic (MZ): share 100% of their genes.
- Strober et al (1990)- parents of Anorexic daughters were 4X more likely than average to have the disorder themselves
- Eating disorders (ED) tend to run in families.
- Kaye (1999)-10% of ED patients have a reative who also sufferes from an ED.
- depression, anxiety and OCD are more prevelant in families of ED patients.
- AO2: difficult to seperate the effects of genes from the effects of the shared environment.
- Holland et al (1984)- Concordance rates for anorexia.
- 55% MZ twins.
- 7% DZ twins.
- Reduces confounding effect of a shared environment.
- sugessts a genetic contribution, but not a cause.
- AO2: small sample, findings not always replicated (e.g. Wade et al 1998).
- Neural factors
- Kaye et al (2005)-found a reduction in levels of the serotonin metabolite 5-HIAA in people with eating disorders.
- AO2
- Suggests that the serotonin pathways are underactive.
- Done on people who are currently suffereing from AN-serotonin levels could have been affected by starvation.
- How do we know that it is the cause?
- AO2
- PET Scans
- Fewer serotonin receptors in the brain of AN sufferers.
- AO2- SSRI's arent effective for AN- other factors must be involved.
- ok in preventing relapse.
- AO2- SSRI's arent effective for AN- other factors must be involved.
- Fewer serotonin receptors in the brain of AN sufferers.
- Kaye et al (2005)-found a reduction in levels of the serotonin metabolite 5-HIAA in people with eating disorders.
- Evolutionary explanations
- Psychological explanations of AN
- Sociocultural Influences
- Early examples from tyhe 19th Century (Gull, 1874).
- Hock et al (1998)-Curacao.
- They are both affected by their culture.
- Survey of the majority black population in Curacao in the Caribbean.
- Black inhabitants had no AN. White population had similar eating behavior to the US.
- Whites aspired to a western represen-tation of an ideal body weight (petite).
- Black population had a larger ideal body shape.
- AO2
- Social desirability bias.
- Relying on memory and honesty.
- Nature VS nurture.
- Medicines can target the population most prone to AN.
- Becker et al (2002)-Fiji study
- Study of 63 Fijian school girls
- 2 samples-before TV and after TV. Were interviewd and also took a questionairre on eating behaviour.
- Findings; disorded eating was more prevelant following exposure to TV. Stated a desire to lose weight to model themselves on TV characters.
- AO2
- High ecological validity
- Low reliability
- Natural experiment
- cultural pressures that glorify "thinness" and place a high value on obtaining the the 'perfect body'.
- Narrow definitions of beauty.
- helped by social learning theory.
- limitation of role models.
- Vicarious reinforce-ment-praise being put on someone because they are thin.
- Keel & Klump (2003). Are ED's culture-bound syndromes?
- Major review of cross-cultural and historical studies of ED.
- Bulimia is culture-bound, AN is not.
- AN-found in all cultures studied. even those not exposed to cultural influences.
- Historical examples of AN are frequent (found in 12th C)
- Cultural factors may influence AN but these are not sufficient or necessary.
- AO2
- Expansive study.
- Includes quantitative and qualitative data-increases reliability and validity.
- depriving someone of media will not prevent AN.
- Nature VS nurture.
- Psycho-dynamic explanations
- Causes of anorexia: (Bruch, 1973).
- 1. Ineffective parenting (e.g. thinking the child is hungry when they actually cold).
- 2. Child is confused about internal needs-reliant onthe parents.
- 3. Adolesence-want autonomy.
- 4. Eating behaviour can be controlled-abnormal eating habits.
- Crisp (1980)-amenorrhea is an attempt to remain a child and postpone adult reponsibility.
- Minuchin (et al (1978)-
- AN is used to divert attention away from other family problems (e.g relationship breakdown). Its a misguided attempt to keep the family together.
- AO2
- Which comes first?
- High face validity-but dificult to test scientifically and often based on cases studies
- Psycho-therapy and family treatment is often successful.
- Causes of anorexia: (Bruch, 1973).
- Sociocultural Influences
- Clinical character-isitics
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