Psychological Explanations for Anorexia Nervosa

• Anorexia fits into one of three categories of eating disorders.
• An eating disorder is a maladaptive or a dysfunctional relationship with food.
• It symptoms appear in 4 different types; physical, cognitive emotional and behavioural.
• It is characterised by 4 criteria set out by the DSM iv (Diagnostic and Statistical Manual of Mental Disorders). These are:

1. Anxiety; the fear of being fat.

2. Weight; weight drops below average. 

3. Body Image distortion; they see their weight and shape as distorted.

4. Amenorrhoea; the stopping of the menstrual cycle.

Cultural Ideas

AO1; It is a widely held belief that western standards of attractiveness are an important factor to the development of anorexia nervosa (AN). Many studies have reported that teenagers (mainly girls) have a disorted view of their body image. 16% of girls aged 15-18 stated that they were currently on a diet.

AO2; There is a view that AN is rare in non-western cultures. Hoek (1998) tested this theory. Researchers examined records of over 44,000 people admitted to hospital between 1987 and 1989 in Curacao (it is more acceptable to be overweight here). They found only six cases of AN. This suggests that anerexia still exists but may be rarer in non-western cultures.

Media Influences

AO1; The Media in an important influence for body image attitudes. The portrayal of thin models in the media is a significant factor in body image concerns and the strive for thinness among western adolescent girls. The media does not influence everyone this way though.

AO2; The media may influence the perception of body image. Fijian girls were introduced to television in 1995. The girls then had a greater desire to loose weight. However, if someone were to talk to them about it beforehand, the effects may not be as bad. This is instructional intervention.

Ethnicity

AO1; Other cultural groups do not place the same value on thinness as an ideal for women. In AN in non-western cultures, black populations is much lower than a white society. In many non-western cultures, there are more positive attitudes towards larger body sizes.

AO2; There may be a problem with studies into ethnicity. Not all studies found differences in the incidence of AN between black and white groups. Cachelin and Regan (2006) found no difference in disordered eating in a adolescent sample. This stereotype only appears to to be true in older adults.

Peer Influences

AO1; Peer acceptance is important during adolescence. This makes adolescence more suceptible to peer influence on patterns of disordered eating. A US study found that dieting among friends was related to unhealthy weight control behaviour (Eisenberg). One mechanism of peer influence is teasing.

AO2; Research does not always show a significant relationship between peer influence and the development of AN. Shroff and Thompson found no correlation between friends on measures of disordered eating in an adolescent sample. This suggests that peer influence may not be the mean reason that an adolescene may develop AN.

Bruch's Psychodymanic Theory

 AO1; Hilde Bruch (1973) said that the orgins of AN are in early childhood. She pointed out the difference between effective parents who responded appropriately to their child's needs and ineffective parents who failed to respond to their child's internal needs. An ineffective parent may feed a child when they need comforting and vice versa. These children may grow up confused about their needs and become overly reliant on their parents.

Adolescence have an increasign desire to establish autonomy, but these adolescence are unable to do so. To overcome this sense of helplessness they can take control of their body shape by developing abnormal eating habits.

A02; This theory is supported by observations of parents. Bruch found that many of these parents claimed to 'anticipate' their childs needs rather than letting them feel hungry. People worry about how other view them and feel a lack of control over their lives.

Personality

Perfectionism

A01; This is often found in individuals with an eating disorder. Strober Et Al (2006) evaluated personality traits in teenagers recieving treatment for AN. They found high levels of perfectionism in 73% of the girls and 50% in the boys. 

A02; The importance of perfectionism is a risk factor for AN. One study shows the importance of perfectionism in the duration of AN. Individuals who had a short illness duration had lower levels of perfectionism, and those with higher levels were more at risk of long illness duration. 

Impulsiveness

A01; Recent research has that people with AN act more impulsively than self report. Butler and Montogomery (2001) found that patients with AN responded rapidly but inaccurately to a performance task, indicating behavioural impulsiveness, despite their low self report ipulsiveness. 

A02; There are methodological problems with this. These probles include seperating out lasting personality traits from short-lived states that may be caused by starvation. Clinically diagnosed samples represent a biased view of the relationship between personality and disordered eating. 

Ethical Issues and Research

Researchers are turning to the internet as a source of data relating to AN from those who have the disorder and from those who support them. These include discussion boards, chatrooms and newsgroups. 

However, internet research on AN also raised several ethical issues in relation to privacy, informed consent, confidentiality and the protection from harm. 

Real Worls Applications

The fashion industry in France is trying to change the damaging influence of the media on body shape by signing a charted of good will. The charter is a first step in stopping eating disorders  and promoting a healthy body image. These include methods such as advertising AN as a bad thing on things such *** billboards.