Etiology of Anorexia Nervosa

Consensus is lacking as to the etiology of anorexia nervosa, an eating disorder that almost exclusively affects middle- and upper-class girls and young women in the United States, Western Europe, Japan, and other postindustrial societies. Those who suffer from anorexia display a morbid fear of becoming overweight, spurred on by distorted body image, and severely restrict their intake of food, leading to numerous biomedical complications and frequently, if untreated, to starvation. Each of the three principal explanatory models--the biomedical, the psychological, and the cultural--supplies insights into the nature, prevalence, distribution, and causes of the disorder. But no one model can be shown to locate the ultimate cause of the disease and there is a growing conviction that aspects of all three models will form a part of any eventual demonstration of its etiology. It is, however, clear that anorexia occurs primarily at crucial points in female lives and, no matter which model predominates, the syndrome is understood to be intimately connected with development. A review of the principal theoretical models will demonstrate how they conceive of the connection between female development and anorexia. In tandem with the review a number of empirical studies that support certain aspects of each theory will also be discussed.

Discussions of anorexia nervosa frequently involve bulimia nervosa (commonly referred to as bingeing and purging) as well. Bulimia also features a

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This "edge of adolescence" has long been understood to be "a time of heightened psychological risk for girls," who have been found to lose vitality, resilience, immunity to depression, and their sense of themselves at this time (Brown & Gilligan, 1992, p. 2). Girls at this point are sometimes subjected to various types of sexual abuse, face increased expectations regarding autonomy, and generally are involved in changes over which they have no control but which seem destined to affect every aspect of their lives. It has been understood for some time that "an inner sense of connection with others is a central organizing feature of women's development" and that disconnections often initiate psychological crises (Brown & Gilligan, p. 3). Yet in adolescents and women there is a strong tendency to remain silent in relationships in order to avoid conflict. In a study that contrasted prepubescent girls' voices with those of women, however, it was found that young girls did not register this silencing behavior until they made the passage into adolescence. This called for a revision of developmental ideas because it suggested that "adolescence is a time of disconnection, sometimes of dissociation or repression in women's lives as th

Category: Psychology - E