Psychosocial Factors Associated with Anorexia Nervosa - Literature review Example

Psychosocial factors associated with anorexia nervosa: Literature Review Name College Abstract This Integrative literature review seeks to find out the psychosocial factors that cause anorexia nervosa. Anorexia nervosa is a disorder that is related to eating habit and is associated with low body weight, fear of gaining extra weight and imprecise observation of the body weight. This literature review was completed by doing a systematic search of all articles or journals that are related to anorexia nervosa and the psychological factors that cause this condition. Keywords: Psychological factors, anorexia nervosa Introduction Anorexia nervosa is derived from two Latin words which loosely translate to nervous inability to eat. By definition, this is anorexia nervosa is a psychiatric eating disorder that is characterized by an obsession by the sufferer to limit food intake, primarily driven by an unrealistic fear that food will distort their body image or the fear of gaining weight(Bulik, Siega-Riz, & Reichborn 2005). In extreme cases, this condition is fatal, as the health of the individual is compromised. Agreeably, this condition is associated with many mental problems. Iannaccone, D'Olimpio, Cella, and Cotrufo, (2016) in their study states that depression and helplessness are related to anorexia nervosa. People with anorexia nervosa were found to experience more negative emotions and anhedonia (Paterson et al., 2011). A study by (Parkinson and Manstead, (2015) revealed that a different psychological feature is the inability for the victims to identify their feelings and to have a sense of ineffectiveness. This happens because of the reduced self-esteem and anxiety (Hulme, Hirsch & Stopa, 2012). A disorder in the eating habits is mostly complicated and arises from several potential factors which are grouped into risk and correlate factors that are potential in causing the eating disorders (Creitz, 2013). These factors include psychological factors, social factors, and interpersonal factors (Jaeger & Câmara, 2015). However, this study aim is to examine the psychosocial factors that are related to anorexia nervosa. Moreover, based on the DSM-5 diagnostic criteria, individuals who are conclusively diagnosed with this condition should display three major symptoms and behavior. To begin with, the individual must show a persistent influence and interference with their body weight shape. In this regard, the person behaves in a manner that shows obliviousness with the seriousness of their low body weight. Secondly, they showcase a persistent and deliberate restriction in taking foods that increase energy, the effect of which is relatively low body weight compared to the minimally expected (based on sex, age, etc.). Thirdly, the individuals must display an intense fear of becoming fat or gaining weight (Brown, Holland, & Keel 2013) . Psychological factors People who develop anorexia nervosa experience behavioral and personality characteristics that make them vulnerable to get this condition because they have a tendency towards being anxious, depressed and occupied by fear (Dellava, Kendler & Neale, 2011). Fear and anxiety are described as overwhelming and invading emotional feelings. These feelings are those that are usually ever-present and restless lump experienced in the stomach. Fear, anxiety and depression related to food intake and body weight (Hulme, Hirsch & Stopa, 2012). This is because; the victims are typically afraid of gaining body weight in the sense that they feel anxious, fat and out of control when they eat food. Studies have shown that most victims with anorexia nervosa report to be mostly concerned with other people’s opinions or comments. This is because the victims feel tension and fear that triggers fear of being fat or failure in case the victims meet other people (Thomas & Lovell, 2014). Anxiety, depression, and fear are more than just feelings. In some case, these feelings happen due to a typical reaction to an occasion or situation and typically go away after that stressful situation is long gone (Pila, Sabiston, Brunet, Castonguay & O'Loughlin, 2015). However, people with anorexia nervosa also experiences stress about their body weight. They become anxious about doing some steps that can help them resolve such stress, and their first resolution is developing an eating disorder. In the case that such resolutions do not work, they end up becoming depressed and obsessed about their current body weight condition. The research was done by Wilsdon and Wade (2006) on the relationship between anxiety, fear, and depression with anorexia nervosa. In this study, three groups of women who had anorexia nervosa were researched on using the Hamilton Rating Scale