Clinical characteristics (DSM-IV-TR)
- Anxiety: excessive fear and anxious feeling of being fat
- Weight: it is considered abnormal when it drops below 83% of their normal weight, they may also repeatedly check their weight and obsessively try to control weight by excessive exercise
- Body image distortion: they do not see their own thinness and deny their own low body weight
- Amenorrhoea: the cessation of menstrual period for more than 3 months, usually caused by malnutrition
Psychological Explanations
Neural Explanations: Neurotransmitters
Dopamine
Recent studies suggest a role for dopamine in anorexia nervosa. Kaye et al (2005) used a PET scan to compare dopamine activity in the brains of 10 recovering women and 12 healthy women. In the AN women, they found over activity in dopamine receptors (basal ganglia). In this part of the brain dopamine plays a part in the interpretation of harm and pleasure. Increased activity in this area appears o alter the way people interpret rewards. Therefore those with Anorexia find it difficult to associate good feelings with the things that others find pleasurable, such as food.
Evaluation:
There is supporting evidence for the role of dopamine in individuals with AN. Castro- Fornieles et al (2006) found that adolescent girls with AN had higher levels of homovanillic acid (a waste product of dopamine) than a control group. Improvement in weight levels is associated with normalisation of homovanillic acid levels. Research has also shown lower than normal levels of dopamine receptors in the brains of obese individuals (Wang et al 2001). Therefore, levels of dopamine appear to be inversely related to weight, whether this is a cause or a consequence is not known.
Neural Explanations: Neurodevelopment
Pregnancy and Birth Complications
Lindberg and Hjern (2003) found a significant association between premature birth and development of AN. Birth complications may lead to brain damage from a lack of oxygen which may impair their neurodevelopment. Also, nutritional factors may be effected if mothers have an eating disorder. Bulik et al (2005) suggests that mothers with AN expose their children to both genetic vulnerability and nutrition inadequacy during pregnancy.
Evaluation:
There is support for the contribution of obstetric complications in the development on an eating disorder. Favaro et al (2006) found that the complications immediately before or after birth associated with developing AN were obstructed blood supply in the placenta, early eating difficulties and low birth weight.
Evolutionary Explanations
The Reproductive Suppression Hypothesis
Surbey (1987) suggests that adolescent girls desire to control their weight represents an evolutionary adaptation of delaying sexual menstruation in order o avoid having offspring that would be born at a bad time and would be unlikely to survive.
Evaluation:
The reproduction suppression hypothesis is supported by the observation hat the onset of puberty is delayed in girls with AN. Additionally, since amenorrhoea is a characteristic of AN, this means that reproduction is suspended in anorexic females. However, despite the supporting research, AN research suffers from gender bias. Most studies of eating disorders have focused on women despite recent statistics that suggest 25% of adults with an eating disorder are men. This suggests that AN is not solely a female disorder and cannot be explained in just term of the repression of reproduction as this is not applicable to men.
Psychological Explanations
Media Influence
The media are a major source of influence of body image attitudes of western adolescents. For example, thin models can cause teens to strive for similar thinness.
However, the media doesn’t affect everyone in the same way. Media will have a bigger impact on low self-esteem individuals. (Jones and Buckingham 2005)
Evaluation:
There is supporting evidence for the role of the media in shaping perceptions of body image. Eating attitudes and behaviours were studied among adolescent Fijian girls following the introduction of TV in 1995 (Becker et al 2002). The girls stated a desire to lose weight o become more like western TV characters. However, there have been positive real world applications of the research as the fashion industry in France has acknowledged the damaging influence of the media on body image by signing a charter of goodwill. He charter is the first step in preventing eating disorders and promoting a healthy body image. The charter involves a pledge by fashion houses, advertising agencies and magazine editors to use a diverse range of body types and not to stereotype the ‘thin ideal’.
- Psychological Explanations
- Peer Influence
Peer acceptance is especially important in adolescents so they may be especially susceptible to disordered eating patterns to gain acceptance or avoid teasing. Jones and Crawford (2006) found that overweight girls and underweight boys were most likely to be teased by their peers. This may suggest that through teasing, peers serve to enforce gender based ideas.
