Diagnostic and Statistical Manual of Mental Disorders, Research Paper Example

Eating disorders are characterized by unhealthy eating habits, stemming directly from beliefs held by the individual that causes such behavior, although there are many more factors that cause eating disorders that are not fully understood.  Anorexia and bulimia nervosa are the two primary types of eating disorders that affect individuals.  Eating disorders continue to affect many individuals across all socioeconomic levels, and has a very high mortality rate compared to other psychiatric disorders.

Symptoms of Eating Disorders

The present analysis looks at the two overwhelmingly most common eating disorders, bulimia nervosa and anorexia nervosa.  Individuals who exhibit either of these eating disorders are normally dieting out of a fear of becoming fat or obese.  Preoccupied with becoming thin, they continue to worry about food, weight, and their appearance.  They also feel as if they need to be perfect, where they struggle with anxiety, obsessiveness, and depression.

Attempts at suicide are not uncommon with eating disorders.  Characterized by both disorders’ disturbed view of eating, substance abuse is commonly seen, beginning with the form of dieting pills.  Anorexia and bulimia are characterized by an individual’s view that they are too heavy, regardless of their weight or appearance.

Anorexia

A proper diagnosis of anorexia nervosa requires the following four applicable traits, according to DSM.  According to the individual’s normal weight for age and height, the individual must exhibit a refusal to maintain body weight in these standards.  The individual also demonstrates an intense fear or gaining weight, even when underweight.  The individual’s perception of his or her body weight, shape, or serious must be undermined.  Finally, amenorrhea is present in postmenarcheal females (APA 583-596).

Individuals exhibit some form of limiting their intake of food.  In restricting-type anorexia nervosa, individuals restrict their intake of food directly.  Beginning with sweets and fatty food, individuals in this type of anorexia start to cut out foods in their diet.  Eventually more and more foods become eliminated from the individual’s diet.  As it becomes, those with this type of anorexia demonstrate no variability in diet (Comer 342).

Others resort to purging to limit their food intake.  This method is characterized in binge-eating/purging-type anorexia nervosa.  Laxatives or diuretics may become abused in this type of anorexia.  Characterized typically in bulimia, this type of anorexia exhibits common similarities to it in reference to vomiting and binge eating.  According to Costin, 30 to 50 percent of individuals with anorexia demonstrate these behaviors (9).

Anorexia is often marked by a period of stressed.  Family difficulties, moving away from home, or personal issues are often seen in this regard.  According to Comer, 2 to 6 percent die from the medical problems that ensue, although most recover (343).

People with anorexia are largely preoccupied with food.  It becomes obsessive to those who have the disorder.  Even dreams may be filled with images of food.  Individuals often find themselves reading about food, and planning a number of limited meals to make sure they limit their intake of food.

Bulimia

According to DSM, the following four traits are present to complete a diagnosis of bulimia.  The presence of binge eating and inappropriate behavior to prevent weight gain is seen.  The continuance of these symptoms for three months at twice a week must be seen, on average.  Finally, undue influence in regards to self-evaluation or shape is evident (APA 583-596).

Binging is one major aspect of bulimia.  These binges may occur anywhere from one to thirty times per day (Comer 347).  More than 1,000 and at times more than 3,000 calories are consumed in these binges.  Binges are often done in secret, without the food being tasted or thought about.

Binges display a number of emotions that are difficult to handle.  Binging releases a period of tension in which the person acts out of these fears.  The individual feels unable to stop eating as well.  In response to the feelings associated with binging, it is normally followed by shame, guilt, and other fears related to gaining weight and one’s actions being realized by others who may look down on the person.  According to Costin, these actions become a normal part of one’s everyday life (13).

In relationship to binging, there are compensatory behaviors that occur.  These behaviors seek to undo the effects of binge eating.  They are done to reduce the anxiety and self-disgust of binge eating, as well as the feelings of fullness.

Vomiting is the primary compensatory behavior that occurs in bulimia.  Consequently, vomiting leads to additional hunger, which in turn perpetuates the cycle of binging and vomiting.  Other compensatory behaviors are seen in the form of laxatives or diuretics, which also perpetuates these behaviors.

Differences

Those with bulimia are often more concerned with pleasing others.  They tend to be more active and sexually experienced as well.  Strong emotions, mood swings, and related behaviors characterize those with bulimia.  A portion of those with bulimia display characteristics of a borderline personality disorder.

Those with anorexia display differences in their menstrual periods.  Almost all have irregular periods, as opposed to half of those with bulimia (Comer 351).  Those with anorexia are not in danger of the many negative medical effects of repeated vomiting, such as dental problems, potassium deficiencies, and further effects that lead to medical complications.

Treatments

Eating disorders are subject to a number of types of treatments.  Medications are used as well as forms of psychotherapy.  They are often used in conjunction with each other in order to establish healthy behaviors and provide clarity to underlying beliefs.

Medications

Anorexia nervosa is generally not responsive to psychotopic medications.  In regards to delusional thinking, atypical antipsychotics are best for dealing with the thoughts around the need to lose weight (Preston 55).  A psychiatrist can help identify relevant treatments although there are no successful medications that have been demonstrated to assist with anorexia nervosa.