for Anxiety and depression while fear was analyzed using the Yale- Brown Obsessive Compulsive Scale throughout this study. After a thorough comparison of anxiety, fear, and depression, it was found out that severe eating disorder was most prevalent in the underweight women. This study, therefore, reveals that these psychological factors, anxiety, depression, and fear have a significant relationship with anorexia nervosa condition. Low self-esteem is another psychological factor that is associated with anorexia nervosa. In this case, the victims have poor body images towards themselves. Disturbance in body image is common clinical features that occur as results of eating disorder. Contemporary theories consider poor body image to the development of anorexia nervosa and the related studies also confirms this. Recent studies have related low self-esteem about one’s body image to psychopathology that is measured by eating disorder and all the temperamental characteristics. This relates to body image disturbance and other factors that include feelings of ineffectiveness and having poor interoceptive awareness. Therefore, self-esteem becomes an important factor in the eating disorders (Noordenbos, Aliakbari & Campbell, 2014). It has been known that self- esteem have a significant relationship with dietary habits and any eating disorders. However, most researchers have been at the forefront of understanding this relationship in a clearer manner. As a result, many kinds of research has been carried out on the individuals who experiences eating disorders and have found out that such individuals tend to have low self-esteem than those people who do not have an eating disorder (Herbozo, Schaefer & Thompson, 2015). This research and others have revealed that anorexia nervosa have a significant association with lower levels of self-esteem and the perceived self-concept hence a significant influence on the eating disorder. Anger is another psychological factor that is associated with anorexia nervosa (Misra, 2015). The relationship between anger and eating disorders has been on the research lists for some time now. Anger appears to be a hard emotional factor to control (Ducharme, Wharff, Kahn, Hutchinson & Logan, 2012). Research was done by Ester et al. to determine the relationship between negative emotions and anorexia nervosa wins the patients who had eating disorders. In this study, all the participants in the study viewed anger as a factor that is an uncontrollable, terrifying emotion and unpredictable factors as they revealed having encountered difficulties in tolerating anger. This is to say that, people with anorexia nervosa experiences anger towards them, and thus they develop eating disorder so that to avoid anger that is haunting them (Huke & Slade, 2006). This is to say, that as long as they concentrate on food and body weight, they do not have chance of dealing with their irritation and anger that had occupied them (Appelhans, Whited, Schneider, Oleski & Pagoto, 2011). Anger is described as an emotional factor that is unpredictable and uncountable, and thus, it is an emotional factor that is indeed needed to be controlled (Kirkbride, 2013). Therefore, anger and anorexia go hand in hand as it is attributed to bad self-esteem and thus the victims tend to develop as a measure to cope up with their emotion rise due to anger. As an eating disorder, anorexia nervosa involves a lot of anger. Anger is however not only caused by self-denial but hunger as well (Kuppens & Tuerlinckx, 2007). This is because a malnourished body normally has a hard time trying to regulating itself in any way possible. When a person feels weak, hungry and tired is just enough to make people with anorexia nervosa to lash at their loved ones. Sadness is another psychological factor that is associated with anorexia nervosa (Javela, 2008). Studies have shown that, many victims feel sad, hopeless and lonely most of the time (Sullivan, 2008). There is usually closeness between being depressed and feeling sadness and body dissatisfaction in such that when they had a bad day or feeling depressed because they had experienced their bodies as being disgusting, awful and fat (Sejčová, 2008). As a result, the people with anorexia nervosa come up with strategies so that to manage their sadness and such strategies are related to the eating disorder and behaviors. Victims of anorexia use their anorectic behaviors as the way of defocusing or trying to avoid being sad. As a result, they try not to associate their feelings as measures to prevent feeling depressed as long as they focused on food, their body weight so as to avoid relating to their sadness. In their studies Naumann, Tuschen-Caffier, Voderholzer, and Svaldi, (2014) found out that, grief is experienced because it is an emotion that