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Behaviour & Society group seminar

peer group dynamics and teen anorexia

Ty Ferguson

on 5 November 2012

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Transcript of Behaviour & Society group seminar

Behaviour & Society Group Seminar Biopsychosocial
Response Presentation by Josephine Ceravolo, Esther Chan, Ty Ferguson,
Lisa Hornell, Celeste McGregor & Megan O'Connor Case Study Anorexia nervosa Eating disorder characterised by severe restriction of food intake (starvation).

Type of mental illness with significant physical complications.

Complex array of physical, psychological and behavioural effects. Sociological analysis Historical Cultural Critical Structural Psychological References Conclusion PEER GROUP DYNAMICS
TEEN ANOREXIA Jessica is a 16 year old girl who presents at your physiotherapy practice with a sprained ankle. Her physical presentation would suggest to you that she is severely under weight and likely to be suffering from anorexia nervosa. When asked, Jessica states she has no existing health issues. Peer group dynamics STATISTICS International prevalence: 0.3% to 1.5% in females, 0.1% to 0.5% in males

1 in 100: Number of adolescent girls will suffer anorexia

17 years old: The median age of onset

7 years: The average duration. Those who recover are unlikely to return to normal health

Highest mortality rate of any psychiatric disorder, 1 in 5 anorexia related deaths by suicide

Estimated up to 20% of females may have undiagnosed eating disorders (NEDC 2011) Physical Effects
Muscle fatigue, wastage and ache
Reduced metabolism and immune function and physical maturation
Cardiovascular: slow heart rate, hypotension, poor circulation, hypothermia, reduced white blood cell volume
Anaemia (iron deficiency)
Abdominal pain, constipation, diarrhoea
Thinning of the hair, Lanugo
Reduction of bone density which results in dry and brittle bones (osteoporosis)
& many others. Psychological Effects
Distorted body image
Self-evaluation based largely on weight and appearance
Pre-occupation with food and weight
Refusal to accept weight is dangerously low despite warnings
Low self esteem, mood swings, withdrawal
Clinical depression Behavioural Effects
Excessive exercise and/or food restriction
Secretive or aggressive behaviour surrounding eating or exercise
Overly sensitive to references about weight or appearance
Obsessive interest in cooking or preparing food
Refusal to eat in the presence of others
Suicide attempts, self harm, substance abuse Thank you! How will Jessica's condition affect your treatment? Anorexia is a mental illness, outside of our scope of practice, doesn't mean we can't help.
Referral if patient receptive.
Identify stage of change, may not see their condition as problematic.
Provide education on anorexia nervosa.
Communication style very is important.
Knowledge of physical effects when providing treatment, precautions and contraindications.
Involvement in community based prevention Peer groups can be extremely influential with either positive or negative effects
Anorexia is a prominent topic amongst teen girls
Peer groups can serve to neutralize individual experiences of social and cultural processes
Peer groups can provide a supportive and reassuring environment
“Peer influence predicts body dissatisfaction and dieting behaviour, and may influence disordered eating”
Group psychotherapy is a crucial component of a comprehensive medical and psychological treatment process stimulates the development of identification patterns, and helps to shape behaviours
Peer group dynamics is a significant factor affecting the process of forming an adolescent identity Cultural
Peer groups
Family dynamics What are the structural changes which could contribute to anorexia?
•Computer based occupations
•Increase reliance on computers
•Increase advertising opportunities
•Increase exposure with hand held technology Physiology




actualization Hierarchy of control Transtheoretical model • Targeting the media
-Prohibiting pro-ana websites
• Targeting the role models
- Modelling agencies banning anorexic models
• Targeting the Community
- Education and training “Anorexia Nervosa patients become preoccupied with thoughts about food, eating, shape and weight. They engage in ritualistic eating habits and have intense fears of becoming fat, despite being seriously underweight” (Wilson 2003) Psychological Factors “Motivational Interviewing helps to change patterns of behaviour that have become habitual” (Treasure 2004)
Reflective listening
Empathic understanding
Use AND rather than BUT to link ideas
Referral Motivational Interviewing •Psychopathology underlying anorexia has changed over time:
In 13th to 16th – control of appetite was linked to spiritual beauty. The modern anorexic strives for perfectionism in terms of society's ideal physical beauty
In the 1870’s - influence of the patients psychological state became a focus point
In 1961 – A young woman’s resistance to growing up
In 1962 – First mention of disturbance to body image
In 1970 – Fear of becoming fat
In 2000’s – dieting became popularised Anorexia is a mental illness with severe physical effects.

Peer groups can be extremely influential with either positive or negative effects.

Psychological and Sociological influences to the illness.

