Social Cultural and Psychological Factors in Anorexia Nervosa - Coursework Example

Social Cultural and Psychological Factors in Anorexia Nervosa Name: Date: Abstract Anorexia nervous is identified as a critical eating disorder that is associated with mental disorder. Issues of anorexia nervosa are commonly present in teenage girls and young women who are in art ventures such as modeling and dance or those that are insecure about their bodies. Although anorexia nervosa is present among boys and girls, there is a higher rate among girls who are affected three times more as compared to male patients. According to Lindblad et al. (2006) eating disorders are multifaceted conditions which develop from psychological, social, emotional, behavioral and interpersonal interactions. The prevalent nature of this eating disorder is attributed to competitive environments where an individual has a lot of physical and emotional pressure to be slim or meet certain expectations. Due to the serious nature of this eating disorder, anorexia nervosa has been defined as chronic disease whish has a high mortality rate. Gender, ethnicity, sexual abuse, childhood eating habits, physical insecurities such as weight and body shape, gastrointestinal issues and psychiatric morbidity are among the most diverse risk factors linked to anorexia nervosa. The primary aim of this study is to investigate the psychological and social factors associated with anorexia nervosa. The impacts of social- cultural factors are discussed as a multi-determining element in anorexia nervosa. Additionally, this study will investigate the predictive factors of the mortality rate resulting from anorexia nervosa. Introduction Eating disorders develop as a way to compensate for feelings or emotions that one is unable to control or express. As a result a person may decide to indulge in dieting, bingeing or purging in order to deal with the emotional conflicts that one is faced with (Joergensen, 1992). These behaviors act as a coping mechanism that allows them take control of their lives and overcome painful emotional encounters. Unfortunately these eating disorders end up interfering with the health, physical and mental wellbeing of an individual as it influences their self-esteem, self-efficacy, emotional competence and control. The variants of eating disorders exhibit serious disturbances in their diets and weight regulation (Wentz et al., 2001). The character traits of an eating disorder are related to various psychological, physical and social outcomes that influence their eating habits. These characteristics begin once a person starts to regulate the amount of food they ingest. An eating disorder starts to develop slowly and accelerates real quickly and will commence when one starts to eat small or large amounts of food without taking any health precautions. The urge to control the food amounts consumed and weight in a person with an eating disorder is no longer manageable for them thus leading to the development of an eating disorder (Herzog, 2000). Extreme mental stress in regards to body shape, size and weight in an effort to manage ones physical appearance is part of the symptoms associated with eating disorders. It is however important to note that eating disorders can be managed and are treatable medical conditions. Majority of eating disorders coexist with mental illnesses such as depression and anxiety which can easily accelerate and be life threatening. Patients are encouraged to receive medical assistance to treat these symptoms as they could easily lead to death (Crisp et al., 1992). In the past anorexia nervosa among teenagers and young women has been a major concern for the public as well as the diverse health practices in human anatomy. Research has shown that anorexia nervosa is no longer identified as an atypical disorder but rather a growing concern that is recurrent in young women mainly of the ages 14 and 25 years (Wentz, 2001). Symptoms of anorexia nervosa register high mortality rates due to the psychiatric conditions linked to it. Hoek (2006), describes anorexia nervosa as an eating and mental health disorder whereby a person works hard to maintain a low body weight of 25% less than the expected weight as much as they can. This is achieved by altering ones diet and reducing the amount of food one should consume to maintain a healthy body weight for their BMI. According to Silberg and Bulik (2005), patients with this eating disorder are fixated on maintaining a minimum expected body weight, have a distorted body image of them and possess a great fear of gaining any body weight. Anorexia nervosa patients will often force themselves to vomit, exercise excessively or miss their daily meals. This mental and eating health disorder develops as a result of body insecurities and low self esteem. Individuals with anorexia nervosa have the notion that they are fat when in real sense they are not and as a result they embark on starving themselves. Social cultural and psychological factors are identified as the common and critical factors that contribute to the rising cases of anorexia nervosa. Predisposing, precipitating and perpetuating factors are stages of anorexia nervosa that are divided into both social and psychological factors which accelerate the development of anorexia nervosa at the beginning, intermediate and adverse stage (Silberg & Bulik, 2005). During the initial stages of anorexia nervosa, the predisposing factors increase the chances of one developing anorexia nervosa. This is because the predisposing factors are strongly influenced by the social aspects rather than the psychological ones. Social cultural factors include; family interactions, parental views on weight gain or loss, the desire to be thin and environmental attributes resulting to stress. All these factors play a critical role in the development of anorexia