cannot be expressed. As a result of most people with anorexia nervosa, resort to masking their sadness while in front of other people despite feeling depressed most of the time, they pretend to be happy in the company of others. Lee and Lee( 2015) In their study on the association of sadness to anorexia found out that, the victims of this condition suppresses their sadness by coming up with measures like purging behavior or food restriction as such acts comforts themselves. He explains that people with this condition restrict themselves by not eating to suppress his negative emotions that include their sadness. Nonetheless, restraint eating behaviors are described by Türker (2013) as strategies used to regulate the emotions by the act of controlling their food intake as it is seen to induce positive feelings such as mastery, control and happiness and these are the means that are intended to suppress one’s sadness. Disgust is another psychological factor that is associated with anorexia nervosa, and it recognized as a psychological condition (Aharoni & Hertz, 2011). Disgust affects the anorexia nervosa victims in such a way that it gives them a feeling of nausea and sickness as well. This feeling is associated with other emotional reactions including feeling fat, ghastly and filthy (Powell, Simpson & Overton, 2015). Disgust is in anorexia nervosa condition is mostly related to food intake and the general feeling of being satisfied as eating food makes the victims feel disgusting and obese. Disgust in anorexia is said to be triggered by occurrences when the victims become reminded of their body image for instance when they look at themselves in a mirror, taking a bath and being touched with other people. Feeling disgusted is also described as an emotional reaction that is experienced when the victims of the eating disorders feel vulnerable towards the judgments that are usually made other people or in the cases that they receive negative feedbacks or comments from other. This situation makes the victims react and feel awful in front of others, and this implies that there exists a significant association between body dissatisfaction and disgust. This is to say, when the victims feel disgusted, they have also felt big and fat as well. The victims of this condition thus come up with the measure to avoid feeling nauseated through avoidance which was directly related to the disorders in the eating behaviors, for example, body awareness, eating food and restrictive eating. In a research done by O’Brien et al., (2013) it was revealed that the victims of anorexia nervosa prevented being disgusted by avoiding situations that were directed related to disgust. This is done by avoiding body awareness campaign and food as well as the situation in their social life that meant exposing their body to other people. The victims also avoid sexuality and closeness to other people. A study by Brytek-Matera, (2012) pointed out that, the victims of anorexia nervosa prevents the relationship with their body by avoiding to look at it or paying attention to what takes place in their body. Perfectionism is another factor that is related to anorexia nervosa (Brytek-Matera, 2012). In reality, nobody is ever perfect that the anorexics they think that they should be perfect. Studies have revealed that perfectionism is one of the major factors that are associated with increased risks of developing eating disorder. Perfectionism is a situation where people strive to be flawless through setting of performance standard that are beyond reach. Such expectations are usually accompanied by critical self- evaluation and then developing concern about other people’s evaluations. In this regard, perfectionism propels people to attempt achieving ideals that are difficult to attain and therefore they develop some adaptations so as to motivate them in attaining goals. In the cases where the individual strives to achieve perfect body figure and weight, the victims may try to limit food intake as way of reducing weight gain. At the end, such people are deprived pleasure from developing this eating disorders and this implies that, when they fail to achieve their goals, they therefore become depressed hence developing eating disorders. Neuroticism is also another factor that is related to the eating disorders. Neuroticism refers to a character trait that is characterized by fear, jealousy, loneliness and moodiness. Researches have found out that people having this character trait are prone to developing psychiatric problems such as eating disorders (Cassin & Ranson, 2009). Nevertheless, the mechanism through which Neuroticism is related to the eating disorders is unknown. The association between these two variables is attributed to stress and coping lifestyle that can be explained by the interaction