anorexia

Question 1

features of anorexia

Answer 1

restrictive type

• show weight loss through dieting
• excessive exercise
• extreme periods of fasting

binge eating and purging type

• recurrent bouts of binge eating
• followed by bouts of purging
• self induced vomiting
• misuse of laxatives
• people with AN usually have high anorexia levels
• all must occur for 3 consecutive months

Question 2

symptoms of anorexia

Answer 2

Criteria A - (all about losing weight)

• restriction of energy intake and weight significantly below expected
• BMI of 18.5kg/m2 and below

Criteria B - (all about maintaining weight)

• intense fear of gaining weight (body weight already low)
• persistent exercise that interrupts gaining weight

Criteria C

• distortion of body image where weight is overestimated
• unable to accept severity of low body weight
• poor self image

Question 3

biological explanation for anorexia

Answer 3

Genetics:

• If genetics then frequency of anorexia in relatives of someone with it should be higher than population
• identical twins should be more concurrent

zeeland et al 2013: specific gene linked to disorder
- he compared 152 different genes in women with and without anorexia and found significant differences between EPHX2 gene
EPHX2 = enzyme that metabolises cholesterol suggesting that the disorder may be caused by a disruption in how the body processes cholesterol

Question 4

difference between concordance rates and heritability estimate

Answer 4

concordance rates is the probability that individuals will both have certain characteristics given that one has it

heritability estimate is the similarity between family members or twins that is due to genes

Question 5

family studies

Answer 5

Kipman et al 1999
- increased risk of AN on female relatives of someone who has the disorder than controls which supports genetic theory

• however, this could be that they share the same environment
• although, one relatives do no share the same environment e.g. aunt

Question 6

twin studies

Answer 6

Kipman 1999

• 46.2% MZ twins concordance for disorder
• 7.1% DZ twins
• 71% heritability estimate when it comes to anorexia

Question 7

biological explanation evaluation

Answer 7

pros
- supporting evidence from Kipmann

cons

• research is still new and little known
• difficult to separate biological explanation as a cause as opposed to being a result. Poor diet can cause a biological change making it hard to determine if genes are explanation

Question 8

non- biological theory

Answer 8

sociocultural theory = contributions society makes to individual development. Suggests that learning is a social process

Garner and Garfinkel 1980 - ‘slim is beautiful’ they found AN more common in dancer and model students because the social setting reflects in them having AN (slimmer physique required to do well)

Rackoff and Hoing 2006 - female athlete triad. Female may attempt to enhance performance by altering diet/ over exercising which can lead to amenorrhea, low bone density, disordered eating

Thompson and Johnson - looked at miss americas beauty across 20 years and found the average weight of contestants were decreasing but average weight of normal women were increasing. Suggests that the body type being celebrated as ideal was far from reality which makes women see themselves as fat

Garner et al 1980 - 10 year span and found that diet articles in magazines were increasing which suggests that society and culture has predisposition to the idea that slim is beautiful

Question 9

evaluation of the non-biological explanation of anorexia

Answer 9

Pros

• supporting evidence from the studies
• more males have anorexia which links with the changes in mens magazines to include more diet

Cons

• if theory is 100% then all dancers should have AN
• theory may only influence people with predisposition to develop the disorder
• reductionism as it doesn’t take into account other causes of AN
• cultural images and influences are something we are all exposed to but we all don’t have anorexia

Question 10

treatments of anorexia (intro CBT)

Answer 10

enhanced cognitive behavioural therapy

• tracks thoughts and behaviours linked to disordered eating
• ‘enhanced’ has developed so can be used to treat changing patterns linked to AN and targets multiple aspect
• one to one basis
• 20 sessions, very low weight 40
• life impacts highlighted and if severe they may be refused treatment

Question 11

stages of CBT

Answer 11

Stage 1: 4 weeks, 2 per week

• to encourage rapid change of behaviour
• weekly weigh in and regular eating
• patients briefed about disorder and treatment
• need positive mindset to see progress

Stage 2: 2 appointments, 1 week apart
- discuss progress being made in stage 1 and talk about how patient is currently doing
Good progress = praise to increase motivation
Bad progress = identify things that aren’t going well

Stage 3: 8 appointments, once a week

• tackle factors involved in the maintenance of E.D
• Body image = behaviours and triggers that make them feel fat
• Dietry rules = consider the impact of rules on life and foods being avoided gradually add to diet
• external events = that impact major changes in eating tackled

Stage 4: 3 appointments 2 weeks apart

• look into future and factors they need to manage to prevent relapse
• plan made together and personalise for specific circumstances
• post treatment review made after 5 months and they look at setbacks and issues

Question 12

evaluation for CBT

Answer 12

pros
- pike et al 2003: out of 33 patients the relapse rate of those receiving CBT-E was lower than nutritional counselling

cons

• client has to be motivated to change so this form of therapy does not cater to everyone
• for patients who live at home family therapy is better as CBT-E is most suited to older patients

Question 13

treatments for anorexia (drug therapy)

Answer 13

SSRI’s

• form of antidepressant
• block reuptake of serotonin in presynaptic neurones making more serotonin available in synapse. More serotonin can now be passed to post synaptic neurone and increase serotonin levels

Olanzapine

• atypical anti-psychotic drug, also used for anxiety
• block absorption of dopamine and serotonin in certain pathways

Question 14

evaluation for drug therapy

Answer 14

Pros

• good for comorbid conditions as medication enables patients to benefit more readily than psychological therapies
• 3 patients treated with olanzapine and found positive effects to patients body which suggests that antipsychotic effect makes patients body image more realistic

Cons

• AN patients are malnourished and may have serious heart issues and drugs have cardia side effects
• drugs can make patients gain weight
• there is little evidence that drugs are useful
• not to be used as a primary treatment