Laung ulsorders

sychology 360
lall 2013
Mlchelle 8amos, h.u.
!"#$% '()*+,-+)
Barbie
Height: 6
Weight: 101
(recommended
weight, 140)
Dress Size: 4
Bust Size: 39
Waist: 19
Hips: 33
Fact #1: Shes
likely stopped
menstruating.
Fact #2: If she
was a real
person, she
would not be
able to stand
because of her
bust size.
Cur Changlng 8eauLy SLandards:
Medla SpeculaLes: 1oo laL, 1oo Lhln
Stars criticized if
perceived to be outside of
normal ranges:
8ody ulssausfacuon: normauve ulsconLenL
PBS NOVA Special, Dying to be Thin
Video:
http://www.pbs.org/wgbh/nova/thin/program.html#
Anorexla nervosa
8efusal Lo malnLaln body welghL
aL or above mlnlmally normal
welghL for helghL & age by
resLrlcung calorlc lnLake
lnLense fear of galnlng welghL
unreallsuc percepuon or focus
on body welghL
Anorexla nervosa
AlmosL always
assoclaLed wlLh
slgnlcanL medlcal
compllcauons
MorLallLy raLes are
qulLe hlgh





SubLypes of Anorexla nervosa
uSM-3 allows for Lwo
subLypes of Anorexla:
8esLrlcung subLype:
Avolds Lhe consumpuon
of food buL does noL
engage ln blnglng and
purglng behavlor.
SubLypes of Anorexla nervosa
8lnge-eaung/urglng
subLype: uses
mechanlsms such as
vomlung, excesslve
exerclse, or laxauves Lo
conLrol welghL. May also
engage ln brlef perlods of
compulslve blnglng of
food.
SubLypes of Anorexla nervosa
8emember: Lven ln
blnge-eaung/purglng
subLype, resLrlcuon of
food lnLake ls
consLanL. So, an
anorexlc may blnge
before purglng, buL
resLrlcLs when noL
blnglng.
8ullmla nervosa
noL characLerlzed by
consLanL eorLs Lo
monlLor welghL.
8ecurrenL eplsodes of
blnglng.
8ullmla nervosa
urglng (vomlung) or oLher
lnapproprlaLe compensaLory
behavlors.
1end Lo have Lhe same
cognluve focus on body Lype as
anorexlcs, alLhough bullmlcs
don'L Lend Lo dlsLorL body
shape Lo Lhe same degree.
8ullmla nervosa
As wlLh anorexla, loLs
of poLenual medlcal
compllcauons.
8uL, forLunaLely,
morLallLy ls noL as
frequenL an ouLcome
as ln Anorexla.
Medlcal Compllcauons
Lanugo








Epidemiology of Anorexia Nervosa
0
1
2
3
4
5
6
1930-
'40
1940-
'50
1950-
'60
1960-
'70
1970-
'80
1980-
'90
Incidence of AN
Per 100,000
population
Laung ulsorders
Anorexla nervosa
1-year prevalence: 0.4
eak age onseL: age
14-18 years
10:1 lemales Lo Males

8ullmla nervosa
1-year prevalence: 1-3,
6-8 college women
eak age onseL: young
adulLhood (ranges older
adolescenLs Lo young
adulLs)
10:1 lemales Lo Males
An & 8n: Commonallues and ulerences
8lnge-Laung ulsorder
new Lo uSM-3
WhaL ls Lhe cause of Laung ulsorders?
Soclal lnuences
revalence ln uS has rlsen dramaucally ln recenL decades
ldeallzed woman has lncreaslngly emphaslzed Lhlnness