between the two variables. Social factors Pressure from the society Eating disorder happens in industrialized cultures that emphasize on being thin and especially in circumstances where being thin is related to success. The pressure to be thin leads to intense dieting procedures that even affects young children and this can turn into a dieting disorder in the lives of people that are vulnerable to get the disturbances. Televisions and magazines and all other related media have portrayed an unrealistic image what a perfect and fruitful person should be. For instance, the models in the daily magazines and television shows have continuously grown thinner and thinner every passing day. In most cases, an average modeling woman weighs approximately 25% less than the ordinary woman as she struggles to maintain a body weight that is about 15 to 20 percent below the standard weight that is considered healthy for the height (M. Gardner, 2011). In some cases, some of the models even contemplate plastic surgery so that they mold their bodies to be more photogenic. In reality, these body images are not the standard types and cannot be obtained in normal circumstances. Most of the people with such desires to achieve such body image come develop eating disorders by controlling their diets so that to achieve their goals. Research that was done by Monro and Huon, (2006) associated exposure to the thin ideal in the media to body dissatisfaction, eating disorder among women and internalization of the model thin. Family attitudes Family attitudes also contribute significantly to some children developing anorexia nervosa (Lyke & Matsen, 2013). This happens in families that place most focus on high achievement, emphasizes on an individual being perfect and are more concerned with the general body appearance. This makes the affected children develop difficulty in discussing or coping up with the negative emotions that include sadness and anger as well. As a result, the children start worrying about the instance of being socially accepted, and thus they develop an anorexia nervosa as a measure to achieve the family’s expectation. Studies have shown that children who have anorexia nervosa usually have a poor family relationship (Kral & Rauh, 2010). This is because the children become afraid of disappointing the parents or the children try to control the conflict within them that are unspoken due to lack of harmony in the family. Eating disorders can also crop up in children who are overprotected by the family. Research has shown that relatives of the children or individuals who develop eating disorders tend to be focused on success, rigid and perfectionists (Kral & Rauh, 2010). This is because such families develop unreasonable expectations of their children and places exaggerated attention on outside rewards. This is to say that, the children from such families try as much as possible to achieve the appearance of success by being attractive and thin. Reflection of the study The purpose of the paper review was to describe the psychological factors that are associated with the eating disorder commonly referred to as anorexia nervosa and how the victims of this condition manage the experiences. However, anorexia can be diagnosed basing on the eating habits, signs and symptoms of the disorder. People with the eating disorders are advised to visit the doctors so that the doctors can perform the psychological exams and various tastes so that to pin point the diagnosis. In the diagnosis of the eating disorders, exam tastes that can be carried out include, physical examination, psychological examination and other studies that checks for complications that emerge from the eating disorders. In this paper Emotional problems have been discussed in detail as psychological factors underlying the eating disorders. This literature review contributes significantly to the literature because throughout this study, a description of how patients themselves formulate measures to counter their eating disorders is discussed. Emotional problems have been discussed in detail as psychological factors underlying the eating disorders. This literature review contributes significantly to the literature because throughout this study, a description of how patients themselves formulate measures to counter their eating disorders is discussed. Throughout this study, it is revealed that the victims of anorexia nervosa associate their emotions is particular ways. A good example is where fear and sadness is related to body dissatisfaction and body disgust. This research does not challenge the preexisting reviews in the literature about the eating disorders. Many types of research have been before this research but what surprised me throughout this research is the fact that some people are not just satisfied