nervosa. Psychological factors associated with anorexia nervosa include personality and behavioral traits. Depression and anxiety are the main psychological factors which are attributed to this illness. This is because most of the individuals that develop anorexia nervosa tend to worry a lot about certain aspects of their lives which they cannot control, as well as possess a certain kind of obsession and compulsion on what they eat and how they look (Arcelus et al., 2013). Discussion Studies have revealed that the prevalent nature of anorexia nervosa is high among girls and begin to develop during the early stages of adolescence (Crisp, 1977). Nonetheless, the development of anorexia nervosa is related to gender, social class and age whereby some researchers argue that there are higher rates of anorexia nervosa in some communities as compared to others. In a past research, Crisp and Kalucy (1979) argue that anorexia nervosa has a high prevalence in wealthy communities, whereby individuals from wealthy families are likely to succumb to anorexia nervosa in comparison to those from poor backgrounds. Despite the biasing criteria in these studies, these social cultural determinants are identified as important factors contributing to the growth and development of anorexia nervosa (Crisp, 1965; Crisp et al. 1976; Bruch, 1973; Russel, 1977). Wealth communities tend to have an idea of how women should look and further influence how females perceive themselves. According to Crisp (1965), ideas of weight loss or gain will trigger feelings of inadequacy which further contribute to anxiety and depression hence contributing to the development of anorexia nervosa. Thus, the individual, family and cultural beliefs on dieting have become the main drivers of eating disorders in these communities. Furthermore, starvation will accelerate the psychological factors of anorexia nervosa such as depression and anxiety which will contribute to the cognitive disturbance in an anorexia nervosa patient (Bruch, 1973). Cultural preferences in terms of the ideal body image and weight for a woman are some of the social characteristics that have contributed to the development of anorexia nervosa. Crisp et al (1976), argue that this eating disorder has increased in most societies due to the cultural aesthetic preferences, where slim or thinner women are more desirable. This has put pressure on women and especially teenagers and young women to exercise excessively, diet and appear slim. The cultural pressures put on women to diet and assume a slim body is a predisposing that has lead to the high rates of anorexia nervosa (Bruch, 1973). These cultural expectations that women have to maintain a thin body is most popular among women in high class. According to Morgan and Russell (1975), the idea of having a thin body is perceived as a symbol of success and fashion statement in the contemporary world where beauty is measured by a woman’s physical statue. The ideal body preference varies from different communities and over the past 20 years the western world has embraced the slim body as ideal among women. Moreover, in the past decade, there has been a significant increase in the of diet articles in women’s magazine. These aesthetic beliefs are evident in the pervasiveness of dieting in women. The number of women following a dieting plan or taking diet pills continues to increase so as they can attain the standard ideal body shape within their social context. Statistics from a research by Slade and Russel (1973), revealed that 65-70% of girls perceive themselves as overweight and would like to lose weight. Women tend to start ‘feeling fat’ while in high school and start to diet hence explaining the interpersonal conflicts that teenagers and young women have leading to anorexia nervosa. Parental attitudes towards shape, weight and appearance act as precipitating factors that stress young girls especially those in upper socio-economic environments to obsess over weight loss. The psychological factors associated with anorexia nervosa are identified as predisposing, precipitating as well as perpetuating factors of anorexia nervosa (Silberg & Bulik, 2005). As a result patients start developing psychopathological changes which influence the level of mental stress and emotional stability among patients. Anorexia nervosa is closely related to the self-perception and self-efficacy of an individual as it influences their emotional, physical and mental wellbeing. Depression and anxiety is prevalent among teenagers suffering from anorexia nervosa as compared to young women (Arcelus, 2013). These two psychological effects of anorexia nervosa are developed once a patient starts to develop obsessive compulsive behaviors about food and their weight. Anorexia nervosa patients are reluctant to eat or be seen eating by others and take part in intensive exercise to maintain a very low weight or keep off any weight. Body dissatisfaction, ineffectiveness, perfectionism, interpersonal distrust, interceptive awareness and maturity fears are among the psychological factors which precipitate and perpetuate anorexia nervosa (Crisp, 1977). These characteristics are linked to the mental fears leading to depression and anxiety. Garner and Garfinkel (1978), state that body dissatisfaction reflects on the idea that the changes in body size, shape and weight during puberty is a form of deficit. Puberty developments such as the enlargement of hips, thighs and buttocks are viewed as a symbol of being overweight among anorexia nervosa adolescents. As a result these teenagers start taking part in intense dieting and exercise (Crisp, 1977). Body dissatisfaction leads to the feeling of ineffectiveness whereby the patient feels inadequate and is filled with feelings of insecurities with their body image. As a result the patient lacks control of their own life; this precipitating