Outline and evaluate psychological explanations for anorexia nervosa [20 marks].

Behavioural explanations of anorexia nervosa (AN) suggest that slimming becomes a ‘habit’, through stimulus response mechanisms. For example, the person does on a diet and receives praise either for their efforts or their new slimmer appearance. Operant conditioning then takes effect as the admiration from others further reinforces their dieting behaviour. Rewards may also come in the form of attention gained from parents by not eating. Behavioural psychologists also propose anorexia as a phobia concerning the possibility of gaining weight. The portrayal of thin models on TV and in magazines is a significant contributory factor in body image concerns and the drive for thinness among Western adolescent girls. Jones and Buckingham found people with low self-esteem are more likely to compare themselves to idealised images portrayed in the media. Garner et al (1980) noted that the winners of Miss America and the centrefolds in Playboy magazine have consistently been below the average female weight and have become significantly more so since 1959. Thus the slender female perceived as being the cultural ideal might be one cause of the fear of being fat. A study by Becker of adolescent Fijian girls found that after the introduction of television to the island, these girls stated a desire to lose weight and to b like the women they saw on Western television; this lead to a significant increase in eating disorders over five years. Other research has shown that instructional intervention prior to media exposure to idealised female imaged prevents the adverse effects of media influences (Yamamiya et al). this suggests that the media can and does have an effect on the development of disordered eating and AN, but these effects can be avoided. In Groesz et al’s (2002) meta-analysis of 25 studies, they concluded that body dissatisfaction increased with media images of thin women. Another psychological approach used to explain AN is the psychodynamic approach. This sees AN as an attempt by adolescents to separate themselves from their patents and establish their own identities. Bruch(1991) distinguished between effective parents who respond to their child’s needs, and ineffective parents who fail to respond appropriately. Children of ineffective parents grow up confused about their internal needs and become overly reliant on their parents. Bruch argues that the parents of anorexics tend to be domineering, and the disorder represents an attempt to gain a sense of autonomy and control as ‘such children experience themselves as not owning their own bodies’. Thinness and starvation are signs of self-control and independence. Minuchin et al (1998) suggest that girls use the control over their bodies to divert attention from other family patterns. They suggest that families of anorexics have one of the following problems: enmeshment; overprotection; rigidity; conflict avoidance. Steiner found that parents of adolescents with AN had a tendency to define their children’s needs rather than letting them define their own needs. This supports the claim that children of ineffective parents become overly reliant on their parents to identify their needs. Button and Warren examined a group of AN sufferers seven years after they were diagnosed with the disorder. These individuals relied excessively on the opinions of others and felt a lack of control over their lives.However, even within the psychodynamic approach, other suggestions have been put forward as to the potential explanations for anorexia. For example, Wonderlich (1996) argued that sexual abuse during childhood is a cause of anorexia during adolescence, although these are issues with the validity of retrospective data and it is also hard to distinguish a causal relationship between childhood sexual abuse and the development of AN. Another psychodynamic approach suggests that the two personality traits perfectionism and impulsiveness are commonly associated with AN. A major problem with psychological approaches is that, although they give a full explanation of AN in their own terms, they completely ignore the biological approach or any possibility that the two could work together as a form of diathesis stress model.