Qualitative Systematic: Motivation and Emotion in Anorexia Nervosa - Literature review Example

Contents INTRODUCTION 3 Problem ment 4 Background 5 Context of the study 6 OBJECTIVE 7 THEORETICAL/CONCEPTUAL FRAMEWORK 7 RATIONALE 8 METHODOLOGY 9 RESULTS &DISCUSSION 10 Low positive emotion differentiation 10 Emotional distortion 10 Strengths and limitations of the study 10 CONCLUSION AND RECOMMENDATIONS 11 LIST OF REFERENCES 13 Qualitative Systematic Literature Review: motivation and emotion in anorexia nervosa Name: Course: Lecturer: Date: INTRODUCTION Eating disorders result in serious ad complex mental illnesses. Anorexia nervosa being a debilitating illness reportedly has a lifetime prevalence of 1.9%, a relatively poor prognosis and high mortality rate in all psychiatric illnesses (Hatch et al, 2010). A growing consensus shows improved characterization of social and cognitive impairments in anorexia nervosa that overlaps with Autistic disorders. With regard to cognitive functioning, anorexia nervosa patients usually show a lack of flexibility and extreme attention to details all of which are common features within Autism Spectrum Disorders (ASD). Interestingly, difficulties in cognition within anorexic patients go beyond starvation. Studies indicate that AN patients have high scores of autistic features compared to healthy controls making it difficult for them to process their emotions as well as motivation for others (Courty et al, 2013). However, according to Courty et al (2013), show that anorexic individuals have a propensity to care for others and are capable of feeling concern within an interpersonal situation although they have low systemizing skills. Courty et al (2013), show that empathetic concerns reflect the ability to experience appropriate emotions like compassion and sadness among others are significantly high in individuals suffering from AN compared to those with autistic disorders. Studies suggest that individuals suffering from anorexia nervosa have a strong desire for control and they try to achieve this through dieting. Control in diet is reinforced through resultant feelings of success in weight loss at the onset of the disorder, resulting in intense motivation to continue losing weight. Study findings indicate that many individual with anorexia consider the ability to lose weight as an opportunity for making them more attractive, build self-control, enhance their feelings of expertise, and improves their capability to push their bodies further. Problem statement Anorexia nervosa being a severe disorder of the mind has high levels of disability, and mortality. There are various ways of categorizing thinking and feeling processes in humans among them the reflection of cold cognition that has its foundation on rational thinking and hot cognition that relies on emotional response and motivation. Various studies show alterations in cold cognition that includes central coherence and decision-making. Moreover, with regard to “hot cognition,” systematic analyses evaluating socio-emotional processes point out impairment within the area. This is complemented by both qualitative and quantitative studies that underscore individuals with AN experience emotional and motivation problems. Individuals suffering from eating disorders have for a long time been considered to suffer from distorted emotions, especially with regard to the harmful effects that contribute to the difficult eating behaviors. Moreover, studies show individuals with anorexia have problems identifying and describing feelings, recognizing facial expression of emotions and expressing emotions through facial and nonverbal ways (Selby et al, 2013). One source of positive reinforcement in anorexia occurs through exposure to stimuli that promote extreme weight loss like images of thin women and inspirational words that promote weight loss. According to Selby et al (2013), a study on anorexic women indicate that women who considered themselves “pro-anorexics” showed greater average in experiencing positive emotion and great focus on eating behavior compared to other concerns. The positive emotion that promotes weight loss actions in anorexia appears to be a function of decreased positive emotion differentiation. When individuals with anorexia are successful in making incremental progress toward their goal of attaining the desired body shape and weight, the individual experience positive emotion such as pride that, motivate them to make another step toward the difficult goal (Selby et al, 2013). Low positive emotion differentiation triggers other positive emotions apart from pride like confidence, accomplishment, attentiveness, and happiness. The activation of positive emotions in anorexic individuals results from a distorted cognitions with regard to positive implications of being thin as well as the implied associations regarding thinness as success or happiness (Selby et al, 2013). Therefore, the frequency of weight loss in anorexia is associated with low positive emotion differentiation and