CHAPTER-3

LIFE SPAN DEVELOPMENT

{i} meaning of development , growth and maturation

why is the study of lifespan development important? Determinants – interaction of heredity and
environment, context of development.

{ii} infancy- motor, cognitive development, socio-emotional development.

Motor- milestones; cognitive- piaget’s sensory motor stage; socio emotional development-
emergence attachment.

{iii} childhood- motor, cognitive development, socio emotional development.

Motor development; cognitive development- piget’s theory [preoperational, concrete and formal
operation]; emergence of self- gender awareness, emergence of peer relationships; moral
development- kohlberg’s perspective- pre conventional morality.

{iv} Adolescence- physical changes cognitive development, socio emotional development;

some major concerns.

Physical changes at puberty; cognitive development- piaget’s formal operations stage; socio-
emotional development- forming an identity with sexuality and gender identity; some major
concerns- delinquency, substance abuse (drugs and alcohol) meaning of substance abuse,
symptoms and treatment, eating disorders- bulimia, anorexia.

{I} meaning of development, growth and maturation.

Growth:
Growth generally refers to quantitative changes in an organism, particularly growth in size
and structure.
Development:
Development refers to the progressive series of an orderly coherent type towards the goal of
maturity. It refers to the development, both in the prenatal and post natal period. It is a
dynamic and sequential change and it leads the human organisms to maturation.
Maturation:
Maturation is the changes determined largely by our genes.

Contribution of Heredity to Child’s Development:

According to Pintner (1931) “The potency of environment is not merely so great as commonly
supposed. A child’s abilities are determined by his ancestors and all that the environment can do
is to give the opportunity for the development of his potentialities.”

Pintner further adds that an environment cannot create new powers and abilities. He finally
concludes “All that we can claim is that our calculations agree perfectly with the hypothesis that
intelligence is inherited in the same way as physical characteristics are inherited. Thus, in his
view, heredity is more important than environment in growth and development.

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Several experimental findings also emphasize that importance of heredity in individual
differences. Pearson (1904) found a remarkable resemblance among members of the same
family in colour of eyes, ratio of width and length of head and in physical traits which are
by and large affected by environment influences. Interestingly, he noted that the effect of
heredity upon mental characteristics is the same as upon physical characteristics.

Contribution of Environment to Child’s Development:

The effect of changed environment upon mental traits – two studies concluded by Chicago
University group headed by Freeman (1925), and Stanford University group headed by Bruks
(1928) are notable. Both these investigations emphasized somewhat different methods, though
the purpose was same, that it is to study the influence of home environment upon the
development of mental traits in children. Freeman agrees with Burks view that heredity is a force
in the determination of mental ability by the side of which all other forces are dwarfed in
comparison. Both the studies agree upon the influence of heredity in shaping mental ability. Both
the groups show a general agreement on the role of environment in the development of
individual intelligence. But the Chicago group seems to give greater emphasis to environment
than to heredity. Watson has strongly emphasized the importance of environment in the
development of human personality. If an individual’s abilities, efficiency and traits of personality
would have been exclusively influenced by genetic factors, environment, training and learning
would have no value. Similarly, if training and education is considered as a sole factor
influencing personality differences, then favourable environmental opportunities are everything
and potentialities and gifted qualities have no implications for personality development. It seems
more reasonable to say that both nature, heredity and environment have important roles to play in
the development of human beings

But their relative importance differs in the development of various traits of personality. Heredity
is more important in determining the physical traits like height and weight, colours and
texture of hair, body strength, etc. although to some extent, the effect on environment on these
traits cannot be ruled out. Similarly, environment has the upper hand in the development of
personality traits like sociability, amiability, honest, dominance, submission, introversion-
extroversion, interests and several other socially desirable, undesirable traits. Regarding the
mental activities, there are sufficient evidences to believe that hereditary factors determine the
potential level or physiological limit of development which an individual achieves at the
maximum. Within this limit, the environmental factors vastly influence the level of development
that really occurs. Hence, neither nature nor nurture alone can explain one’s personality
development. Heredity and environment cooperatively and co-ordinately help in the growth and
development of the child’s behaviour and personality. Human behaviour and personality is
therefore, undoubtedly the result of an interaction between genetically determined traits and
environmentally determined qualities.

ii} (INFANCY-MOTOR, COGNITIVE DEVELOPMENT, SOCIO-EMOTIONAL

DEVELOPMENT EMERGENCE OF ATTACHMENT.)