Bulimia is more responsive to medical treatments.  The treatment of bulimia is recommended to take a similar course to that of depression.  Preston notes that the anticonvulsant topiramate is being regarded well in bulimia and binge eating (Preston 55).  Antidepressants may not be well suited for bulimia as they lower the seizure threshold for patients (55).

Therapies

Psychotherapy is used for the treatment of eating disorders as well.  In fact, there are many perspectives in this regard.  However, to generalize the forms of psychotherapy in regards to eating disorders, strides are made to look at the root of these patterns.  Establishing healthy eating habits are also a goal, often in conjunction with medications.

Cognitive-behavioral therapy is the most common type of therapy employed for the treatment of eating disorders.  Techniques employed encourage the individual to alter behaviors and thought processes in regards to one’s restrictive behaviors.  Logs are kept, especially for those who have bulimia, in order to document and record the behaviors that perpetuate binging and purging.

Other forms of therapy exist alternatively or in supplement.  Interpersonal and psychodynamic are often used if cognitive-behavioral therapy is not helpful.  Family therapy is often used in supplement of other types of therapy.  Finally, group formats of therapy are seen with respect to the aforementioned types of therapy.

Generally speaking, bulimia patients have a better chance at achieving status as fully recovered.  Many individuals with anorexia find improvement, yet battle with the longing effect of the condition.  According to Comer, 25 percent were fully recovered from a study after being interviewed several years after they began treatment (366).  After ten years of initial treatment from those with bulimia, 70 percent were fully recovered (Comer 368).

Causes of Eating Disorders

Researchers use a multidimensional risk perspective to explain eating disorders, where an individual that demonstrates more factors has a higher risk of developing an eating disorder.  Individuals often display more than one or two risk factors for developing an eating disorder.  These risk factors may include a number of perspectives, which will be analyzed briefly in this analysis of eating disorders.

The psychodynamic theory of eating disorders from Hilde Bruch is largely used to explain eating disorders.  Ego deficiencies are involved in mother to child interactions, which demonstrate a poor sense of independence and control, among other effects.  This also leads to perceptual differences that help account for disordered eating patterns.  These negative behaviors often lead to the child looking outside of parental influence, leading to helplessness.  This accounts for the control involved in eating disorders, out of this helplessness that occupies the individual’s childhood and family interactions.

There are many links made in regards to biological explanations.  Genetics is given as having a major role in the onset of eating disorders.  Serotonin and areas of the hypothalamus are pointed towards in the conversation of eating disorders as well.

Societal pressures are often a significant influence in the discussion on risk factors and causes of eating disorders.  Thinness is increasingly valued in society, in light of advertisements, models, and among many dimensions of society.  According to Comer, prejudice regarding those who are overweight, and in favor of thinness, occupies a deep-rooted place within aspects of society and culture (357).

Family also can play a role in the development of eating disorders.  Perfectionistic mothers who diet can have a large influence.  Families of people who emphasize diet, thinness, and physical appearance greatly increases the risk of an individual developing an eating disorder.  Dysfunctional families who are often over concerned can lead to clingy and obsessive behavior, which can lead one to develop an eating disorder.

There are also a number of multicultural factors involved in eating disorders.  There are differences in the way body image is believed in different racial and ethnic groups.  For instance, according to Comer, white American and African American girls displayed differing views on what it means to be beautiful.  The former attributed it in relationship to body weight, while the latter group put it into terms personality traits, and not physical characteristics (360).

Multicultural factors also exist in the case of gender differences.  The double standard of weight pressures is seen in regards to gender.  While women are held to this standard, it on the most part does not exist for men.  Men only account for 5 to 10 percent of eating disorders, which are largely in regards to requirements and pressures in regards to a job or sport, in developing an eating disorder (Comer 361).

Conclusion

Bulimia and anorexia remain the two most common eating disorders.  Largely developed in women, they incur a number of harmful medical implications, which accounts for the high mortality rate of eating disorders.  They are both characterized by obsessive tendencies in regards to food and body images, and both exhibit clearly defined compensatory behaviors for the intake of food.

Treatment is usually seen in medications and therapy.  Cognitive-behavioral therapy is often the first tried therapy, although others exist in a group and individual format.  Bulimia remains more responsive to psychotropic medications.

There are a number of risk factors seen for the explanation of eating disorders.  Biological and genetic factors play a significant role in eating disorders.  There are a number of psychological dynamics that are involved as well, such as those found in psychodynamic theories.  The pressures in society, cultures, and family can also lead to the development of eating disorders as well.

Works Cited

American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC: American Psychiatric Association, 2000. Print.

Comer, Ronald. Abnormal Psychology. New York: Worth Publishers, 2010. Print.

Costin, Carolyn. The Eating Disorders Sourcebook: A Comprehensive Guide to the Causes, Treatments, and Prevention of Eating Disorders. New York: McGraw-Hill, 2007. Print.

Preston, John and James Johnson. Clinical Psychopharmacology Made Ridiculously Simple. Miami, FL: MedMaster, 2009. Print.