factor is described as disturbance in anorexia nervosa (Bruch, 1973; Selvini-Palazzoli, 1978; Strober, 1980; Wingate and Christie, 1978). The feelings of ineffectiveness bring about negative self-evaluation and low self-esteem yet another accelerating psychological factor of anorexia nervosa (Garner et al., 1982). This results to the desire to be perfect and attain high expectations. Garner et al. (1982), describes this as the “over compliant adaptation” in anorexia nervosa where a patient has an increasing pressure to succeed. Interpersonal distrust, interceptive awareness and maturity are the perpetuating psychological factors of anorexia nervosa as they involve feelings of alienation, reluctance and denial (Selvini-Palazzoli, 1978; Goodsitt, 1969,1977; Story, 1977; Strober, 1980). Patients develop paranoia and do not want to form any relationships as well as express their feelings. Bruch (1973) and Selvini-Palazzoli (1978) argue that this is a deficiency that is related to interceptive labeling and is seen as central to anorexia nervosa. The psychological aspects of anorexia nervosa may become adverse leading to severe chronic diseases related to the eating disorder or in extreme cases may lead to death. Thus in the management of these factors, it is important that the patient is put under a therapeutic treatment. Family therapy as well as psychotherapy for the patient is critical as they offer supportive and psychiatric medical assistance which enables a patient to develop an attitude of acceptance. This way the recovery processes is aided by physical, emotional and mental treatment which encourage the psychological well-being of a patient (Wentz et al. 2001). Summary Anorexia nervosa is a multidimensional disorder which is characterized by biological and environmental factors. As an eating disorder anorexia nervosa is accompanied by obsessive traits that trigger the development and adverse nature of the psychopathological mental and emotional changes of a patient. This obsession is compulsive and disrupts the health and social wellbeing of an individual. Anorexia nervosa is an assertion of both social-cultural and psychological factors which are the predisposing, perpetuating and precipitating features of anorexia nervosa (Wentz et al., 2001). As discussed above, cultural differences in varying communities directly influence the individual, parental and communal attitudes towards body shape, weight and size. Society beliefs and practices influence the eating behaviors of individuals who are part of that community. Despite the fact that anorexia nervosa is evident in both male and females, women are mostly affected due to the pressure they face in the society. Women receive both internal and external pressure to look and maintain a specific body image. The popular belief that being thin is more desirable among women continues to influence the attitudes of the society towards anorexia nervosa. As a result anorexia nervosa patients over look their body size and fail to recognize themselves as being malnutrition or underweight (Hoek, 2006). Hypothalamic dysfunction has been identified as part of the bodily disturbances that play a critical role in the development of anorexia nervosa. These disturbances are characterized by the patient’s lack of ability to put on weight, malnutrition and vulnerability to succumb to adverse stages of anorexia nervosa. Obsessive behaviors lead to starvation which triggers mental instability that contributes to depression, anxiety and neuroticism furthering the cycle of anorexia nervosa in patients (Herzog, et. al., 2000). Taking into account the various social and psychological, it is evident that they play an etiological role that in the patient’s health and interactions. Thus in order for a patient to develop a full recovery, the treatment of anorexia nervosa must involve a comprehensive management plan that will see to it that a patient is cured. Therefore a multidimensional approach in the treatment plan must encompass therapy that not only focuses solely on the patient but also on their immediate environment. Critics argue that it is important to have a rehabilitation treatment plan that involves family members, behavior therapy supportive psychotherapy as well as a physical medical and management plan (Silberg and Bulik, 2005). Reflection Research on eating disorders continues to evolve as scientists come up with new and current ways to diagnose an eating disorder and administer treatment. Eating disorders are mental and physical ailments that are often overlooked until a patient succumbs to the final stages of the disease. It is a challenge for most patients especially young girls to admit that one is suffering from an eating disorder as they assume that their behaviors are normal. The high mortality rate associated with anorexia nervosa is as a result of natural and unnatural factors that lead to the development and adverse stages of the eating disorder. There are no distinctive factors that cause anorexia nervosa since the social and psychological factors are intertwined and every patient has unique traits. Nonetheless, studies use these factors as preliminary tools used in the diagnosis and treatment of anorexia nervosa. Despite these qualifications, these preliminary screening procedures must undergo clinical analysis whereby psychological tests are viewed as an aid and not a replacement for clinical trials. Past research on anorexia nervosa use an isolation and objective procedure in the study of this eating disorder in order to come up with measurable psychological features associated with it. Data gathered on this subject presents reliable and valid answers as most of the information collected heavily depends on economical instruments in the evaluation and analysis of the social cultural and psychological characteristics among patients. However, most of the