MOTOR- MILESTONES; COGNITIVE – PIAGET’S SENSORY MOTOR

STAGE; SOCIO- EMOTIONAL DEVELOPMENT-EMERGENCE OF
ATTACHMENT

Motor milestones of development in infancy.

Infancy is the period of development between the neonatal period and the appearance of useful
language; the upper limit is about 18 months.

Motor Milestones: Motor milestones are marked by milestones- achievements that develop
systematically.

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A baby first learn simple skills and then combines them into increasingly complex ‘systems of
actions’, which permits a wider or a more precise range of movements and more effective control
of the environment.

HEAD CONTROL:

• At Birth – most infants can turn their heads from side to side while lying on their back. While
lying chest down, many can lift their heads enough to turn them.

• Within the first two-three months – They lift their heads higher and higher – sometimes to the
point where they lose their balance and roll over on their backs.

• By 4 months – Almost all infants can keep their heads erect while being supported in a sitting
position.

HAND CONTROL:

• Babies are born with a grasping reflex. If the palm of an infant’s hand is stroked, the hand
closes tightly.

• At 3 ½ months – Most infants can grasp an object of moderate size , such as a rattle, but have
trouble holding a small object. Next they begin to grasp objects with one hand and transfer them
to the other, and then to hold small objects.

• Between 7 and 11 months – their hands become coordinated enough to pick up a tiny object,
such as a pea, using the pincer grasp. After that the hand control becomes increasingly precise.

• By 15 months – An average baby can build a tower of two cubes.

• After 3 years – An average toddler can copy a circle fairly well.

LOCOMOTION:

• After 3 months – The average infant begins to roll over deliberately – first from front to back
and then from back to front.

• By 6 months – An average baby can sit without support, and can assume a sitting position
without help about two and a half months later.

• Between 6 and 10 months – Most babies begin to get around under their own power by
creeping or crawling. This new achievement of self-locomotion has striking cognitive and
psychological ramifications.

• A little past 7 months – The average baby can stand by holding onto a helping hand or a piece
of furniture. For some months before they can stand without support, babies practice ‘cruising’.

• 4 months later – Most babies let go and stand alone. The average baby can stand well about
two weeks or so before the first birthday.

• The major motor achievement of infancy is walking.

• At about 11 ½ months – Most infants take their first unaided step. Within a few weeks, soon
after their first birthday, the average child is walking well and achieves the status of a toddler.

• During the second year – Children begin to climb stairs one at a time, putting one foot after
another on the same step; later they will alternate feet. Walking down the stairs comes later.

• In their second year – Toddlers learn to run and jump.

• By 3 ½ years – Most children can balance briefly on one foot and begin to hop.

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 COGNITIVE- PIAGET’S SENSORY MOTOR STAGE DEVELOPMENT THAT
OCCURS DURING INFANCY.

In Piaget’s view, the development of knowledge is a form of adaptation and as such involves the
interplay of two processes, assimilation and
accommodation.

Assimilation- means modifying one’s environment so

that it fits into one’s already developed ways of
thinking and acting. For example, when a child hoists a
banana and runs around in a circle shouting “Look – it
is a jet”, the child is assimilating the banana into ways
of thinking and behaving that are already in place.

Accommodation- means modifying oneself so as to fit

in with existing characteristics of the environment. The
child who, for the first time manages to peel a banana and adjust his mouth so that the banana
will fit into it has accommodated his ways of thinking and behaving to the banana as it really is.