strong relation between positive emotion intensity and frequency of eating disorder behaviors. One of the programs endorsed in dealing with anorexia nervosa in adolescents is family therapy because the condition mainly affects young people with high incidences in females. However, reluctance to recover poses a huge challenge for the treatment process. The unwillingness is continued by their ego that strengthen the illness making it ordinary for relapse to occur propelled by the positive perception regarding consequences of AN. The various means of treating anorexia nervosa involves medical treatment, nutritional treatment and counseling as well as therapy for anorexia. These mechanisms are ineffective in addressing the emotional and motivational aspects within anorexia nervosa. Background Difficulties regarding emotional regulation for a long time have been recorded as an essential feature in patients suffering from Anorexia nervosa. Emotional regulation is the ability to comprehend a person’s emotions and being able to regulate emotional experience an expression (Davies et al, 2012). Studies describe the way patients suffering from AN have problems in identifying ad regulating their negative affects. Some theoretical studies indicate that the eating disorder behaviors is a way of regulating affect and has been regarded as a means of escaping aversive self-awareness (Espeset et al, 2012). Motivation entails the appraisal of drivers of certain behavior. For a long period, emotional disturbance is the core feature in anorexia nervosa, a condition characterized by pathological concerns regarding weight and shape leading to extreme loss of weight. Various socio-emotional difficulties exist in AN including prejudice toward emotional stimuli, and poor deduction of others’ emotional conditions (Oldershaw et al, 2012; Oldershaw et al, 2011). Anorexia nervosa as a serious mental disorder has high morbidity and significant lifetime mortality. Distorted perceptions regarding weight and shape as well as certain behaviors targeting weight loss are the main characteristics associated with the disorder. Moreover, various psychodynamic systems and object-relational theories indicate autonomy disturbance as the significant factors that cause anorexia nervosa. Frequent occurrence of AN takes place in early adolescence, which is a critical time in human development and is also prevalent in women (Brockmeyer et al, 2013). Since eating is influenced by psychological factors, it is positively reinforced by good taste and variety. Therefore, anorexia nervosa as eating disorder is propelled by psychological needs that severely restrict food intake posing serious health problems. Context of the study Theoretical models suggest that behavior in anorexia nervosa serves as a way of regulating affect and even blocking painful emotions. Studies suggest that the exclusive mental focus on food and eating relate to emotions becoming less salient and patients considering themselves as emotionally numb. The emotional response to psychological desire within an individual suffering from anorexia nervosa leads to disgust, which motivates the individual to keep distance between the object of disgust and the individual. Various basic emotions may be linked together in having an inhibitory function to others. For instance, according to Espeset et al (2012), feelings of disgust are over-learned in patients suffering eating disorders, which can motivate them to inhibit the expression of other painful emotions. OBJECTIVE The study is a collaborative research project on anorexia nervosa patient experience using different studies as a source of knowledge in understanding the various aspects of anorexia nervosa. To maximize validity of the study, the study uses a two-phase design with the first phase dealing with exploratory study through describing the various experiences associated with anorexia nervosa. The second phase uses studies, which address emotional experiences evident in patients suffering from anorexia nervosa that motivate their behaviors. THEORETICAL/CONCEPTUAL FRAMEWORK At its basic level, motivation is considered an internal state that activates, energizes or even drives action or behavior and establishes its intensity and direction. Moreover, motivation encompasses arousal and persistence of action behavior, which accounts for psychological needs like fulfillment and self-actualization. Social cognitive perspective in studying motivation underscores information processing, volition and explicit motivational constructs as significant processes that result in the goal-oriented behavior. Theories on intention and self-efficacy are influential in social cognitive theories regarding motivation because they consider motivation to be the pursuit of target behavior in achieving a certain goal. Theories based on psychological needs are also used in the study because they offer a basis on which motives aimed at achieving certain behaviors arise from like self-determination. Cognitive model of motivation