with their body image. It is true that people should keep their bodies fit and not overweight to prevent the health factors that emerge as a result of that, but caution must be taken through the application of the recommended measures. However, it is not just acceptable or advisable to starve them just to reduce their weight. There are some safe ways of keeping a healthy and body plus the required body weight. This teaches me that, people should love themselves and accept their body image rather than having a poor body image. Conclusion It is true that anorexia nervosa is a critical life threatening eating disorder that arises due self starvation and the excessive exercise of weight loss. People with this condition eat inadequate food, have intense fear of gaining weight, low self- esteem and they have inability to accept the severity of the condition. Since these factors are not that predictive, they may contribute significantly towards the creation of an eating disorder. People with these eating disorders become sensitive toward comments that are made about food, they often talk about body weight and food and expresses dissatisfaction with their body thus making them anxious and depressed. References Aharoni, R., & Hertz, M. (2011). Disgust Sensitivity and Anorexia Nervosa. European Eating Disorders Review, 20(2), 106-110. http://dx.doi.org/10.1002/erv.1124 Appelhans, B., Whited, M., Schneider, K., Oleski, J., & Pagoto, S. (2011). Response style and vulnerability to anger-induced eating in obese adults. Eating Behaviors, 12(1), 9-14. http://dx.doi.org/10.1016/j.eatbeh.2010.08.009 Breithaupt, L., Payne, H., & Rose, M. (2014). Body checking as a behavioral link: A preliminary study assessing inhibition and its association to idiosyncratic body checking in anorexia nervosa. Eating Behaviors, 15(4), 591-594. http://dx.doi.org/10.1016/j.eatbeh.2014.08.003 Brown, T., Holland, L. and Keel, P. (2013). Comparing operational definitions of DSM-5 anorexia nervosa for research contexts. Int. J. Eat. Disord., 47(1), pp.76-84. Brytek-Matera, A. (2012). The relationship between body image disturbance and coping with stress in patients suffering from anorexia nervosa. Polish Psychological Bulletin, 43(4). http://dx.doi.org/10.2478/v10059-012-0028-z Bulik, C., Reba, L., Siega-Riz, A. and Reichborn-Kjennerud, T. (2005). Anorexia nervosa: Definition, epidemiology, and cycle of risk. Int. J. Eat. Disord., 37(S1), pp.S2-S9. Cassin, S.E.. & von Ranson, K.M. (2005). Personality and eating disorders: A d Creitz, A. (2013). Sources: Eating Disorders: An Encyclopedia of Causes, Treatment, and Prevention. Reference & User Services Quarterly, 53(2), 197-197. http://dx.doi.org/10.5860/rusq.53n2.197b Dellava, J., Kendler, K., & Neale, M. (2011). Generalized anxiety disorder and anorexia nervosa: evidence of shared genetic variation. Depression And Anxiety, 28(8), 728-733. http://dx.doi.org/10.1002/da.20834 Ducharme, P., Wharff, E., Kahn, J., Hutchinson, E., & Logan, G. (2012). Augmenting Anger Control Therapy with a Videogame Requiring Emotional Control: A Pilot Study on an Inpatient Psychiatric Unit. Adolescent Psychiatrye, 2(4), 323-332. http://dx.doi.org/10.2174/2210676611202040323 ecade in review. Clinical Psychology Review, 25, 895-9. Herbozo, S., Schaefer, L., & Thompson, J. (2015). A comparison of eating disorder psychopathology, appearance satisfaction, and self-esteem in overweight and obese women with and without binge eating. Eating Behaviors, 17, 86-89. http://dx.doi.org/10.1016/j.eatbeh.2015.01.007 Huke, K., & Slade, P. (2006). An exploratory investigation of the experiences of partners living with people who have bulimia nervosa. European Eating Disorders Review, 14(6), 436-447. http://dx.doi.org/10.1002/erv.744 Hulme, N., Hirsch, C., & Stopa, L. (2012). Images of the Self and Self-Esteem: Do Positive Self-Images Improve Self-Esteem in Social Anxiety?. Cognitive Behaviour Therapy, 41(2), 163-173. http://dx.doi.org/10.1080/16506073.2012.664557 Iannaccone, M., D'Olimpio, F., Cella, S., & Cotrufo, P. (2016). Self-esteem, body shame and eating disorder risk in obese and normal weight adolescents: A mediation model. Eating Behaviors, 21, 80-83. http://dx.doi.org/10.1016/j.eatbeh.2015.12.010 Jaeger, M., & Câmara, S. (2015). Media and Life Dissatisfaction as Predictors of Body Dissatisfaction. Paidéia (Ribeirão Preto), 25(61), 183-190. http://dx.doi.org/10.1590/1982-43272561201506 JAVELA, J. (2008). ANGER AND ASSOCIATED EXPERIENCES OF SADNESS, FEAR, VALENCE, AROUSAL, AND DOMINANCE EVOKED BY VISUAL SCENES. Psychological Reports, 103(7), 663. http://dx.doi.org/10.2466/pr0.103.7.663-681 Kirkbride, R. (2013). The Anger Alphabet: understanding anger – an emotional development programme for young children aged 6 to 12 (second edition). Educational Psychology In Practice, 