Of course, most steps in development accommodates to the banana (adjusting his ways of
holding his hand and his mouth) also assimilates the banana (by chewing and swallowing it).
Piaget also spoke of equilibration – the tendency of the developing individual to stay in balance
intellectually by filling in gaps in knowledge and by restructuring beliefs when they fail to test
out against reality.

According to Piaget, the processes of assimilation, accommodation and equilibration operate in

different ways at different age levels. Piaget called the period of infancy the sensory motor stage,
The label reflects the infant’s way of knowing the world are sensory, perceptual and motoric.
Piaget called each specific way of knowing a scheme.

A scheme is an action sequence guided by throughout.

For example, when infants suck, they are exercising a sucking scheme. When young infants see
an object and the object is then hidden, they seem unaware that the object continues to exist.
Hold an object within view of the baby until he or she is clearly interested and is reaching for it;
then quickly cover the object with a cloth. Chances are that the baby will stop in mid reach and
will not search for the object at all.

Repeat the same experiment with the same youngster 3 or 4 months later, and you are apt to see
the baby search for the hidden object. The search suggests that the baby has attained what Piaget
called object permanence – the idea that objects continue to exist even when we can no longer
see them. To understand the importance of object permanence, remember that the mother and
father are also objects in a baby’s world. Evidence suggests that very young infants are not aware
of the permanence of people – even their own parents when these people are hidden from view.

1. Reflexes scheme – birth to one month

2. Primary Circular Reaction 1 to 4 months

3. Secondary circular reaction 4 to 8 months

4. Coordination of secondary schemes 8 to 12 months

5. Tertiary circular reaction 12 to 18 months

6. Mental combination 18 to 24 months

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 SOCIO- EMOTIONAL DEVELOPMENT-EMERGENCE OF ATTACHMENT

Attachment is a reciprocal, enduring emotional attachment between an infant and a care

giver, each of whom contributes to the equality of the relationship. Attachment has adaptive
value for babies, ensuring that their psychological as well as physical will be met. According to
theological theory, infants and parents are biologically pre disposed to become attached to each
other and attachment promotes a baby’s survival.

Strange situation test: A pattern of attachment in which a care giver leaves a child alone with a
stranger for several minutes and then returns.

1) Secure attachment: a pattern of attachment in which infants actively seek contact with
their care giver and take comfort from her presence when she returns in the strange
situation tests.
2) Secure base: infant’s use of a parent or other familiar care givers as a department point
for exploration and a safe place to return periodically for emotional support.
3) Insecure/ avoidant attachment: a pattern of development in which children don’t cry
when their care giver leaves in the strange test, and are slow to greet their care giver
when this person returns.
4) Insecure / ambivalent attachment: a pattern of attachment in which infants seek contact
with their care giver before separation but then after she leaves and then returns, first seek
her but then resist or reject her offers of comfort.
5) Disorganised or disoriented attachment: a pattern of attachment in which infancy show
contradictory reactions to their care giver after being reunited with her in the strange
situation tests.

One factor that was long assumed to play a certain role in maternal sensitivity was the long term
effects of attachment time- during the childhood, youngsters who are securely attached to their
care givers are more sociable, better at solving certain kinds of problems, more tolerant to
frustration and more flexible and persistent in a many situations that children who are insecurely
attached. Further, securely attached children seemed to experience fewer behavioural problems
during later childhood. Infancy may have strong effect on the kind of relationship individuals
have when they are adults. Persons who show ambivalent attachment at infancy seem to be
ambivalent about romantic relationship too.

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 iii} (CHILDHOOD-MOTOR, COGNITIVE DEVELOPMENT, SOCIO-EMOTIONAL
DEVELOPMENT EMERGENCE OF ATTACHMENT.)

