Anorexia nervosa
The concept I chose for this paper is anorexia nervosa. And another concept is a parental-children bond as the factor of developing symptoms of anorexia nervosa.
Anorexia nervosa - eating disorder characterized by deliberate weight loss, caused by / or supported by the patient, for the purpose of weight loss or prevention of weight gain. It is more common among girls. Many experts believe that anorexia nervosa is a kind of self-harm.
DSM-IV recommends for diagnosis "anorexia nervosa" four criteria:
A. Refusal to maintain body weight at a minimum for age and height of an individual;
B. Expressed fear of an increase in weight or volume of the body, despite severe thinness;
C. Violations in the perception of own body weight and shape, exaggerated the effect of these external characteristics of self-esteem or the denial of the obvious fact that the current weight is abnormally small;
D. The presence of female amenorrhea after the onset of menses, an absence of at least three consecutive menstrual cycles (suspected of having amenorrhea in women, if menstruation begins only after using hormones such as estrogen). Eating disorders usually begin in adolescence and early adulthood, and rarely - before puberty. The onset of the disease anorexia nervosa refers on average to the age of 17 years with peaks at 14 and 18 years (Agras, 2001, p. 375).
The interaction in families where are cases of anorexia nervosa can characterize by rigidity, the low capability of coping with conflicts, excessive care, etc. Researchers suggest that eating behaviors of mothers as well as their ideas about beauty, shape and normal weight play important role in the development of anorexia in their daughters. Mother of daughters with eating disorders often show themselves the tendency to eating disorders; they demonstrate dissatisfaction with body shape and weight of their daughters (Shapiro, 2011).
Underweight and malnutrition can lead to many diseases. Thus, there may be hormonal changes and changes in the blood picture. One type of anorexia, accompanied by regular vomiting may cause electrolyte metabolism disorders (for example, lack of potassium), with negative consequences for the functioning of heart and kidneys. Eventually, estrogen deficiency may occur because of a strong decrease in body weight and due to the lack of fat. Such deficiency can lead the development of osteoporosis.
The analyze of research
Canetti and his colleagues conducted the study of female patients suffering from anorexia nervosa. This study became the first research which investigated to the influence of relationships between parents and grandparents of women from the clinical group on the development of anorexia nervosa. The study was based on the suggestion that quality of parental-children bonds can contribute to development of such mental condition as anorexia nervosa. Researchers examined different characteristics of parents and grandparents of adolescent girls with anorexia nervosa. Hypotheses of the study were built on the basis of literature review provided by authors of the article. The first hypothesis was that mothers and father of girls who suffer from anorexia nervosa demonstrate higher control and lower degree of care in relationships with their child.
The second hypothesis was that grandparents of patients with anorexia nervosa will be evaluated by parents of anorexic girls as less caring and more controlling. One more hypothesis was about that less caring and more controlling relationship between anorexic girls and parents, among parents of anorexic patients and grandparents will be associated with higher severity of symptoms of anorexia (Canetti, Kanyas, Lerer, Latzer & Bachar, 2008, p. 706).
The first goal of this study was to compare parents of women suffering from anorexia and parents of women from a nonclinical group on the pattern of parental bonding styles. The second goal of the study was to examine how parental bonding styles influence eating disorders of their granddaughters. And the third purpose was to examine if parental bonding correlate with severity of anorexia nervosa (Canetti, Kanyas, Lerer, Latzer & Bachar, 2008, p. 705).
There were clinical and control (nonclinical) groups in the study. The clinical group included 43 young women with anorexia nervosa, 36 mothers of these women and 31 fathers of anorexic patients. The control group included 33 women without symptoms of anorexia or other eating disorders, their mothers and fathers.
