Eating disorders - causation models Flashcards
Name the four main eating disorders
Anorexia Nervosa; Bulimia Nervosa; Binge Eating Dorder; Eating Disorder Otherwise Specified (EDOS)
Define how eating disorders are recognisable
By disordered eating habits EG avoiding, binging or restricting consumption and absorption of food.
Who does eating disorders effect the most? Please add statistics for each disorder
Women mainly: Anorexia 20:1 women; effecting 0.5%-1% of teen girls. Bulimia 1.2% women aged 16-35 Binging 3.6% women; 2.1% men EDOS unknow?
Symptoms of Anorexia Nervosa
a. Restriction of food intake
b. Dangerously underweight
c. Inhibits growth and productive organ (periods stop)
d. Impairs both physical and mental health
e. Distorted beliefs of body type, see self as fat when
dangerously underweight
f. Fear gaining weight
g. Choose foods low in calories and fat
h. Obsessed with body shape/type
TWO TYPES OF ANOREXIA:
- Restrictive: no binging: fasting/starving: excess exercising
- Binge Eating: Eating: purging = vomiting/laxatives
Symptoms of Bulimia Nervosa
a. Eating larger portions of food than normal (eg eating
equivalent of two+ portions in one meal)
b. Person feel out of control
c. Persistent weight gain prevention = Fasting, purging,
excessive exercising, medication for weight
reduction
d. Binging and purging more than once a week for 3
months
e. Motivation is body weight/shape
Symptoms of Binge Eating Disorder
a. Consuming larger portions of food than normal in
one meal.
b. Fast eating
c. Eating until uncomfortably full
d. No control over eating, even when full/eating one
thing after another, mixing food types (puddings with
main). Just eating anything, for the sake of eating.
e. Eating when not hungry
f. Secret eating
g. Feelings of shame, loathing self, depressed, very
guilty.
Name three models of causation
- Quality of Family dynamic
- Pre-dispositional (personality traits)
- Cognitive deficits - genetics
Describe Family Dynamic model
For:
Schmide, Humfress, and Treasure (1997) = Childhood experiences are a causal factor of eating disorders. More especially in families who are over bearing, protective, controlling. Enmeshment family structures (families without clear, defined boundaries. Families who live cold and separate lives to one another).
Abuse from family:
Physical and mental, and sexual abuse are causations.
Strober and Yager (1985). Similar to above
Two theories
Centripetal = Family all consuming/controlling/intense (like the petal of a rose)
Centrifugal = Opposite to above, lack interactive relationships, lack of love, communication and lots of conflict.
Weak attachments cause eating disorders. Family dysfunctional type trigger eating disorder type.
Studies have shown that dysfunctional families are at the heart of of eating disorders.
Ward (2000) = This model is too simplistic. Family dysfunctional behaviours are secondary, because causation of eating disorders is too complex.
Empirical studies have produced mixed results between eating disorders and dysfunctional families.
FAMILY GENES:
Extensive research on 600 families with 2+ members with anorexia/bulimia and 700 families with 3+ FOUND chromosomes 1 and 10 were linked to anorexia and bulimia.
If genetics play a role in anorexia and bulimia, conditions can be dormant until triggered by either social pressures, or stresses/crisis.
Genetic cognitive deficits and impact of family influence (copying what your mother/dad/siblings/grandparents do) … may also contribute as triggers for the onset of eating disorders.
Therefore, family influences may be present in how families function and their genetics, but eating disorders may surface during stressful situations or by social pressures. Concluding that family dynamics model is secondary.
Describe Pre-disponsitional model
Pre-dispositional model or personality traits believes individuals with specific personalities will be more likely to have an eating disorder.
Personality traits help frame the eating disorder for effective psychological treatment.
Five main personality traits:
- Anxious
- Perfectionism
- Sensation seeking
- Obsessive
- Neroticism
Bruch (1973) found children with higher levels of compliances, perfectionism and dependency, were more likely to develop an eating disorder.
Studies found that strong correlations between personality traits and eating disorders. Longitudinal studies of adolescent girls establishing personality traits before onset of eating disorders. 19 months later, found girls who had developed an eating disorder scored higher on neroticism. Therefore the pre-dispositional model strongly suggests people with high levels of some personality traits, such as, neroticism/perfectionism/obsessiveness are more likely to develop an eating disorder.
Therapy may benefit from knowing a persons personality trait.
Describe Cognitive Deficits model
Conflicting:
On the one hand: Eating disorders are caused by cognitive deficits in motor skills, sensors, body senses. For example, sensory hormones may alter hunger levels. Motor skills functions may be affected by levels of depression which may reduce appetite. Additionally, depression levels may alter a persons self-reflection in a negative way.