Biopsychosocial response to anorexia. Brumberg, J 1988. Fasting Girls: The Emergence of Anorexia Nervosa as a Modern Disease. Harvard University Press. Cambridge, MA and Landon.
Borders, D 1991, ‘A Systematic Approach to Peer Group Supervision’, Journal of Counselling and Development, Vol. 69, no. 3, pp. 248-25
Brunner, R, Daniels, S, Farrell, M, Maloney, M & Mays, W 1989, ‘A Controlled Study of Type A behaviour and Psychophysiologic Responses to Stress and Anorexia Nervosa’, Psychiatry research, vol. 30, pp. 223-230
Burraston, B, Dishion, T & Poulin, F 2001, ‘Peer Group Dynamics Associated with iatrogenic Effects in Group Interventions eith High-Risk Young Adolescents’, new Directions for Child and Adolescent Development, vol. 91, pp. 79-91
Chou, C, Hofffman, B, Monge, P & Valente, T 2007, ‘Perceived peer influence and peer selection on adolescent smoking’, Addictive Behaviours, vol. 32, pp. 1546-1554
Dishion, T, Patterson, G & Yoerger, K 2000, ‘Adolescent Growth in new Forms of Problem Behaviour” macro- and micro-Peer Dynamics’, Prevention Science, vol. 1, no. 1, pp. 3-12
Dodge, K & Dishon, T 2005, ‘Peer Contagion in Interventions for Children and Adolescents: Moving Towards an Understanding of the Ecology and Dynamics of Change’, J Abnorm Child Psychology, vol. 33, no. 3, pp. 395-400
Durham, M 1999, ‘Girls, Media, and the Negotiation of Sexuality: A Study of Race, Class, and Gender in Adolescent Peer Groups’, Journalism and Mass Communication Quarterly, vol. 76, no. 2, pp. 193-203
Fact sheet: Anorexia nervosa 2011, National Eating Disorder Collaboration (NEDC), viewed 25 October 2012, <http://www.nedc.com.au/files/logos/0638_NEDC_FS_AN_v4.pdf>
Hoek, HW 2006, ‘Incidence, prevalence and mortality of anorexia nervosa and other eating disorders’, Curr Opin Psychiatry, vol.19, no. 4, pp. 389 - 94
Minuchin, S, Rosman, BL, & Baker, L 1978, Psychosomatic families: Anorexia nervosa in context. Cambridge, MA: Harvard University Press.
Park, S 2005, ‘The influence of presumed media influence on women’s desire to be thin’, Sage publications, vol. 32, no. 5, pp. 594 - 614
Penrose-Wall, J 2009, 'Anorexia nervosa: Australian treatment guide for consumers and carers', The Royal Australian and New Zealand College of Psychiatrists, viewed 25 October 2012 <http://www.ranzcp.org/Files/ranzcp-attachments/Resources/Publications/CPG/Australian_Versions/aus_anorexia_nervosa-pdf.aspx>
Polivy, J & Herman, CP 2002, ‘Causes of Eating Disorders’, Annual Reviews, vol.53, pp.187-213.
Rowen, K, Kerig, P, Geller, J 1999, ‘The family and anorexia nervosa: examining parent–child boundary problems’, European Eating Disorders Review, vol. 9, no. 2, pp. 97-114
Strober, M, Humphrey, L 1987, ‘Familial contributions to the etiology and course of anorexia nervosa and bulimia’, Journal of Consulting
Schwarzer, R. (1992). Self-efficacy in the adoption and maintenance of health behaviors:Theoretical approaches and a new model. In R. Schwarzer (Ed.), Self-efficacy:Thought control of action (pp. 217-243). Washington, DC: Hemisphere. Clinical Psychology, vol. 55, no. 5, pp. 654 – 659
Treasure, J & Woerwag-Mehta 2008, ‘Causes of Anorexia Nervosa’, Diagnosis, Aetiology and Assessment, vol. 7, no. 4, pp. 147-151
Niziolek, E & Izydorczyk, B 2010, ‘Application of group psychotherapy in the treatment of adolescent girls and women with anorexia nervosa’, Archives of Psychiatry and Psychotherapy, vol. 3, pp. 27-35
Treasure, J 2004, Motivational Interviewing, Advances In Psychiatric Treatment, Vol. 10, Pp. 331-337.Wentz E, Gillberg I.C, Anckarsater H, Gillberg C, Rastom M, 2009, Adolescent onset Anorexia Nervosa: 18 year outcome, The British Journal of Psychiatry, vol. 194, pp. 168-174.
Wilson G, 2003, Psychological Interventions for Eating Disorders: A review, John Wiley and Sons Ltd., Chapter 5, pp. 321-327. What is anorexia? Self-actualization
becomes the foundation
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