Psychological Theory for Anorexia Nervosa - Cognitive Processes

AO1

cognitive distortions

irrational beliefs

cognitive inflexibility

cognitive distortions

= faulty bias and irrational ways of thinking

... mean we perceive ourselves, the other people, and the world inaccurately and usually negatively

=> a person with AN has a disturbed perspective of their own body image

Disturbed perspective - Murphy et al. (2010)

... all clinical features of AN stem from these distortions including preoccupations with thoughts of food, eating, weight, and body shape, and behaviours such as food restriction and checking

- People with AN become more critical of their own bodies

- They misinterpret their emotional state as "feeling fat"

Disturbed perspective - Williamson et al. (1993)

Choosing from silhouettes to match their own size - people with AN consistently overestimate their body size

The ideal body shape for the AN participant was significantly thinner than it was for the control group

Irrational beliefs

... can also be called dysfunctional thoughts

=> in Ellis' model and therapy, these are defined as thoughts that are likely to interfere with a persons happiness

=> Such dysfunctional thoughts lead to mental disorders

e.g., depression and anorexia

Aaron Beck irrational beliefs

these irrational beliefs become second nature and give rise to automatic negative thoughts

ALL OR NOTHING THINKING

i.e.,

"If I'm not thin, I'm fat"

"If I don't control my weight, I'm worthless"

CATASTROPHISING = putting the worst possible gloss on even the least important events

i.e.,

"I ate half a biscuit, I've got no willpower"

Irrational Beliefs - Perfectionism

= failure to meet their most demanding standards is judged severely

- Applies to all areas, academic success, relationships, career aims, but especially eating, body shape and striving for weight loss

- Accompanied by intensive record-keeping, excessive exercise, or food restraint

Hewitt et al. (2003) Perfectionism

AN patients reach their goals but then raise their standards higher still, so they are forever pursuing an unrealistic goal

= trapped in a vicious cycle

Cognitive Inflexibility

... recent research has focused on the possibility that people with AN lack cognitive flexibility

Treasure and Schmidt (2013)

Proposed a Cognitive Interpersonal Maintenance Model of Anorexia

- Model suggests people with AN experience problems with set-shifting, they find it difficult to switch fluently from one task to another requiring a different set of cognitive skills

- Once a vulnerable individual starts to lose weight, they rigidly persist with it and continue to perceive themselves as needing to lose weight

- They then find it hard to switch to a more adaptive way of thinking about their body shape and size

- They are unable to perceive that they no longer need to lose weight

- Their weight loss is a solution to a problem that no longer exists

A03 STRENGTH - scientific research support

P

A strength of the cognitive explanation is that it is supported by scientific research.

EV

Sachdev et al (2008) studied participants who were shown images of their own and other people's bodies while their brain was being scanned using fMRI. The same brain areas were activated in both groups when they were shown non-self-images, but the participants with AN showed very little activation in parts of the brain thought to be involved in attention, such as the occipital lobe, when they were shown images of themselves, compared to the control group.

EX

Sachdev concluded that AN patients process non-self-images similarly to control subjects, but their processing of self-images is inconsistent, possibly due to conflicting emotional and perceptual processing that ay underlie their distortion.

C

However, by stating the cause of anorexia is due to a psychological problems and an individual faulty thinking processes, this explanation may place blame on the sufferer by suggesting that their own perceptions are reason for their problems. This therefore should be viewed with caution.

LB

Although this is true, by identifying the psychological problems that lead to the development and maintenance of AN, psychologists can treat and dispute these in therapy during treatment for patients with anorexia.

A03 STRENGTH - perfectionism research

P

In addition to this, there is research evidence to support the idea that perfectionism underlies the development of anorexia.

EX

Research carried out has used the EATATE Lifetime Diagnostic Interview. This measures AN symptoms and indicators of perfectionism in childhood.

EV

Halmi et al. (2012) studied 728 women diagnosed with anorexia who all participated in the interview. The research found that childhood perfectionism was a significant predictor of the later development of AN, concluding that perfectionism is a potential risk factor.

C

On the other hand, this study may be subject to retrospective bias. The study requires adults to think back to their childhood, which could be influenced by distorted recall, and therefore overexaggerate the level of childhood perfectionism, and its relevance to the development of AN.

LB

Despite this, Halmi's study used a large sample size and notable measurement scales, which increases its reliability due to the scientific methodology of the experiment.

A03 WEAKNESS - contradictory research

P

However, there is also research which opposes the principle of the cognitive approach.

EX

Research used a morphing task which focuses on the central concept of the cognitive explanation, which is body image distortion.

EV

Cornelissen et al.'s (2013) study involved participants adjusting a computerised image of themselves until it matched their estimate body size. There was found to be no significant difference between the groups of women in the accuracy of their estimates.

EX

This suggests that over estimation is not pathological

EXT

In addition to this, there is an issue with causation. Shott et al. (2012) found that younger participants with AN were no worse at set shifting than non-AN controls, but older participants were. This suggests that cognitive inflexibility does not make an individual vulnerable to developing AN but is a consequence of the disorder instead.

LB

As a result of this, the cognitive explanation for AN could be viewed as reductionist as it only considers these cognitive processes as a cause, rather than an effect of anorexia, and the contradictory research suggests that this is a limited explanation.