involves cognitive representation of the desired future outcome by considering the prevailing conditions that compel the desired states. Need theories complement social cognitive approach because they show human behavior as involving various contexts underpinned by psychological needs. Therefore, the combination of the two approaches is essential in the study because the approaches show that motivation is the driving force in behavior characterized by focus and intensity. Social cognitive perspective is useful because it bases on processing of social information while the need-based approach shows that psychological needs explain origin and formation of cognitive antecedents in action. Cognitive model shows that once an individual establishes a goal, an individual engages in behaviors that are expected to result in attaining the goal. The direction of the behavior targets a positive terminal stimulus and according to Deci and Ryan (1985), toward regions of an individual’s ‘life space’ with positive intensity. Cognitive model of motivation shows that individuals seek stimuli prompted by internal activity that orient the individual toward the stimuli. RATIONALE The study has the potential of showing the emotional and motivational factors involved in anorexia nervosa. The study would be valuable in addressing the emotional and the motivational aspects that propel anorexia nervosa by understanding the psychological aspects of the disorder. Studies have shown that anorexia nervosa to be problematic in dealing with because they are unable to establish a way that properly addresses the problem. However, by understanding the emotional and motivational factors associated with the disorder would be a huge relief in finding proper ways of dealing with the problem. The study would be useful to psychologists, patients suffering from anorexia and people caring for those suffering from the disorder because it provides extra information regarding the condition. The study highlights a fresh construct that can help in comprehending emotional alteration within anorexia nervosa and motivation in the disorder. METHODOLOGY The study uses qualitative research in showing the emotion and motivation within anorexia nervosa. The study was carried out using peer-reviewed journals that participated in studies associated with anorexia nervosa propelled their analysis and results of the data. The main source of the peer-reviewed journal is Ebscohost, which is a renowned database for scholar materials. The sources used in the study were mainly from the field of psychology that support the psychological aspects associated with the disorder by showing the emotion and motivation within individuals suffering from the disorder. The design of the study incorporated a two-phase approach with the first approach using studies that showed the general aspects associated with the disorder and the second phase using studies that showed the specific emotional and motivational aspects of anorexia nervosa. The selected studies portrayed emotional and motivational aspects in anorexia in the manner they presented their findings. Some studies showed that AN has emotional characteristics associated with the disorder, while others indicated motivational factors associated with the disorder. Through analysis of the emotional and motivational aspects in the various studies, it was clear that both emotions and motivation play a significant role in the disorder and even makes it for patients to be reluctant in recovering from the disorder. A combination of cognitive model of motivation and needs theory was used in the study in showing the emotions and motivation behind the disorder. A combination of these approaches is useful in showing the various aspects of emotion and motivation that propel the disorder. Phrases: emotion and motivation in anorexia nervosa, cognitive theory in anorexia nervosa. RESULTS &DISCUSSION Low positive emotion differentiation The study indicated that positive emotion promotes weight loss behavior in anorexia because of the low positive emotion differentiation. The triggers of positive emotion like confidence accomplishment and attentiveness enhance the low positive emotion. These positive emotions according to Selby et al (2013) are shown to be “functions of distorted cognitions regarding positive implications of being thin.” The enhanced positive emotions stimulate further weight loss actions that are reinforced by success in attaining the weight loss goal. Emotional distortion Individuals suffering from anorexia nervosa have for a long time been considered to experience distorted emotions, especially in the harmful realm that propel the problematic behaviors. Various studies in the review indicated that participants suffering from AN showed problems identifying and describing feelings. The difficulties in distinguishing negative behaviors have been shown to elevate purging in individual suffering from anorexia nervosa (Sato et al, 2013). Strengths and limitations of the study The study provides