Lecture 9 and 10 - causes and risk factors

Question 1

Set point theory

Answer 1

Biological: bodies resist marked variation playing a role

Question 2

Genetic contribution of AN (research)

Answer 2

Strober (2002) - EDs 3x more common among relatives of AN and BN patients comapred to relative controls - some transmissibility

Question 3

How is genetic influence mediated?

Answer 3

via the determination of…

• body weight/shape/size
• brain chemistry
• personality traits

Question 4

Neurotransmitter dysfunctions:

Answer 4

Seretonin: AN have low levels of 5HT metabolites (specific abnormalities not identified yet)
Dopamine: hyper - sensitivity of the DA system

Question 5

Neurotransmitter dysfunctions research

Answer 5

Kaye et al 2009 - In AN dieting reduces eating, leads to weight loss, leads to changes in neurotransmitter

Question 6

puberty and role of sex hormones

Answer 6

• arise from psychological effects (dystatisfcation w body etc)
• before puberty 0% genetic influences but genetic factors influenced 50% after puberty
• Oestradiol (ovarian hormones) may activate genetic risk of eating disorder

Question 7

Role of leptin and grehlin

Answer 7

Leptin is satiety hormone and grehlin is hunger hormone - disrupted in AN patients

Question 8

ABA model (activity based anorexia)

Answer 8

Rodent studies show caloric restriction combined with access to running wheel leads to rapid increase in loco - motor activity - reduce food intake and eventually death

Question 9

Research: ABA - hyperactivity in AN

Answer 9

40-80% AN patient’s excessive levels of activity to motor restlessness - deliberate calorie-burning weight reduction strategy, coping strategy to suppress neg states and form of thermoregulatory behaviour (Carrera et al 2012 warming is beneficial treatment)

Question 10

Individual risk factors (8)

Answer 10

• Gender and age
• Negative body image
• Internalization of thin ideal
• Perfectionism
• Neurocognitive impairments
• Dieting
• Negatively emotionally
• Childhood sexual abuse (debateable)

Question 11

Reserach: Internalization of thin ideal

Answer 11

Women rate their own body shape as heavier than their ideal and what they think is attractive (fallon and rozin 1985)

Question 12

neurocognitive impairments

Answer 12

difficulties may be an intermediate phenotype triggered by a specific neurocognitive profile - poor set shifting, weak central coherence

Question 13

Research: neurocognitive impairments

Answer 13

Lang et al 2015 - no diff in IQ but AN showed more errors on WCST and lower styles on central coherence scores (inflexible thinking etc)

Question 14

Research: social and emotion processing

Answer 14

Kanakam et al 2013 - disordered eating is a maladaptive strategy to regulate emotions which is reinforced with the temporary reduction of anxiety - twins with AN have difficulty w emotion recognition and stronger attentional bias to social threat

Question 15

Sociocultural: family characteristics of AN

Answer 15

• limited tolerance of disharmony, tension or poor conflict resolution skills
• propriety and rule-mindedness
• parental over - direction of child, discouragement
• preoccupations with thinness, dieting etc

Question 16

Research: fam characteristics

Answer 16

Not always the mothers to blame - one study found that eating and weight problems were predicted by low parental affection, communication and time spent with child, Johnson, et al. (2002)

Question 17

Media influences

Answer 17

• female idols
• pro ED sites
  increase in dieting/weight websites
• changes in ‘ideal’ women

Question 18

Research: media influences

Answer 18

Katzmarzyk and Davis 2001 - shows trend of women’s actual weight comapred to play boys and miss America

Question 19

Research: peer influence negative self-image

Answer 19

McLean et al (2015) - girls engaging in social media photos, reported higher overvaluation of shape weight etc - - Active SM use may be a maintaining factor for body-related/ eating concerns – not likely to be the sole cause for Eds

Question 20

Socio cultural: culture

Answer 20

western cultures historically associated with EDs - thinness desirable but EDs becoming more common among females in high-income asian societies and more.

Question 21

Research - Socio cultural: culture

Answer 21

Becker et al 2002 - natural environment, Fijian adolescents exposed to westernised tv for the first time - - Within 3 years the number of girls who vomited to control weight rose from 0% to 11% and increased score on EAT-26 scale

Question 22

Research - socio cultural: Keel & Klump (2003) – historical survey and meta-analysis

Answer 22

AN more historically and culturally reported (sometimes lacking western influence) - strong genetic basis for AN less so for BN

Question 23

The Cognitive Interpersonal Maintenance Model of AN

Answer 23

(Treasure & Schmidt, 2013) - Model proposes that cognitive, socio-emotional, and interpersonal elements act together to cause and maintain AN. Includes premorbid traits, cognitive processing style, socio emotion impairments, shared fam traits

Question 24

Obesity DSM - 5?

Answer 24

obesity is not ED but central problem is habit/addiction to food - controversial that it is a mental disorder however is an increasing acceptance

Question 25

Binge eating disorder DMS - 5

Answer 25

• frequent episodes of binge eating disorder
• typically overweight/obese - no compensatory weight loss behaviour
• unhappiness and lack of control

Question 26

Fam influences: obesity

Answer 26

• high fat/ calorie diet
• eating to alleviate distress/ show love
• overfeeding
• “Socially contagious” obesity – if around someone who is obese a lot, it may influence our behaviour due to influencing our social norms

Question 27

stress and comfor food

Answer 27

• watching TV
• attending parties
• becoming anxious, angry, or bored