Adolescence ls a ume of lncreased rlsk for eaung dlsorder
Also ume when culLure places emphasls on appearance, beauLy,
Lhlnness
!"#$%&'(&: Laung ulsorders are more common among
young women who reporL greaLer exposure Lo popular medla,
endorse more gender role sLereoLypes, or lnLernallze socleLal
sLandards abouL appearance.
e.g., prevalence of Lus are hlgher among Arab and Aslan women
sLudylng ln WesLern counLrles Lhan among women llvlng ln Lhelr
nauve counLry
Internalization of ideal is key
Soclal lnuences
lamlly 8elauonshlps
Plghly lmpllcaLed as conLrlbuLory facLors ln Lhe onseL of
Laung ulsorders.
Some emplrlcal work, buL mosL evldence ls Lheoreucal or
anecdoLal
Modeling: What a Parent Says About Their
Own Body
I need to lose five pounds.
I was good today. No desserts.
I need to go to the gym. I ate too much last night.
Have I gained weight?
Thats it. I cant even fit into my clothes
anymore.
From Strober & Schneider, 2006
Learnlng-based Soclal lnuences:
Modeling: What a Parent Says About a Childs Body
Are you sure you want to eat that?
Maybe its time for you to watch your diet.
You had that huge slice of cake last night. You should go
work out today.
Are you eating enough?
Probably you should stay away from carbs.
You look great. You've lost weight!
From Strober & Schneider, 2006
Learnlng-based Soclal lnuences:
sychologlcal lnuences
() +,-./0 1+234)/).,35/ 1564752 6) 859-.
:,+);<0;
erfecuonlsm (especlally for An)
Lack of lnLerocepuve awareness
ulmculLy regulaung emouon
Low self-esLeem
ulchoLomous Lhlnklng (All-or-noLhlng)
*8ody ulssausfacuon*
8lologlcal lnuences
Genetics
MZ > DZ concordance rates
but not as strongly as other disorders
Serotonin disruption
links not totally clear
Whats inherited?
Personality types
Weight set point/body type
Hormones appetite suppressing
1reaLmenL for Anorexla
Medical Treatment
Limited efficacy for meds, though refeeding may be
required
Team approach is critical
Weight gain is crucial
Psychological Treatment
Education, behavioral, and cognitive interventions
Others: psychodynamic, inpatient, nutritional
Treatment often involves the family, couples
Long-term prognosis is poorer than for bulimia
Special Issues: Honesty/deception
1reaLmenL for 8ullmla nervosa
Medlcal 1reaLmenL
AnudepressanLs can help reduce blnglng and
purglng, buL noL emcaclous ln Lhe long-Lerm
sychologlcal (lndlvldual, group, famlly)
Cognluve-behavlor Lherapy (C81) ls LreaLmenL of
cholce because lL works fasLer
lnLerpersonal psychoLherapy resulLs ln long-Lerm
galns slmllar Lo C81
MosL LreaLmenL done as ouLpauenL, buL can be
dellvered ln lnpauenL semng
Challenglng SocloculLural SLandards

Jamie Lee Curtis
Dove Models
Before After
8esources for More lnformauon

nauonal Laung ulsorders Crganlzauon (nLuA)
hup://www.nauonaleaungdlsorders.org/
CvereaLers Anonymous
www.overeaLersanonymous.org
Anorexla nervosa & 8elaLed Laung ulsorders, lnc.
www.anred.com
Resources: Warning Signs, Anorexia
(from NEDA)
Dramatic weight loss.
Preoccupation with weight, food, calories, fat grams, and dieting.
Refusal to eat certain foods, progressing to restrictions against whole
categories of food (e.g. no carbohydrates, etc.).
Frequent comments about feeling fat, overweight despite weight loss.
Anxiety about gaining weight or being fat. Denial of hunger.
Development of food rituals (e.g. eating foods in certain orders,
excessive chewing, rearranging food on a plate).
Consistent excuses to avoid mealtimes or situations involving food.
Excessive, rigid exercise regimen--despite weather, fatigue, illness, or
injury--the need to burn off calories taken in.
Withdrawal from usual friends and activities.
In general, behaviors and attitudes indicating that weight loss, dieting,
and control of food are becoming primary concerns.
Resources: Warning Signs, Bulimia (from NEDA)
Evidence of binge-eating, including disappearance of large amounts of
food in short periods of time or the existence of wrappers and containers
indicating the consumption of large amounts of food.
Evidence of purging behaviors, including frequent trips to the bathroom
after meals, signs and/or smells of vomiting, presence of wrappers or
packages of laxatives or diuretics.
Excessive, rigid exercise regimen--despite weather, fatigue, illness, or
injury--the need to burn off calories taken in.
Unusual swelling of the cheeks or jaw area.
Calluses on back of hands and knuckles from self-induced vomiting.
Creation of complex lifestyle schedules or rituals to make time for
binge-and-purge sessions.
Withdrawal from usual friends and activities.
In general, behaviors and attitudes indicating that weight loss, dieting,
and control of food are becoming primary concerns.