Eating Behaviour

1. Eating Behaviour Anorexia Nervosa Unit PSYA3

2. AQA A Specification Where we are now What we have covered

3. What is anorexia nervosa? • Clinical characteristics of anorexia nervosa. • Psychological explanations of anorexia nervosa. • Cultural ideals and the role of the media. • Ethnicity and peer influences. • Personality. • Evaluationand IDA. Today’s lesson

4. In pairs, discuss and write down answers to the following questions. • What is anorexia nervosa? • Can you identify any other types of eating disorder? • What are the clinical characteristics used to diagnose an individual with anorexia? • Can you identify any famous celebrities that have suffered from anorexia? You have 5 minutes! Starter

5. Eating disorder – obsessed with losing weight through self-starvation. • Emaciation – extreme weight loss and thinness. • Anorexia nervosa means ‘nervous loss of appetite.’ • 90% of cases are female although AN is increasing in males. • Typical age of onset is between 13-18. • Four clinical characteristics identified for diagnosis of AN. What is anorexia nervosa?

6. Anxiety • Excessive fear of gaining weight and becoming fat (associated with a loss of control). Weight • Refusal to maintain a minimally normal weight (at least 15% below what is regarded as normal). • Avoid or restrict the amount and type of food eaten. • Carefully weigh and portion their food. • Repeatedly check body weight. • Engage in strategies to control weight – excessive exercise or use of laxatives. Clinical characteristics of AN

7. Body-image distortion • Disturbance in the way individuals perceive their body shape - see themselves as fatter than they are. • Denial of problem – don’t see the seriousness of their low body weight. Amenorrhoea • Cessation of menstrual periods due to inadequate nutrition. • Absence of periods for more than 3 months. Can also experience symptoms of depression/OCD. A02: Cause or consequence of AN?? Clinical characteristics of AN

8. Celebrities with eating disorders

9. What do you think plays a major role in the development of AN? Hint: think about the images you have just seen. Cultural ‘ideals’ and the media have a huge impact on the development of eating disorders (behaviourist approach). Psychological explanations of AN

10. Emphasis on ‘thinness’ being ‘ideal.’ • Suggested AN is a learned behaviour in response to cultural ‘ideals’ and that dieting is ‘normal’ in Western cultures. • Gregory et al (2000) – survey, 16% of 15-18 year old girls in the UK said they were ‘on a diet.’ • Studies have reported that many teenagers, especially girls, have body dissatisfaction and have a distorted body image. Cultural ideals Western cultures

11. Hoek et al (1998) • Examined if AN IS rare in non-western cultures where there is no emphasis on ‘thinness’ being ‘ideal.’ • Examined records of over 44,000 patients admitted to hospital over a two-year period in Curacao (non-westernised Caribbean island). • In this culture it is acceptable to be overweight. • They found 6 cases of AN that they claimed was within the range of rates reported in western cultures. • Evidence of AN in different cultures even when the cultural ideals are not focused on ‘thinness.’ • This suggests… Evaluation

12. Emphasis on ‘thinness’ in the media - ‘slim is beautiful.’ The portrayal of thin models and celebrities in the media is a contributory factor in body image concerns and the ‘drive for thinness’ in western cultures. Dieting is considered ‘normal’– the latest diets are often advertised in magazines and on the TV. Role of the mediaWestern cultures

13. The media influence may explain why some eating disorders are maintained once they are established. However it doesn’t explain why some people develop AN and others do not, even though we are all exposed to the same images. Research to support Jones and Buckingham (2005) – Individuals with low self-esteem are more likely to compare themselves to the idealised images in the media. Personality traits could play a role in the development of AN. Role of the mediaEvaluation

14. + Becker et al (2002) – eating attitudes and behaviours of adolescent Fijian girls were observed following the introduction of TV; they stated a desire to lose weight to become more like the Western TV characters. + Other research has shown that suitable intervention before exposure to idealised images in the media can prevent any negative effects of the exposure (e.g. desire to lose weight). Role of the mediaEvaluation

15. In pairs, discuss and write down ideas for the following questions: - • How could operant conditioning explain AN? • How could classical conditioning explain AN? You have 5 minutes. Behaviourist approach to AN

16. Operant conditioning • Positive reinforcement. • Avoiding food can be positively reinforced through rewards from others. • The reward of not eating = attention and approval from others if slimness is admired (compliments). • These rewards positively reinforce the behaviour. Behaviourist approach to AN

17. Classical conditioning • Learn to associate eating with anxiety. • They see eating too much as making people overweight and unattractive which makes them anxious. • Therefore they avoid eating to reduce this anxiety. Behaviourist approach to AN

18. Other cultural groups do not place the same value on thinness as an ideal for women(lower incidence of AN). + Grabe and Hyde (2006) • Meta-analysis of 98 studies. • Found difference between African-American and Caucasian females. • African-Americans reported significantly less body dissatisfaction. • In many non-western cultures (Fiji and the Caribbean) there are more positive attitudes towards large body sizes (associated with attractiveness and fertility). Ethnicity

19. Gap fill on the psychodynamic approach to AN by Bruch. • Evaluation of the psychodynamic approach to AN by Freud. Independent tasks

20. Outline a criticism of the psychodynamic explanation by Freud (1889) Freud’s explanation of AN suggests the idea of avoiding adult sexuality by stopping menstruation (thus preventing possible pregnancy). However, this explanation has difficulty explaining the development of AN in older women (menopause) and CANNOT explain AN in men!!! Evaluation of Freud (A02)

21. Personality traits (enduring characteristics that define who we are) can play a role in the development and maintenance of AN. What is perfectionism? • Concern for mistakes. • Set high standards for personal performance. • Self-critical. Perfectionism associated with body dissatisfaction and a pursuit of thinness. Personality: Perfectionism

22. Strober et al (2006) – retrospectively evaluated personality traits in teenage girls and boys receiving treatment for AN. They found high levels of perfectionism (73% vs. 50%). Nilsson et al (1999) – longitudinal study; individuals who had a short duration of AN had lower levels of perfectionism and those with high levels were more at risk of a long duration of AN. Personality: Perfectionism

23. Independently, select 2 IDA from the list below and write elaborated paragraphs on these in relation to AN. • Gender bias. • Culture bias. • Determinism vs. Free Will. • Nature vs. Nurture. • Oversimplistic. IDA

24. Gender bias – much of the research into AN has focused primarily on females, although AN is increasing in males. Can the findings be generalised e.g. personality traits? Culture bias – much of the research has focused on AN in western cultures, can the findings be generalised? There is evidence of AN across all cultures regardless of their ‘ideals.’ For example… This suggests that there could be a biological cause behind AN such as… IDA

25. Determinism vs. Free Will – Could be argued that AN is determined by external forces outside of our control (i.e. the environment – media/culture). However, all exposed to media yet don’t all develop AN – suggests some free will over eating behaviour and who to look to as role model? Nature vs. Nurture – psychological explanations provide support for the role of nurture in development of AN (childhood/media/culture). Ignores nature side: biological explanations e.g. role of neurotransmitters (serotonin) and hypothalamus. For example… IDA

26. Methodological – samples studied are mainly AN patients that have been clinically diagnosed – what about those that don’t quite meet the criteria but are suffering from AN? Can we generalise the findings of research across different groups i.e. clinical to sub-clinical? Ethical – researchers use Internet Communities as a source of qualitative data e.g. discussion boards and chat-rooms for individuals with AN. What about privacy, informed consent and confidentiality? General evaluation