data collected mainly focuses on female subjects as opposed to the male counterparts. This is despite the fact that anorexia nervosa affects both women and men across the spectrum. As a result in studying the social and psychological aspects of anorexia nervosa the outcomes are biased as the various factors and outcomes are restricted to female in-patients or subjects. It would have been more informative in the data was inclusive to allow the audience to have a broad overview and understanding of the topic and its subjects. Extensive research is needed to provide specific risk factors that contribute to the deathly outcomes of anorexia nervosa. This way better treatment technique can be employed to assist patients according to the symptoms they possess. In the future specific treatment plans have to be introduced which are designed to meet a patient’s needs. Additionally, assessment in the treatment and management of anorexia nervosa should look more into other aspects of the disease that influence it. For instance behavioral patterns and genetics are some factors of anorexia nervosa which encourage the development of this eating disorder. Literature provided on this topic exempts the different notions that people have previously had on the topic of eating disorders. In most instances we tend to assume that eating disorders are self-imposed behaviors that a person adopts as part of their lifestyle. In most circumstances, people fail to think that these illnesses are actual life threatening diseases that endanger the health and life of a person. The literature used in this study has revealed that an eating disorder is closely related to the social interactions as well as the psychological wellbeing of a person. This goes to the ideas that society has on eating disorders, whereby most of us tend to assume that a person with an eating disorder does not really require treatment in order to overcome the ‘habit’ adopted. There should be more awareness in our communities to get rid of the ignorance that the society possesses on the subject of eating disorders. References Arcelus, J., Haslam, M., Farrow, C., & Meyer, C. (2013). The role of interpersonal functioning in the maintenance of eating psychopathology: a systematic review and testable model. Clinical Psychology Review, 33(1), 156-167. Bruch, H. (1973): Eating Disorders. New York: Basic Book Crisp, A. H., & Kalucy, R. S. (1974). Aspects of the perceptual disorder in anorexia nervosa. British Journal of Medical Psychology, 47(4), 349-361. Crisp, A. H. (1977). Anorexia Nervosa: Diagnosis and Outcome of Anorexia Nervosa: the St George's View. Crisp, A. H., Callender, J. S., Halek, C. H. R. I. S. T. I. N. E., & Hsu, L. K. (1992). Long-term mortality in anorexia nervosa. A 20-year follow-up of the St George's and Aberdeen cohorts. The British Journal of Psychiatry, 161(1), 104-107. Crisp, A. H., Palmer, R. L. & Kalucy, R. S. (1976), How common is anorexia nervosa. British Journal of Psychiatry, 128, 549-55 Crisp, A. H. (1965). Anorexia Nervosa: Some Aspects of the Evolution, Presentation and Follow-up of Anorexia Nervosa. Proceedings of the Royal Society of Medicine 58:814- 820. Duddle, M. (1973). An increase of anorexia nervosa in a university population. The British Journal of Psychiatry, 123, 711-712. Garner, D.M. & Garfinkel, P.E. (1978), Socio-cultural factors in anorexia nervosa, Lancet, II, 674. Garner, D.M., Garfinkel, P.H. & Bemis, K.M. (1982) A multidimensional psychotherapy for anorexia nervosa. International Journal of Eating Disorders 1, 3-46. Goodsitt, A, (1969) Anorexia nervosa. British Journal of Medical Psychology 42:109-118, Goodsitt, A, (1977) Narcissistic disturbances in anorexia nervosa. In Adolescent Psychiatry, Vol. 5. Edited by Feinstein, S.C, and Giovacchini, P.L, New York: Jason Aronson. Herzog, D. B., Greenwood, D. N., Dorer, D. J., Flores, A. T., Ekeblad, E. R., Richards, A., ... & Keller, M. B. (2000). Mortality in eating disorders: a descriptive study. International Journal of Eating Disorders, 28(1), 20-26. Hoek, H. W. (2006). Incidence, prevalence and mortality of anorexia nervosa and other eating disorders. Current opinion in psychiatry, 19(4), 389-394. Joergensen, J. (1992). The epidemiology of eating disorders in Fyn County, Denmark, 1977– 1986. Acta Psychiatrica Scandinavica, 85(1), 30-34. Lindblad, F., Lindberg, L., & Hjern, A. (2006). Improved survival in adolescent patients with anorexia nervosa: a comparison of two Swedish national cohorts of female inpatients. American Journal of Psychiatry, 163(8), 1433-1435. Russell, G. F. M. (1977). The present status of anorexia nervosa, editorial. Psychological Medicine, 7, 363-36 Selvini-Palazzoli, M. (1978) Self-Starvation — From individual to family therapy in the treatment of anorexia nervosa. New York. Silberg, J. L., & Bulik, C. M. (2005). The developmental association between eating disorders symptoms and symptoms of depression and anxiety in juvenile twin girls. Journal of Child Psychology and Psychiatry, 46(12), 1317-1326. Slade, P. D., & Russell, G. F. M. (1973). Awareness of body dimensions in anorexia nervosa: Cross-sectional and longitudinal studies. Psychological medicine, 3(02), 188-199. Story, I, (1977) Caricature and impersonating the other: Observations from the psychotherapy of anorexia nervosa. Psychiatry 39:176-188, Strober, M. (1980). Personality and symptomatological features in young, nonchronic anorexia nervosa patients. Journal of psychosomatic Research, 24(6), 353-359. Wentz, E., Gillberg, C., Gillberg, I. C., & Råstam, M. (2001). Ten‐year Follow‐up of Adolescent‐onset Anorexia Nervosa: Psychiatric Disorders and Overall Functioning Scales. Journal of Child Psychology and Psychiatry, 42(5), 613-622. Wingate, B. A., & Christie, M. J. (1978). Ego strength and body image in anorexia nervosa. Journal of Psychosomatic Research, 22(3), 201-204. Read More