Motor development, cognitive development- Piaget’s theory (pre operational ,

concrete and formal operational); emergence of self – gender awareness , emergence
of peer relationship; Moral development- Kohelberg’s perspective – pre conventional
morality

COGNITIVE DEVELOPMENT- PIAGET’S THEORY

Piaget’s pre-operational stage of Cognitive Development:

pre conventi

Piaget suggested toddlers acquire the ability to form mental images of objects and
events. At the same time, language develops to the point at which they begin to
think in terms of verbal symbols – words.

These developments mark the transition to Piaget’s second stage, the

preoperational stage. This term reflects Piaget’s view that at this stage children
don’t yet show much ability to use logic and mental operations.

During the preoperational stage, which lasts up to about 7 years, children are
capable of many actions they could not perform earlier. For e.g. they demonstrate
symbolic play in which they pretend that one object is another – that a pencil is a
rocket for e.g. such play is marked by three shifts that afford unique insights into
how children’s cognitive abilities change during this period.

One is Decentration in which children gradually begin to make others rather than
themselves the recipients of their playful actions – for instances, they begin to feed
their dolls or dress them.

The second shift is Decontextualization. Objects are made to substitute for each
other, as when a child pretends that a twig is a spoon.

The third change involves integration –combining play actions into increasingly
complex sequences. For instance, when I was a little boy, I had a collection of toy
cars and I now realize that as I grew older I played with them in even more
intricate ways.

The thought process of pre-operational children is more advanced than those in the
preceding stage. Piaget emphasised that these children are still immature in several
respects.

They can use mental symbols but their thinking remains somewhat inflexible,
illogical, fragmented and tied to specific contexts.

One way in which they think of preoperational children is immature involves what
Piaget termed egocentrism - children’s inability to understand that others may
perceive the world differently than they do. Children in the preoperational stage
seem to lack understanding of relational terms such as lighter, larger, softer.

Further, they lack seriation, the ability to arrange object order along some
dimensions.

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Finally, and most importantly they lack a grasp of what Piaget termed as the
Principle of conservation – knowledge that certain physical attributes of an object
remains unchanged even though the outward appearance of the object is altered.

Concrete cognitive development during childhood

Children in the age of concrete operations can perform many tasks at a much
higher level even than they could in the preoperational state.

They have a better understanding of spatial concepts, of causality, of

categorization, of inductive and deductive reasoning and of conservation.

Space and Causality: Children in the stage of concrete operations can better
understand spatial relationships. They have a clear idea of how far it is from one
place to another and how long it will take to get there, and they can more easily
remember the route and the landmarks along the way. Experience plays a role in
this development; a child who walks to school becomes more familiar with the
neighbourhood outside the home. The abilities to use maps and models and to
communicate spatial information improve with age.

Although, 6 year olds can search for and find hidden objects, they usually do not
give clear directions for finding the same objects – perhaps, because they lack the
appropriate vocabulary or do not realize what information the other person needs.

Judgements about cause and effect also improve during middle childhood. When 5
to 12 year olds were asked to predict how levers and balance scales would perform
with varying numbers and weights of objects placed at varying distances from the
centre, the older children gave more correct answers than the younger children.

Categorization: The ability to categorize helps children to think logically.

Categorization includes such sophisticated abilities as seriation, transitive
inference, and class inclusion. Children show that they understand seriation when
they can arrange objects in a series

according to one or more dimensions, such as weight (light to heaviest) or colour

(lightest to darkest).

Transitive inference: is the ability to recognize a relationship between two objects

by knowing the relationship between each of them and a third object. Class
inclusion: is the ability to see the relationship between a whole and its parts.

Inductive and Deductive Reasoning:

According to Piaget, children in the stage of concrete operations use inductive

reasoning. Starting with observations about particular members of a class of
people, animals, objects, or events, they then draw general conclusions about the
class as whole.

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Inductive conclusions must be tentative because it is always possible to come
across new information (a dog that does not bark) that does not support the
conclusion.

Deductive reasoning: which Piaget believed does not develop until adolescence
starts with a general statement (premise) about a class and applies it to particular
members of the class. If the premise is true of the whole class, and the reasoning is
sound, then the conclusion must be true.

