Eating Disorders

Question 1

What is the Spectrum hypothesis?

Answer 1

Posits that eating disorders (specific bulimia and anorexia) are one syndrome with different manifestations

Question 2

What is one feature that distinguishes bulimia from anorexia?

Answer 2

Impulsivity (e.g. sexual promiscuity, suicide attempts, drug abuse, and stealing/shoplifting) is frequently noted in bulimia patients. “bulimics are failed anorexics”

Question 3

What is the ratio of bulimics to anorexics?

Answer 3

2:1

Question 4

How do the treatment seeking attitudes compare for bulimics and anorexics?

Answer 4

Bulimics are more likely to present themselves for treatment as the binge/purge cycle is extremely disturbing to them. Anorexics are frequently indifferent to their disorder and will only get treatment if referred by a loved one who is concerned for their life.

Question 5

What is the prognosis for eating disorders?

Answer 5

There is no easy treatment. About 1/3 of patients continue to meet diagnostic criteria 5 years and longer after initial treatment. Estimates of mortality including suicide rates range from 5%-8%.

Question 6

According to Polivy & Herman, what are the main obstacles to explaining why people have eating disorders?

Answer 6

It is impossible to conduct true experimental research in which a putative causal factor is manipulated, it is difficult to combine all these factors into a model that is not unwieldy, and it is difficult to find suitable samples of eating disorder patients, which has led to many studies that examine correlates of ED symptoms in normal populations.

Question 7

Some claim that idealized media images are to blame for eating disorders. According to Polivy and Herman, what are some arguments against this claim?

Answer 7

It is difficult to weigh the relative importance of peer influence against family influence and media influence since they all teach the same lessons. Also, culture may not necessarily compel females more than males to be thin, females may just be more attentive to these messages.

Question 8

What are 3 family influences on eating disorders?

Answer 8

• Eating disordered families are enmeshed, intrusive, hostile, & negating of the patients’ emotional needs. Insecure attachment is common.
• Adolescents who perceive family communications, parental caring and expectations as low and those who report sexual/physical abuse are at increased risk for developing EDs.
• Bulimia patients also report greater parental intrusiveness, specifically, maternal invasion of privacy, jealousy & competition, as well as paternal seductiveness.

Question 9

What are 3 characteristics of mothers of children with eating disorders?

Answer 9

• They think their daughters should lose more weight and describe them as less attractive than comparison moms or the girls themselves.
• They are more dissatisfied with the general functioning of the family system
• They are themselves more eating disordered than moms of girls who don’t have EDs

Question 10

What percentage of children of mothers with eating disorders have psychiatric disorders?

Answer 10

50%

Question 11

What are 2 methodological limitations of studies on family influence on eating disorders?

Answer 11

Most studies are correlational and retrospective questioning is frequently used, both of which undermine certainty about the causal relationship between family dysfunction and EDs

Question 12

According to Polivy & Herman, what is the relationship between childhood sexual abuse and eating disorders?

Answer 12

There is a connection between childhood sex abuse and bulimia symptoms. EDs may serve as a desperate attempt to regulate overwhelming negative emotions and construct a sense of self in the absence of internal structures. The refocus to body shape weight and eating can enable one to regain some emotional control.

Question 13

Episodes of binging and purging may _______ anxiety and depression in bulimics.

Answer 13

reduce

Question 14

What is the relationship between self-esteem, and bulimia?

Answer 14

Self-esteem moderates the relationship between [perfectionism and feeling overweight] and bulimic symptoms. Women with high self-esteem and the same diathesis-stress conditions are less likely to exhibit bulimic symptoms.

Question 15

According to Polivy and Herman, what are some problems with conducting research on biological risk factors for EDs?

Answer 15

• The assessment of many of these risk factors is often too costly & invasive to be done in prospective studies w/large nonclinical samples.
• No good empirical studies on genes

Question 16

According to Piran, what are “causes of cases”?

Answer 16

A type of risk factors which explain the occurrence of a specific disease in a specific individual at a specific time. Typically held by front line health care providers. Most ED research addresses this type of risk factors.

Question 17

What are examples of risks factors in “causes of cases”?

Answer 17

Weight concerns and dieting, internalization of thinness, negative body image, negative affectivity, and perfectionism.

Question 18

According to Piran, what are “causes of incidence”?

Answer 18

A type of risk factors that put specific populations at risk.

Question 19

What is an example of “causes of incidence”?

Answer 19

Gender as a risk factor involves gender inequity and its impact and expressions in girls’ social environment (e.g. greater rates of exposure to violation and harassment, greater restriction on physical activities, an emphasis on appearance as a way to obtain social power, or gender harassment).

Question 20

What are the 3 levels of risk factors in Piran’s multi-level model of causality

Answer 20

Macro, Mezzo, and Individual.

Question 21

What is the macro level of risk factors? Give an example.

Answer 21

The highest level of risk factors which related to social structures and position, such as gender, social class, age or ethnicity. These factors have experiences at lower lvls of causality & should be addressed through healthy public policy that aims to redistribute resources in society.

Question 22

What is the mezzo level of risk factors? Give an example.

Answer 22

The second highest level of risk factors relates to environmental influences, such as neighborhoods or schools which are both shaped by the higher level social structures and in turn affect experiences at the lower, individual level.

Question 23

What is the individual level of risk factors? Give an example.

Answer 23

The lowest level of risk factors is seen as epiphenomena (secondary) of gender inequity. Larger social inequities such as gender inequity would lead individual women to try and “improve” their bodies through dieting and cosmetic surgery to enhance their social power.

Question 24

According to Muise et al, how do gender differences in prevalence of eating disorders relate to diagnostic criteria?

Answer 24

When using strict dx criteria, the F:M ratio is large, but when including a partial syndrome (respondents met weight criteria for AN but didn’t meet full criteria for diagnosis) the F:M ratio narrows to 2:1.

Question 25

How do males and females with anorexia compare in terms of age of onset, premorbid characteristics and illness features?

Answer 25

Similar except males were more likely than females to be athletic before onset of illness.

Question 26

What is the relationship between eating disorders and sexuality?

Answer 26

There is a strong correlation between EDs and homosexual or bisexual behavior, especially in bulimics.

Question 27

What are the gender differences in age of onset for bulimia?

Answer 27

Age of onset is later in males (15-26yrs) than females (15-18yrs). There was also a significant delay between onset and average age of first treatment in males (27yrs) but not females. Possibly due to male reluctance to discuss their symptoms because of shame in having a stereotypical “female” disorder

Question 28

What are gender differences in the type of body image preoccupations in EDs?

Answer 28

Adolescent male less concerned than females with exact weight or clothing size and more concerned with attaining an idealized masculine shape (large shoulders, narrow hips & waist)

Question 29

In a study where men and women appraise pictures of different body types, what were the findings regarding women’s appraisals?

Answer 29

Women wanted a body slimmer than the one they perceived as their own body size and wanted to be slimmer than what they perceive as men’s opinion of how slim they should be.