The participants of the nonclinical group were chosen through the social networks of individuals from the clinical group. Researchers formed the control group from those individuals whose educational degree and age-matched the age and educational degree of individuals from the experimental group. Also, researchers with the help of health care professionals and psychiatrists checked if all young women from experimental group meet the criteria of DSM-IV, and if all young women from the control group do not demonstrate any symptoms of eating disorders or other psychopathology. As the result, some of the women from the control group were excluded from the study (Canetti, Kanyas, Lerer, Latzer & Bachar, 2008, p. 706).
In the survey instruments such as Eating Attitudes Test, Eating Disorder Inventory-2, and Parental Bonding Instrument were used. Women from both control and clinical groups completed all three tests while their parents completed only Parental Bonding Instrument where they reported about relationships with their parents Canetti, Kanyas, Lerer, Latzer & Bachar, 2008, p. 706).
In this study, the dependent variable was anorexia nervosa (severity of symptoms). There were several independent variables in the study. The first independent variable concerns the relationship between anorexic daughters and their parents and included such variables as parental control and parental care. The second independent variable concerns the relationship of parents and grandparents of patients suffering from anorexia nervosa.
The results showed that the apparently low level of empathy, caring, affection, combined excessive control of the parents can affect the development of anorexia nervosa. One of the hypotheses has been confirmed by results of the current study.
Hypothesis about that grandparents has some indirect influence on the development of anorexia nervosa in their granddaughters also was partially confirmed. Positive correlation was found between measures of controlling parental style of fathers and controlling parental styles of grandfathers of anorexia nervosa patients. It means that the higher degree of grandparents` controlling style correlate with higher scores of controlling style of anorexia nervosa daughters fathers.
Also, the study demonstrated that the high parental control in relationships with their children has a stronger influence on the severity of anorexia nervosa symptoms in comparison to deficiency of parental care as a factor which can influence the severity of anorexia. It means that although both factors – high level of control and low level of care influence the development of anorexia, high parental control is more likely to influence aggravation of clinical symptoms.
On the other hand, researchers suggested using data obtained by their study that parental controlling style can influence aggravation of symptoms but not etiology of anorexia nervosa. This conclusion is based on that fact that, as results of the study showed, the degree of controlling style of mothers from nonclinical group and mothers of anorexia patients were not significantly different. In other words, it seems that onset of anorexia can happen independently of the degree of parental` control, but dependently on affection, closeness, empathy in parental-children relationships (Canetti, Kanyas, Lerer, Latzer & Bachar, 2008, p.712).
Also, researchers in the study examined the correlation between parental bonding styles and eating attitudes and eating behavior of their anorexia nervosa daughters. Results showed some association between attitudes such as asceticism and social insecurity and parental control and care. Asceticism is the tendency to excessive self-discipline, to ignoring urges of the body and social insecurity means the belief that relationships with other people can bring much disappointment and be insecure and unrewarding (Canetti, Kanyas, Lerer, Latzer & Bachar, 2008, p.712).
The current study one more time proved that family therapy might be applied as a method of treatment because parents can play an important role in aggravation of symptoms as well as in the etiology of the eating disorder. Also, this study showed that anorexia nervosa prevention programs must be directed not only to individuals of preadolescence and adolescence age but also to their parents.
As authors of the article pointed, these prevention programs might highlight questions about the importance of empathy, closeness, care, affection and etc. in the relationship between parents and their children. In other words, teaching parents how to be better parents and how to build more harmonious relationships with their children can be one of the best ways in prevention anorexia nervosa (Canetti, Kanyas, Lerer, Latzer & Bachar, 2008, p. 713).
References
Agras, W. S. (2001). The consequences and costs of the eating disorders. Psychiatric Clinics of North America, 24(2), 371-379.
Canetti, L., Kanyas, K., Lerer, B., Latzer, Y., & Bachar, E. (2008). Anorexia nervosa and parental bonding: the contribution of parent–grandparent relationships to eating disorder psychopathology. Journal of clinical psychology, 64(6), 703-716.
Shapiro, C. M. (2011). Eating disorders: Causes, diagnosis and treatments. New York: Nova Science Publisher.
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