Cognitive explanations for AN

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  • Psychological explanations for anorexia (cognitive)
    • Cognitive distortions are a cause of An
      • Distrted image of ones body is central to the diagnosis of AN in the DSM-5
    • Those with AN filter experiences of life through three factors
      • 1. Disturbed perceptions (DP) about body shape and weight
        • Murphy: argued that the main clinical features of AN stem from DP
          • Create preoccupations with thoughts about food, eating and body shape
          • Leads to behaviours such as food restriction
          • Misinterpretation of emotional signals as a sign of becoming fat, even though they are getting skinnier
        • Overestimation of body size and weight
          • Williamson asked AN patients and a healthy control group to estimate their current and ideal body sizes
            • AN patients estimates were significantly less accurate and tended to overestimate their size
            • AN patients ideal bodies were significantly thinner then the control groups
      • 2. irrational beliefs defy logic
        • Beck: Attitudes about AN that do not make sense and they give rise to automatic negative thoughts
          • 'If I don't control my weight, I am worthless' (ALL OR NOTHING THINKING)
          • ''I ate half a biscuit, I have no willpower' (CATASTROPHISING)
        • Perfectionism is a key irrational belief in AN
          • A person who exhibits perfectionism will...
            • feels as if they must meet demanding standards in all aspects of life, especially in eating behaviours
            • Uses intensive record keeping to ensure that they reach their goal
            • Raise standards higher once targets are reached- forever pushing unrealistic goals and ending up in a cycle
      • 3. Cognitive inflexibility
        • AN patients have problems fluently switching between task requiring a different set of cognitive skills
          • Set shifting
          • Apply the same skills in a different situation where they are no longer useful
        • Treasure and Schmidt: cognitive interpersonal maintenance model
          • when a valunrable person begins weight loss process, they rigidly persist and continue to perceive themselves as needing to loose weight
            • They cannot think to an adaptive way of thinking about body size
              • Weight loss is a solution to a problem that no longer exists, but they cant perceive this accurately
    • Evaluation
      • Weaknesses
        • Contradictory research
          • A psychologist found no significant differences  between AN patients and healthy women in estimating their own body size
        • Distortions and irrational beliefs may not cause AN
          • Shott: found tounger patients with AN were no worse at set-shifting than the healthy controls, but the older patients were
            • It is instead a consequence of the disorder
      • Strengths
        • Support for perfectionism (Halmi)
          • found that perfectionism in childhood was a significant predictor of later development of AN in 728 women aged over 16
            • Suggests it is a casual risk factor
        • Support for cognitive distortions (Sachdev)
          • scanned AN patients brains and found less activation (compared to the control group) in areas involving attention when Pp viewed images of their own body
            • No difference in activation when seeing someone elses body
              • Distortions only linked to your own body

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