Conservation: In solving various types of conservation problems, children in the

stage of concrete operations can work out the answers in their heads; they do not
have to measure or weigh the objects.

Formal Operational Stage as given by Piaget

Formal Operational Stage as suggested by Piaget:

At about the age of twelve (11 years and above/adolescence), Piaget suggested,
most children enter the final stage of cognitive development – the stage of formal
operations, During this period, major features of adult thought make their
appearance. While children in the earlier stage of concrete operations can think
logically, they can do so only about concrete events and objects.

In contrast, those who have reached the stage of formal operations can think
abstractly; they can deal not only with the real or concrete but with possibilities –
events or relationships that do not exist, but can be imagined.

Hypothetical thinking- With formal operations, boys and girls move from the
world of the actual to the world of the hypothetical. They can still think about the
way things are, but they become much more skilled at thinking about how things
might be if certain changes took place. Such thinking allows adolescents to judge
the “reasonableness” of a purely hypothetical line of reasoning.

Deduction and induction- Hypothetical and abstract thinking make sophisticated

deduction and induction possible.

Deduction is reasoning from abstract, general principles to specific hypothesis that

follow from these principles.

Induction thinking is the complementary process of observing a number of

specific events or instances and inferring an abstract general principle to explain
those instances.

The two processes can be seen in the adolescents reasoning about nature, science
and even social problems.

Inter propositional logic- The formal operations involve the ability to judge
whether propositions are logically connected to one another, regardless of whether
the propositions are true. This is called inter propositional logic.

8
Reflective thinking – This allows the formal operational person to be his or her
own critic, to evaluate a process, idea or solution from the perspective of an
outsider and to find errors or weak spots in it. The reflective thinker can then
sharpen plans, arguments or points of view making them more effective, more
powerful.
EMERGENCE OF SELF – GENDER AWARENESS

self-gender awareness that is found during childhood.

By the age of four, one understands the fact that one is a male or female which is
termed as gender identity. Again, children understand that the gender is stable over
the time, which is known as gender stability.

Ruble and her colleagues have proposed that complete understanding of one’s
sexual identity involves all three components and centres around a biologically
based categorical distinction between males and females. It is not until they are six
or even seven, however, that children acquire gender consistency – the
understanding that even if they adopted the clothing, hair styles, and behaviours
associated with the other sex, they would still retain their current sexual identity.

At this time, they can answer correctly questions such as “If Jack were gentle and
cooked dinner, would Jack be a boy or a girl?”

Gender: A society’s beliefs about the traits and behaviour of males and females.
Gender stereotypes: Cultural beliefs about differences between women and men.
Gender Roles: Expected behaviours of males and females in many situations.

Sex consistency is complete understanding of one’s sexual identity, centring

around a biologically based categorical distinction between males or females.

Several contrasting but not necessarily competing explanations have been offered.
One of these social learning theory emphasizes the role of learning – especially
the impact of modelling and operant conditioning. According to this theory,
children are rewarded for behaving in these accordance with gender stereotypes
and gender roles – for behaving as boys and girls are expected to behave.

A second view of gender development, cognitive development theory, suggests

that children’s increasing understanding of gender is just one reflection of their
steady cognitive growth.

A third view is the theory that children develop a cognitive frame work reflecting
the belief of their society about the characteristics and roles of males and females,
this gender schema often strongly affects the processing of new social information.

9
MORAL DEVELOPMENT- KOHELBERG’S PERSPECTIVE – PRE CONVENTIONAL
MORALITY
According to Kohlberg’s Theory of Moral Development, there are 6 stages of moral
development, separated into 3 levels:

§ Pre-conventional
§ Conventional
§ Post-conventional
Age ranges of these levels are considerably more vague in Kohlberg’s stages of moral
development than in Piaget’s stages, as children vary quite significantly in their rate of moral
development.