in-depth and interpreted understanding of the used studies regarding the circumstances, experiences, and perspectives associated with anorexia nervosa. The readings used in the review were deliberately selected based of the salient criteria. Moreover, the analysis was open to emergent concepts and ideas that lead to detailed description and classification in identifying patterns associated with explanations of anorexia nervosa. However, the review has some limitations. One of the limitations was that the quality of the study heavily relied on the skills involved in carrying out the research on the subject; as well, the study is prone to personal biases as well as idiosyncrasies. Moreover, the rigor is hard to maintain, assess, and demonstrate because the available information made it hard to analyze and interpret since it required a lot of time. Moreover, since the study relied on qualitative review, this meant that it was difficult to understand compared to quantitative research carried in the subject. CONCLUSION AND RECOMMENDATIONS Various studies on anorexia nervosa show that emotion and motivation are involved in the disorder and propel the development of the disorder. The inability correctly identify emotions in individuals suffering from the disorder shows that cognitive distortion within the individuals play a significant role in the disorder. Moreover, low positive emotion differentiation promotes the development of the condition since the individuals are unable to associate correctly the right emotion with right outcome because their emotions are distorted. Clearly, emotion and motivation in the studies are portrayed as significant factors in the disorder and this call for interventions that can properly deal with the problem. The findings in the study can be extended several ways in furthering the understanding of the role of emotion and motivation in anorexia. One significant direction involves examining the hypothesis that weight loss activities positively reinforce anorexia by use of experimental methods like experiments where participants with anorexia complete tasks. Inductions of participants with anorexia can focus on inducing positive emotions likely to motivate positive emotions in anorexia. Positive emotions can be assessed before and after tasks as well as reaction of positive emotion in the course of the task in order to be able to compare across conditions. Further study can examine the hypothesis that positive emotion is a motivator for anorexic behavior with computer-based effort expenditure tasks because various computer tasks in the past have been useful in examining the amount of effort people exert in attaining a certain reward. LIST OF REFERENCES Brockmeyer, T., Holtforth, M., Bents, H., Kämmerer, A., Herzog, W., & Friederich, H. (2013). Interpersonal Motives in Anorexia Nervosa: The Fear of Losing Ones Autonomy. Journal Of Clinical Psychology, 69(3), 278-289. doi:10.1002/jclp.21937 Courty, A., Maria, A., Lalanne, C., Ringuenet, D., Vindreau, C., Chevallier, C., & ... Berthoz, S. (2013). Levels of autistic traits in anorexia nervosa: a comparative psychometric study. BMC Psychiatry, 13(1), 1-9. doi:10.1186/1471-244X-13-222 Davies, H., Fox, J., Naumann, U., Treasure, J., Schmidt, U., & Tchanturia, K. (2012). Cognitive Remediation and Emotion Skills Training for Anorexia Nervosa: An Observational Study Using Neuropsychological Outcomes. European Eating Disorders Review, 20(3), 211-217. doi:10.1002/erv.2170 Deci, E. L., & Ryan, R. M. (1985). Intrinsic motivation and self-determination in human behavior. New York: Plenum. Espeset, E. S., Gulliksen, K. S., Nordbø, R. S., Skårderud, F., & Holte, A. (2012). The Link Between Negative Emotions and Eating Disorder Behaviour in Patients with Anorexia Nervosa. European Eating Disorders Review, 20(6), 451-460. doi:10.1002/erv.2183 Hatch, A. A., Madden, S. S., Kohn, M. M., Clarke, S. S., Touyz, S. S., & Williams, L. M. (2010). Anorexia nervosa: Towards an integrative neuroscience model. European Eating Disorders Review, 18(3), 165-179. Oldershaw, A., DeJong, H., Hambrook, D., Broadbent, H., Tchanturia, K., Treasure, J., & Schmidt, U. (2012). Emotional Processing Following Recovery from Anorexia Nervosa. European Eating Disorders Review, 20(6), 502-509. doi:10.1002/erv.2153 Oldershaw, A., Treasure, J., Hambrook, D., Tchanturia, K., & Schmidt, U. (2011). Is anorexia nervosa a version of autism spectrum disorders?. European Eating Disorders Review, 19(6), 462-474. doi:10.1002/erv.1069 Sato, Y., Saito, N., Utsumi, A., Aizawa, E., Shoji, T., Izumiyama, M., & ... Fukudo, S. (2013). Neural Basis of Impaired Cognitive Flexibility in Patients with Anorexia Nervosa. Plos ONE, 8(5), 1-10. doi:10.1371/journal.pone.0061108 Selby, E. A., Wonderlich, S. A., Crosby, R. D., Engel, S. G., Panza, E., Mitchell, J. E., ... & Le Grange, D. (2013). Nothing Tastes as Good as Thin Feels Low Positive Emotion Differentiation and Weight-Loss Activities in Anorexia Nervosa. Clinical Psychological Science, 2167702613512794. Read More