29(3), 328-329. http://dx.doi.org/10.1080/02667363.2013.819666 Kral, T., & Rauh, E. (2010). Eating behaviors of children in the context of their family environment. Physiology & Behavior, 100(5), 567-573. http://dx.doi.org/10.1016/j.physbeh.2010.04.031 Kral, T., & Rauh, E. (2010). Eating behaviors of children in the context of their family environment. Physiology & Behavior, 100(5), 567-573. http://dx.doi.org/10.1016/j.physbeh.2010.04.031 Kuppens, P., & Tuerlinckx, F. (2007). Personality traits predicting anger in self-, ambiguous-, and other caused unpleasant situations. Personality And Individual Differences, 42(6), 1105-1115. http://dx.doi.org/10.1016/j.paid.2006.09.011 Lee, J., & Lee, Y. (2015). The association of body image distortion with weight control behaviors, diet behaviors, physical activity, sadness, and suicidal ideation among Korean high school students: a cross-sectional study. BMC Public Health, 16(1). http://dx.doi.org/10.1186/s12889-016-2703-z Lyke, J., & Matsen, J. (2013). Family functioning and risk factors for disordered eating. Eating Behaviors, 14(4), 497-499. http://dx.doi.org/10.1016/j.eatbeh.2013.08.009 M. Gardner, R. (2011). What Affects Body Size Estimation? The Role of Eating Disorders,Obesity, Weight Loss, Hunger, Restrained Eating, Mood, Depression,Sexual Abuse, Menstrual Cycle, Media Influences, and Gender. Current Psychiatry Reviews, 7(2), 96-103. http://dx.doi.org/10.2174/157340011796391193 Misra, M. (2015). Anorexia nervosa. Bone Abstracts. http://dx.doi.org/10.1530/boneabs.4.is22biog Monro, F., & Huon, G. (2006). Media-portrayed idealized images, self-objectification, and eating behavior. Eating Behaviors, 7(4), 375-383. http://dx.doi.org/10.1016/j.eatbeh.2005.12.003 Naumann, E., Tuschen-Caffier, B., Voderholzer, U., & Svaldi, J. (2014). On the role of sadness in the psychopathology of anorexia nervosa. Psychiatry Research, 215(3), 711-717. http://dx.doi.org/10.1016/j.psychres.2013.12.043 Noordenbos, G., Aliakbari, N., & Campbell, R. (2014). The Relationship Among Critical Inner Voices, Low Self-Esteem, and Self-Criticism in Eating Disorders. Eating Disorders, 22(4), 337-351. http://dx.doi.org/10.1080/10640266.2014.898983 Noordenbos, G., Aliakbari, N., & Campbell, R. (2014). The Relationship Among Critical Inner Voices, Low Self-Esteem, and Self-Criticism in Eating Disorders. Eating Disorders, 22(4), 337-351. http://dx.doi.org/10.1080/10640266.2014.898983 O’Brien, K., Daníelsdóttir, S., Ólafsson, R., Hansdóttir, I., Fridjónsdóttir, T., & Jónsdóttir, H. (2013). The relationship between physical appearance concerns, disgust, and anti-fat prejudice. Body Image, 10(4), 619-623. http://dx.doi.org/10.1016/j.bodyim.2013.07.012 Parkinson, B., & Manstead, A. (2015). Current Emotion Research in Social Psychology: Thinking About Emotions and Other People. Emotion Review, 7(4), 371-380. http://dx.doi.org/10.1177/1754073915590624 Paterson, G., Power, K., Collin, P., Greirson, D., Yellowlees, A., & Park, K. (2011). A mediational model of self-esteem and social problem-solving in anorexia nervosa. European Eating Disorders Review, 19(2), 112-120. http://dx.doi.org/10.1002/erv.1021 Pila, E., Sabiston, C., Brunet, J., Castonguay, A., & O'Loughlin, J. (2015). Do body-related shame and guilt mediate the association between weight status and self-esteem?. Journal Of Health Psychology, 20(5), 659-669. http://dx.doi.org/10.1177/1359105315573449 Pollice, C., Kaye, W., Greeno, C., & Weltzin, T. (1997). Relationship of depression, anxiety, and obsessionality to state of illness in anorexia nervosa. Int. J. Eat. Disord., 21(4), 367-376. http://dx.doi.org/10.1002/(sici)1098-108x(1997)21:43.0.co;2-w Powell, P., Simpson, J., & Overton, P. (2015). Self-affirming trait kindness regulates disgust toward one's physical appearance. Body Image, 12, 98-107. http://dx.doi.org/10.1016/j.bodyim.2014.10.006 SejÄová, L. (2008). Body Dissatisfaction. Human Affairs, 18(2). http://dx.doi.org/10.2478/v10023-008-0017-1 Sternheim, L., Startup, H., & Schmidt, U. (2014). Anxiety-related processes in anorexia nervosa and their relation to eating disorder pathology, depression and anxiety. Advances In Eating Disorders, 3(1), 13-19. http://dx.doi.org/10.1080/21662630.2014.948469 Sternheim, L., Startup, H., & Schmidt, U. (2014). Anxiety-related processes in anorexia nervosa and their relation to eating disorder pathology, depression and anxiety. Advances In Eating Disorders, 3(1), 13-19. http://dx.doi.org/10.1080/21662630.2014.948469 SULLIVAN, M. (2008). Bullies and Victims Feel Worthless, Sad, Unsafe. Clinical Psychiatry News, 36(4), 30. http://dx.doi.org/10.1016/s0270-6644(08)70247-9 Türker, E. (2013). A corpus-based approach to emotion metaphors in Korean: A case study of anger, happiness, and sadness. Review Of Cognitive Linguistics, 11(1), 73-144. http://dx.doi.org/10.1075/rcl.11.1.03tur Thomas, M., & Lovell, A. (2014). Anxiety and compulsion patterns in the maintenance of bingeing/purging behaviours by individuals with bulimia nervosa. J Psychiatr Ment Health Nurs, 22(1), 20-29. http://dx.doi.org/10.1111/jpm.12167 Vardar, E., Vardar, S., & Kurt, C. (2007). Anxiety of young female athletes with disordered eating behaviors. Eating Behaviors, 8(2), 143-147. http://dx.doi.org/10.1016/j.eatbeh.2006.03.002 Wilsdon, A., & Wade, T. (2006). Executive functioning in anorexia nervosa: Exploration of the role of obsessionality, depression and starvation. Journal Of Psychiatric Research, 40(8), 746-754. http://dx.doi.org/10.1016/j.jpsychires.2005.10.006 Read More