Level 1 - Pre-conventional morality

At the pre-conventional level (most nine-year-olds and younger, some over nine), we don’t have
a personal code of morality. Instead, our moral code is shaped by the standards of adults and the
consequences of following or breaking their rules.
Authority is outside the individual and reasoning is based on the physical consequences of
actions.

10
• Stage 1. Obedience and Punishment Orientation. The child/individual is good in order to
avoid being punished. If a person is punished, they must have done wrong.
• Stage 2. Individualism and Exchange. At this stage, children recognize that there is not just
one right view that is handed down by the authorities. Different individuals have different
viewpoints.

{iv} adolescence- physical changes cognitive development, socio- emotional development;

some major concerns.

Physical changes at puberty, cognitive development- piaget’s formal operation stage ,

socio- emotional development- forming an identity, dealing with sexuality and gender
identity, some major concerns –delinquency, substance abuse (drugs and alcohol)-
a meaning of substance abuse, symptoms and treatment, eating disorders- bulimia ,
anorexia

Formal Operational Stage as suggested by Piaget:

At about the age of twelve (11 years and preabove/adolescence),

conventi Piaget suggested, most children
enter the final stage of cognitive development – the stage of formal operations, During this
period, major features of adult thought make their appearance. While children in the earlier stage
of concrete operations can think logically, they can do so only about concrete events and objects.
In contrast, those who have reached the stage of formal operations can think abstractly; they can
deal not only with the real or concrete but with possibilities – events or relationships that do not
exist, but can be imagined.

Hypothetical thinking- With formal operations, boys and girls move from the world of the
actual to the world of the hypothetical. They can still think about the way things are, but they
become much more skilled at thinking about how things might be if certain changes took place.
Such thinking allows adolescents to judge the “reasonableness” of a purely hypothetical line of
reasoning.

Deduction and induction- Hypothetical and abstract thinking make sophisticated deduction and
induction possible. Deduction is reasoning from abstract, general principles to specific
hypothesis that follow from these principles. Induction thinking is the complementary process of
observing a number of specific events or instances and inferring an abstract general principle to
explain those instances. The two processes can be seen in the adolescents reasoning about nature,
science and even social problems.

Inter propositional logic- The formal operations involve the ability to judge whether
propositions are logically connected to one another, regardless of whether the propositions are
true. This is called inter propositional logic.
Reflective thinking – This allows the formal operational person to be his or her own critic, to
evaluate a process, idea or solution from the perspective of an outsider and to find errors or weak
spots in it. The reflective thinker can then sharpen plans, arguments or points of view- making
them more effective, more powerful.

Delinquency

A delinquent violates law, is habitually disobedient, uncontrolled by parents and guardians,

habitual absentees in school or colleges. He also endangers his morality and health and also
poses danger for others in the society. Delinquents are very impulsive and indulge in acts at the
spur of the moment. They are socially insensitive and lack conscience and guilty feeling.(Below
18 years)
Causes of delinquency:
1) Hereditary factor: The early researches held heredity responsible for delinquency. It can be
concluded that delinquency is not inherited and therefore it is unjustified to blame heredity for
delinquent behaviour.(Biological)

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2) Constitutional or psychological factors: Defective constitution or glandular systems were
also thought to be the cause of delinquent behaviour. Udai Shanker observes that poor health,
short or too big stature or some deformity which give rise to feeling of inferiority, dispose one to
more aggression, as a compensatory reaction for his inadequacies. Consequently, this leads to
delinquent behaviour. (psychological)

3) Intelligence factor: While earlier writers like Lombroso and Goddard emphasize that the
most important cause of delinquency and crime is low grade mentality, sometimes it is argued on
the basis of the statistics that since the majority among the delinquents possess low intelligence,
defective intelligence, therefore causes delinquency. But this conclusion is not well founded.
Moreover, defective intelligence may lead to delinquency in one situation and may be a barrier to
it in another situation. Hence, low intelligence alone cannot be held responsible for delinquent
behaviour. (Cognitive).