An eating disorder starts to develop slowly and accelerates real quickly and will commence when one starts to eat small or large amounts of food without taking any health precautions. The urge to control the food amounts consumed and weight in a person with an eating disorder is no longer manageable for them thus leading to the development of an eating disorder (Herzog, 2000). Extreme mental stress in regards to body shape, size and weight in an effort to manage ones physical appearance is part of the symptoms associated with eating disorders.

It is however important to note that eating disorders can be managed and are treatable medical conditions. Majority of eating disorders coexist with mental illnesses such as depression and anxiety which can easily accelerate and be life threatening. Patients are encouraged to receive medical assistance to treat these symptoms as they could easily lead to death (Crisp et al., 1992). In the past anorexia nervosa among teenagers and young women has been a major concern for the public as well as the diverse health practices in human anatomy.

Research has shown that anorexia nervosa is no longer identified as an atypical disorder but rather a growing concern that is recurrent in young women mainly of the ages 14 and 25 years (Wentz, 2001). Symptoms of anorexia nervosa register high mortality rates due to the psychiatric conditions linked to it. Hoek (2006), describes anorexia nervosa as an eating and mental health disorder whereby a person works hard to maintain a low body weight of 25% less than the expected weight as much as they can.

This is achieved by altering ones diet and reducing the amount of food one should consume to maintain a healthy body weight for their BMI. According to Silberg and Bulik (2005), patients with this eating disorder are fixated on maintaining a minimum expected body weight, have a distorted body image of them and possess a great fear of gaining any body weight. Anorexia nervosa patients will often force themselves to vomit, exercise excessively or miss their daily meals. This mental and eating health disorder develops as a result of body insecurities and low self esteem.

Individuals with anorexia nervosa have the notion that they are fat when in real sense they are not and as a result they embark on starving themselves. Social cultural and psychological factors are identified as the common and critical factors that contribute to the rising cases of anorexia nervosa. Predisposing, precipitating and perpetuating factors are stages of anorexia nervosa that are divided into both social and psychological factors which accelerate the development of anorexia nervosa at the beginning, intermediate and adverse stage (Silberg & Bulik, 2005).

During the initial stages of anorexia nervosa, the predisposing factors increase the chances of one developing anorexia nervosa. This is because the predisposing factors are strongly influenced by the social aspects rather than the psychological ones. Social cultural factors include; family interactions, parental views on weight gain or loss, the desire to be thin and environmental attributes resulting to stress. All these factors play a critical role in the development of anorexia nervosa. Psychological factors associated with anorexia nervosa include personality and behavioral traits.

Depression and anxiety are the main psychological factors which are attributed to this illness. This is because most of the individuals that develop anorexia nervosa tend to worry a lot about certain aspects of their lives which they cannot control, as well as possess a certain kind of obsession and compulsion on what they eat and how they look (Arcelus et al., 2013). Discussion Studies have revealed that the prevalent nature of anorexia nervosa is high among girls and begin to develop during the early stages of adolescence (Crisp, 1977).

Nonetheless, the development of anorexia nervosa is related to gender, social class and age whereby some researchers argue that there are higher rates of anorexia nervosa in some communities as compared to others.

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