Cognitive theory of AN

Who originally came up with cognitive theory of emotional disorders?

Beck (1976).

How did Beck believe that emotional disorders were caused?

Through distorted schemas.

These distort reality.

What do cognitive theories of AN focus on?

How individuals with the disorder think differently about themselves, compared to individuals without the disorder.

What are the two ways of faulty thinking that people with AN have?

Cognitive distortions

Irrational beliefs

What are cognitive distortions (In the context of AN)?

Errors in thinking that cause the individual to develop a negative body image.

This leads to a misperception that the individual is overweight.

This leads to feelings of self-disgust and attempts to lose weight.

What are cognitive distortions a result of?

Comparisons with others (eg models in the media, peers) in terms of how they look or the amount they eat.

What are irrational beliefs (in the context of AN)?

Self-defeating habits that aren’t based on fact.

These are unrealistic.

(Eg ‘I don’t have any friends because of my weight’)

What are irrational beliefs a result of?

Faulty beliefs about the self and the world around them.

Who is responsible for the cognitive behavioural model of AN?

Garner and Bemis (1982).

What did Garner and Bemis state in this model?

That anorexia patients tend to have three cognitive characteristics in common.

These characteristics, coupled with the individual’s exposure to cultural ideas of thinness lead them to form ideas about the importance of body weight.

What are these cognitive characteristics?

Perfectionists

Introverted

High self-doubt

What happens as a result of the exposure to cultural ideas of thinness?

The individual develops the irrational belief that losing weight will reduce their distress.

What happens when the individual starts to lose weight (maintenance)?

They receive positive comments from others and feel a sense of achievement.

So losing weight becomes self-reinforcing (behaviourist) for the individual.

What happens when the importance of being thin is established?

Anxiety about eating increases.

This gradually develops into a fear of food and weight gain - so food avoidance becomes the norm.

(Still cognitive behavioural model) What does the individual’s distorted thinking convince them?

That weight and thinness is the sole referent for judging self-worth, that complete control over these is desirable.

Who came up with the transdiagnostic model?

Fairburn (2003).

TRANSDIAGNOSTIC MODEL: How does this model suggest that eating disorders can be understood?

To see the various symptoms as manifestations of a more broadly defined eating disorder (hence transdiagnostic).

According to this model, what is the underlying cause of all eating disorders?

The same set of cognitive distortions.

Fairburn referred to this as ‘core psychopathology’.

What are the four aspects of core psychopathology (cognitive distortions that cause eating disorders)?

Overestimation of body weight

Negative view of appearance

Emphasis on self-control (central factor in AN).

Self esteem is linked to weight and appearance.

(Still transdiagnostic model) How is the restriction of food maintained?

By three mechanisms:

Enhanced self-control - eating little - leads to increased self-esteem (positive reinforcement).

The physiological and psychological changes they experience as a result of their starvation (eg impaired concentration, extreme hunger) are perceived by the individual as being the result of failures in self-control. This leads to more intense reliance on food restriction.

The individual engages in increased self-monitoring of their weight as a result of the focus on weight and appearance. This includes regular weight checking, constant looking in the mirror, etc.

Positive eval

Research support for the role of cognitive factors in AN - Lang (2015) compared AN patients with healthy control participants in terms of psychological characteristics. There were no differences in IQ between the groups. However, AN patients were shown to have a more inflexible cognitive processing style than the control patients - they were less able to adapt to new information.

Success from CBT-E suggests AN has a cognitive cause. This therapy (cognitive behavioural therapy for eating disorders) has been shown to be an effective treatment for individuals with eating disorders.

Negative eval

Methodological limitations of cognitive behavioural model - this is based on self-report. These are stated retrospectively. Also suffers from social desirability. Therefore this model has low validity.

Cooper (1997) claims that cognitive expansion for AN aren’t based on empirical research. There has been little research that has tested the hypotheses derived by cognitive models of AN. cares