4) Environmental and social factors: It has been proved that delinquent behaviour is a learned
reaction. Delinquents do not inherit delinquent characters from their parents or
ancestors but are made so by the uncongenial environment and social conditions. Udai Shanker
observes that delinquency is not inherited. It is the product of social economic conditions and is
essentially a coefficient of the friction between the individual and the community. The most
important causes of antisocial behaviour are environmental and sociological in character. It is
therefore the uncongenial environment of the family, school, neighbourhood and society which
should be blamed for the delinquent behaviour of the child since he picks up delinquent trait in
such situations. (Socio Cultural).

5) Substance abuse risk factors: First, juveniles are using more powerful drugs today than was
the case as recently as 10 years ago. Secondly, the age at which some juveniles begin using drugs
is younger. Children in elementary schools are found to be using powerful illegal drugs. The use
of these illegal substances or the use of legal substances illegally motivates young people to
commit crimes to obtain money for drugs. Additionally, juveniles are far more likely to engage
in destructive, harmful and illegal activities when using drugs.
Prevention: Parental education, child company’s substituting environment, rectifying school
education and environment, counselling and vocational guidance.

Characteristics:
v Theft
v Gambling
v Cheating
v Pick and Pocketing
v Murder
v Robbery
v Destruction of property
v Violence and assault
v Intoxication
v Abduction
v Kidnapping
v Sexual offences

EATING DISORDERS

There is a commonly held view that eating disorders are a lifestyle choice. Eating disorders are
actually serious and often fatal illnesses that cause severe disturbances to a person’s eating
behaviors. Obsessions with food, body weight, and shape may also signal an eating disorder.
Common eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder.

12
 Anorexia nervosa

Signs and Symptoms

People with anorexia nervosa may see themselves as overweight, even when they are
dangerously underweight. People with anorexia nervosa typically weigh themselves repeatedly,
severely restrict the amount of food they eat, and eat very small quantities of only certain
foods. Anorexia nervosa has the highest mortality rate of any mental disorder. While many
young women and men with this disorder die from complications associated with starvation,
others die of suicide. In women, suicide is much more common in those with anorexia than with
most other mental disorders.

Symptoms include:

v Extremely restricted eating

v Extreme thinness (emaciation)
v A relentless pursuit of thinness and unwillingness to maintain a normal or healthy weight
v Intense fear of gaining weight
v Distorted body image, a self-esteem that is heavily influenced by perceptions of body
weight and shape, or a denial of the seriousness of low body weight

Other symptoms may develop over time, including:

v Thinning of the bones (osteopenia or osteoporosis)

v Mild anemia and muscle wasting and weakness
v Brittle hair and nails
v Dry and yellowish skin
v Growth of fine hair all over the body (lanugo)
v Severe constipation
v Low blood pressure, slowed breathing and pulse
v Damage to the structure and function of the heart
v Brain damage
v Multiorgan failure
v Drop in internal body temperature, causing a person to feel cold all the time
v Lethargy, sluggishness, or feeling tired all the time
v Infertility

Bulimia nervosa

People with bulimia nervosa have recurrent and frequent episodes of eating unusually large
amounts of food and feeling a lack of control over these episodes. This binge-eating is followed
by behavior that compensates for the overeating such as forced vomiting, excessive use of
laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviors. Unlike
anorexia nervosa, people with bulimia nervosa usually maintain what is considered a healthy or
relatively normal weight.

Symptoms include:

v Chronically inflamed and sore throat

v Swollen salivary glands in the neck and jaw area
v Worn tooth enamel and increasingly sensitive and decaying teeth as a result of exposure
to stomach acid
v Acid reflux disorder and other gastrointestinal problems
v Intestinal distress and irritation from laxative abuse
v Severe dehydration from purging of fluids
v Electrolyte imbalance (too low or too high levels of sodium, calcium, potassium and
other minerals) which can lead to stroke or heart attack.

13