In this regard, the person behaves in a manner that shows obliviousness with the seriousness of their low body weight. Secondly, they showcase a persistent and deliberate restriction in taking foods that increase energy, the effect of which is relatively low body weight compared to the minimally expected (based on sex, age, etc.). Thirdly, the individuals must display an intense fear of becoming fat or gaining weight (Brown, Holland, & Keel 2013) . Psychological factors People who develop anorexia nervosa experience behavioral and personality characteristics that make them vulnerable to get this condition because they have a tendency towards being anxious, depressed and occupied by fear (Dellava, Kendler & Neale, 2011).

Fear and anxiety are described as overwhelming and invading emotional feelings. These feelings are those that are usually ever-present and restless lump experienced in the stomach. Fear, anxiety and depression related to food intake and body weight (Hulme, Hirsch & Stopa, 2012). This is because; the victims are typically afraid of gaining body weight in the sense that they feel anxious, fat and out of control when they eat food. Studies have shown that most victims with anorexia nervosa report to be mostly concerned with other people’s opinions or comments.

This is because the victims feel tension and fear that triggers fear of being fat or failure in case the victims meet other people (Thomas & Lovell, 2014). Anxiety, depression, and fear are more than just feelings. In some case, these feelings happen due to a typical reaction to an occasion or situation and typically go away after that stressful situation is long gone (Pila, Sabiston, Brunet, Castonguay & O'Loughlin, 2015). However, people with anorexia nervosa also experiences stress about their body weight.

They become anxious about doing some steps that can help them resolve such stress, and their first resolution is developing an eating disorder. In the case that such resolutions do not work, they end up becoming depressed and obsessed about their current body weight condition. The research was done by Wilsdon and Wade (2006) on the relationship between anxiety, fear, and depression with anorexia nervosa. In this study, three groups of women who had anorexia nervosa were researched on using the Hamilton Rating Scale for Anxiety and depression while fear was analyzed using the Yale- Brown Obsessive Compulsive Scale throughout this study.

After a thorough comparison of anxiety, fear, and depression, it was found out that severe eating disorder was most prevalent in the underweight women. This study, therefore, reveals that these psychological factors, anxiety, depression, and fear have a significant relationship with anorexia nervosa condition. Low self-esteem is another psychological factor that is associated with anorexia nervosa. In this case, the victims have poor body images towards themselves. Disturbance in body image is common clinical features that occur as results of eating disorder.

Contemporary theories consider poor body image to the development of anorexia nervosa and the related studies also confirms this. Recent studies have related low self-esteem about one’s body image to psychopathology that is measured by eating disorder and all the temperamental characteristics. This relates to body image disturbance and other factors that include feelings of ineffectiveness and having poor interoceptive awareness. Therefore, self-esteem becomes an important factor in the eating disorders (Noordenbos, Aliakbari & Campbell, 2014).

It has been known that self- esteem have a significant relationship with dietary habits and any eating disorders. However, most researchers have been at the forefront of understanding this relationship in a clearer manner. As a result, many kinds of research has been carried out on the individuals who experiences eating disorders and have found out that such individuals tend to have low self-esteem than those people who do not have an eating disorder (Herbozo, Schaefer & Thompson, 2015).

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