Psychological Explanations of AN

It is debated whether Anorexia Nervosa (AN) is caused by psychological factors alone.

Arguing for the influence of psychological factors in AN, behavioural theories suggest that women are vicariously reinforced (Social Learning Theory, Bandura) to lose weight by observing high status role models in the mass media being reinforced for their slimness (e.g. Kate Moss). According to Classical Conditioning (Pavlov), anorexics are likely to associate food and weight gain with anxiety, and will be directly positively reinforced to continue dieting by peoples' compliments or concern in response to their weight loss (Operant Conditioning, Skinner).

Strong research evidence to support the role of behavioural explanations of AN comes from a meta-analysis of 25 studies which found that non-clinical women felt more negatively about their body image after being show idealised role model images of slim women. This shows the influence of SLT in AN as women learn their dissatisfaction from the mass media.

Further, compelling evidence to support the role of behavioural explanations of AN comes from Hock who found that the black inhabitants of the Caribbean Island Curacao were less likely to develop AN than the white inhabitants. This shows the influence of SLT in AN as Black role models tend to be curvaceous (Beyoncé) and White role models tend to be slimmer (Taylor Swift), therefore this is why more white, middle class women are likely to develop AN.

Finally, strong evidence to support the role of behavioural explanations of AN comes from Behavioural therapies that have been used to successfully treat AN (e.g. by rewarding patients for maintaining a particular body weight). This shows the influence of Operant Conditioning as a therapy for AN as through positive reinforcement it is possible for them to gain weight, and if it works as a treatment it is also likely to be a cause, such as complements about being skinny.

Arguing for the influence of psychological factors in AN, cognitive factors suggest that one of the clinical characteristics of AN is the negative body image shown by sufferer, which causes them to exaggerate the importance of their weight and perceive themselves as larger than they actually are. Cognitive psychologists believe this body image distortion is the cause of AN, rather than merely a symptom.

Strong evidence for the role of cognitive explanations of AN comes from Garfinkle and Garner who are AN patients to choose their genuine body image from a range of images (of themselves) which has been manipulated to look larger or slimmer. AN sufferers overestimated their body size, by choosing an image that was larger than reality. Also Fallow and Rozin also provide support for this as they asked non-clinical male and female participants to estimate their current body size, and the size that would be most attractive to the opposite sex. Female participants were likely to overestimate their current body size and underestimate the size found most attractive by the opposite sex. Both pieces of research show that body image distortion is present in clinical and non-clinical women, therefore must be the cause of AN, rather than merely a symptom.

Also arguing for the influence of psychological factors in AN, psychodynamic explanations suggest that AN can be causes by postponement of menstruation (Crisp, 1980); as AN often causes amenorrhoea (loss of menstrual cycle) it is argued that AN is the outcome of an unconscious attempt to postpone the onset of adulthood, by postponing menstruation and returning to a pre-pubescent state. Additionally, and maybe more convincingly it also suggests that AN can develop unconsciously to divert attention away from family problems. In particular, the concept of 'Enmeshment' has been identified as a cause of AN. This refers to the over-involvement of parents, stopping the child from developing genuine independence (meaning they can only express their independence through eating behaviour).

Compelling evidence for the role of psychodynamic explanations of AN comes from Bruch who used case studies of 64 AN patients to investigate their family relationships. She found that AN patients describes difficulties expressing their independence in their families and often reported conflict with their parents (in particular their mother). Furthermore, psychodynamic therapies are successfully being used to treat AN. In particular family therapy (which resolves conflicts in family relationships) has been most effective. This shows that AN can develop unconsciously to divert attention away from family problems. In particular, the concept of 'Enmeshment' which refers to the over-involvement of parents, stopping the child from developing genuine independence (meaning they can only express their independence through eating behaviour).

However, despite this supporting research, undermining the role of psychological factors for the cause of AN, psychodynamic explanations can be criticised for being unfalsifiable and speculative, this is when the theory cannot be tested using an I.V and a D.V and it makes assumptions beyond the findings of research. This is because psychodynamic explanations are based upon unconscious thoughts which cannot be tested and are therefore assumed.

Therefore, despite its limitations, it is clear that AN is likely to be largely caused by psychological factors, though particularly the interaction between cognitive and behavioural factors.