clinical key question

• what are the implications for society if anorexia is a learned disorder
• AN = nervous loss of appetite, symptoms include: A, B, C, amenorrhea (absence of 3 menstrual cycles)
• • 90% of cases are female between 13-18yrs
  • 20% have 1 episode and recover completely
  • 60% follow an episodic pattern of weight gain + relapse over a number of years
  • mortality rate of those admitted is over 10% due to starvation or suicide
• implications for society

  1. doubling in hospital admissions for ED in past 6yrs - among teen girls
  2. large cost burden for NHS - especially those who have recurring patterns of illness - requires more staff so more funding to treat patients
  3. overall increase in amount of deaths
• if AN is learned = caused by images and cultural expectations exposed in the media
• beauty products/clothing = conformed to specific ideals of beauty such as size zero models so people influences to develop disorder because thinness is an expectation in todays society
• operant conditioning as an explanation for AN

  PR: peer acceptance important during adolescent so teens more encouraged by praise given by others when they lose weight

  PP: where teasing & bullying have an affect on behaviour, those who do not fit an idealised image may be made fun of for their weight

  NP: teens may be excluded by others if they dont fit a certain image = fewer likes and interactions on social media after weight gain

  NR: bullying would stop once weight is lost and increase self confidence after weight loss
• strength for operant

  • jones and crawford (2006)
  • assessed role of teasing and found overweight girls and underweight boys = more likely to be teased by peers
  • through teasing, peers reinforce gender based ideals on need for women to be thin therefore AN may be learned
• counterpoint for operant

  • reducing complex issues like AN down to S-R behaviour is simplistic
  • fails to account for perfectionist personalities, predispositions due to dysregulated neurotransmitters like serotonin and dopamine or childhood experiences
  • therefore unlikely AN is explained by OC, SLT may be a better explanation
• how does OC answer the key question

  • prevent bullying from occurring by educating or raise awareness by showing how bullying impacts peoples lives (e.g: reward other body shapes)
• SLT as an explanation for AN

  attention: looking at magazines or celebs on blogs

  retention: retaining unrealistic beauty expectations of role models

  reproduction: imitating behaviour of eating less food and losing lots of weight

  motivation: when teens see role models being rewarded with fame and money for maintaining idealised body image, more likely to imitate behaviour
• strength of SLT

  • becker study of fijian girls suggests AN is influenced by social factors such as replicating behaviours of role models
  • after the introduction of western TV, teens reported much higher rates of dieting and body image concerns
  • suggests social influences on EDs are important, therefore careful consideration of media images that young people are exposed to is needed
• counter for SLT

  • cases of AN in blind people
  • thomas et al (2012) studied Ms A who had 3% full vision but diagnosed with AN at age 14
  • this disagrees with the argument that SLT explains AN as there are cases without the observations of models, people had AN
• how SLT answers the key question

  • celebrate other body shapes and sizes
• alternative explanation for development of AN

  • kaye (2005) - PET scan to compare dopamine activity in brains of 10 women recovering from AN and 12 controls
  • AN women = overactivity in dopamine receptors of basal ganglia suggests this causes people with AN to have difficulties associating good feelings with things people find pleasurable such as food