On the other hand, deprivation of nutrients may cause cognitive deficits. Thus affecting the patient through distorted beliefs of their appearances. May also increase levels of depression and increase low self-esteem. Other factors to consider also when nutrients are low, physical functioning of the body is interfered with causing mental consequences.
Another consideration is genetic cognitive deficits. May be at risk of greater damage if deprived of healthily nutrients, thus the negative effects will be greater.
Erratic eating habit cause physical and mental consequences. Cognitive deficits could result from genetics causing greater levels of vulnerability to eating disorders. Onset of eating disorder depriving consumption of food, and absorption of nutrients may also effect levels of cognitive functioning. The greater the cognitive deficit the greater chance of developing an eating disorder.
Strober & Yager (1985)
Quality of family relationship model
Centripetal- excessive cohesion
Centrifugal- lack of cohesion
Minuchun, Rosman & Baker 1978
First initial theory that particular family characteristics caused AN- enmesh meant, protectiveness, rigidity, avoidance of conflict & lack of conflict resolution
Schmidt, Humfress, & Treasure 1997
Binger-restricted dichotomy
Holtom-Viesel & Allan 2014
Analysis 17 papers and found over all ED families = constraining family rules &a less conflict.
AN fam- more cohesion, lower fam hierarchy & lack autonomy
BN fam- less flexible
Strober & Humphrey
BN- enmesh meant, poor conflict resolution , emotional-over involvement, detachment and a lack of affection &a empathy
Against: Polivy & Herman 2002
Conduct review on causes of ED & conclude that family dysfunction = spiff ect of ill fam member rather than cause
Against: Treasure et al 2008
Suggested that family dynamics a consequence rather than a cause
Against: Eisler 2005
Conducted review and found no consistent pattern
Holtom-Viesel & Allen 2014
In their study found similar levels of family cohesion to controls, no difference between ED families & control on adaptability & rigidity. Also saw mixed results between BN & AN fams on conflict n relation to controls.
Problem with model Le Grange et al., 2009
Overly simplistic
Erroneous
Blame families
Bring more focus on to families causing rather than aiding burdened families
Predispositional model
Suggests personality construct cause disorder
Based on Lyon et al., (1997) model that trait and disorder are superstore titles
Trait appears before disorder and increases risk of having disorder
Predispositional model
First implied by Bruch’s (1973) work on pre irbid characteristics: compliance, perfectionism and dependence
Evidence for: Linenfield (2006)
8 studies used prospective method (measure trait & ED time A and then again at time B)and found personality predictors: poor intro petite awareness, negative affect, neuroticism, ineffectiveness &a neuroticism
Bruch (1978) perfectionism
AN patients fulfil every parent’s and teachers idea of perfection
Against: Bardone-cone et al., (2002)
Did meta-analysis’ concluded that results were not in enough agreement and more longitudinal studies need to be done to truly establish weather perfectionism causes ED
Stein et al., 2002
Found perfectionism was present before diagnosis and after recovery in BN patients
Neuroticism Cevera et al., 2002
Conduct prospective study on young females. Those who had been found with high levelsof neuroticism were much more likely to develop an ED. Note: high self esteem = protecting factor
Claes et al., 2006
Found from sample of 335 female ED patients there were elevated score of neuroticism
Problems with Predispositional model
Link between perfectionism and Bulimia is less clear
Not all individuals who have associated traits with ED will developm one, suggesting other factors may be involved.
Class et al., (2007) pefectionism was positive in some contexts
Bardone-cone et al., (2007) no explanatory mechanism
Does not account for how different traits interacting one another in pathology outcome
Cognitive deficits model
Cause eating disorder
When people recover these deficits are still there
Suggestion that these deficits are caused by starvation but does not account for BN patients who also have them
Types of deficits
Visuospatial Organisational Tactile-perceptual Psycho-motor coordination Non-verbal problem solving Attention Long-term memory
Evidence for deficits Grunwald et al., 2001
Found somatosensory deficits remained despite weight gain
Evidence for Szmuckler 1992
When anorexics= re-fed 5/18 participants still had visuospatial ability controls
Evidence for Kingston et al., 1996
Visuoconstructional deficits that remained after re-feeding
Lena, Fiocco & Leyenaar (2014)
AN performed worse in 2/3 task required motor control and working memory
Against: Jones 1991, Laessel 1992 & Reiger 1998
found no differences in attention so tasks between EDs and controls
Problems
It can’t explain why do adults get better when they gain weight
Lena (2014) analysed 14 studies suggested that the validity of model is inconclusive
More studies need to be done on adolescents to determine whether deficits cause eating disorders