Hilde Brunch (1973) claimed that he origins are in early childhood. She distinguished between effective parents who respond appropriately to their children’s needs and ineffective parents who fail to respond to their internal needs. Children of ineffective parents may grow up confused about their internal needs, becoming overly reliant on heir parents. Adolescents aim to establish autonomy but many fail to do so and therefore they do no control their own bodies. This leads to trying to control it though their body shape and size by developing abnormal eating habits and thus an eating disorder develops.
Evaluation:
There is conflicting evidence on the relationship between peer influence and development of AN. Shroff and Thompson (2006) found no correlation among friends on measures of disordered eating in an adolescent sample. Although Jones and Crawford found overweight girls and underweight boys were more teased, those gender differences didn’t emerge until adolescence. A study of 10 year olds found a positive correlation between BI and teasing for both sexes. Therefore it can be concluded from the contradictory evidence hat a relationship between AN and peer influence is not always clear, suggesting that it can be solely attributed to the development on AN but may be a partial influence.
Anorexia Nervosa- Essay Plan
Psychological Explanations- Media Influences:
- Media are a major influence for Western Adolescents
- Doesn’t affect everyone in the same way. Low self- esteem individuals, bigger impact. JONES AND BUCKINGHAM 2005
AO2:
P: Supporting evidence
E: Fijian girls studied after introducing TV in 1995, found- they desired to be thin like TV characters and to lose weight. BECKER ET AL 2002
E: Positive real world applications- French fashion industry, signed a charter, aims to promote healthy body image- use a diverse range of body types and not to stereotype the ‘thin ideal’.
Psychological Explanations- Peer Influences:
- Peer acceptance is more important in adolescence, want to gain acceptance so adopt behaviours to gain it, avoid teasing.
- Overweight girls and underweight boys- most likely to be teased. Teasing= way to enforce gender based ideas. JONES AND CRAWFORD 2006
AO2:
P: Conflicting evidence
E: Shroff and Thompson 2006, no correlation of disordered eating among friends (adolescent sample)
E: Despite JONES AND CRAWFORDs findings, gender differences didn’t emerge until adolescence.
E: Whereas, a study of 10yr olds found + correlation between BMI and teasing for both sexes.
Neural Explanations- Neurotransmitters, Dopamine:
- PET scan compared 10 recovering AN women & 12 healthy women
- Found over-activity in dopamine receptors (basal ganglia): AN women
- Basal ganglia: plays a part in interpreting harm and pleasure.
- Over activity- alters the way rewards are interpreted. Therefore, AN people, hard to associate good feelings with food. KAYE ET AL 2005
P: Supporting evidence
E: CASTRO-FORNIELES ET AL 2006– adolescent girls with AN, higher levels of homovanillic acid (dopamine waste product)
E: Also found, low levels of dopamine receptors in obese individuals. WANG ET AL 2001
E: Levels of dopamine, inversely related to weight. Cause or Consequence?
Neural Explanations- Neurodevelopment, Pregnancy and Birth Complications:
- Association between premature birth and AN development
- Complications may lead to brain damage from hypoxia (lack of oxygen), impaired neurodevelopment. LINDBERG & HJERN 2003
- Mothers with AN expose to both genetic vulnerability and nutrition inadequacy. BULIK ET AL 2005
AO2:
P: Supporting evidence
E: complications immediately before or after birth associated with AN were- obstructed blood supply in the placenta, early eating difficulties and low birth weight.
Evolutionary Explanations- Reproduction Suppression Hypothesis
- Adolescent girls alter their weight, represents an evolutionary adaptation
- When women delayed sexual menstruation to avoid having offspring at a bad time, survival wouldn’t be likely. E.g. a famine. SURBEY 1987
AO2:
P: Supported by the observation that onset of puberty is delayed in AN girls.
E: Also, since amenorrhoea is a characteristic of AN, reproduction is delayed in females
E: However, despite all of the supporting research for various explanations
E: AN research suffers from a gender bias. Most studies focus on females- 25% of ED people are men.
E: Suggests- AN isn’t solely a female disorder and cannot be explained simply by the suppression of reproduction.