Analyzing Psychological Disorders in Brief

Analyzing Psychological Disorders 1

Analyzing

psychological disorders

froma Biopsychologist’s perspective

Due on March 26, 2012

ByChristopher C. Emeanua

(IRN:9033704971


Introduction

Psychological disorders are mental disorders of psychological function sufficiently severe

to require treatment by a psychiatrist or clinical psychologist. Psychological disorders, diseases

are mental disorders like Schizophrenia, Depression, Mania, and Anxiety Disorder and Tourette

syndrome just to mention a few. Symptoms manifests in its in patients in form of hearing internal

voices in their heads and terrifying moods disorders, affecting their behaviors negatively,

sometimes making them speak in incomprehensive voices and often making them withdrawn,

depressed and irrational and sometimes showing aggressive behavior if provoked at times.

Severe mental disorders or Psychological disorders. Sometimes causes a sense of delusions,

some patients are known to have hallucinations, incoherent thought and odd displaying odd body

movements and talking to unseen-strangers in voices, the list is includes mental work stress,

other psychological issues, heredity and genes, birth defects, substance abuse and a family

history of mental illness, medical drug side effects and so on Schizophrenia is a psychiatric

mental illness, it affects men and women equally all over the world. Though, it affects more men

than women, men often in early teens, for women in their early thirties, since is it is such a

complicated illness, all the tools of modern biomedical research are being used to search for

genes, critical moments in brain development, and other factors that may lead to the illness.

Sometimes, multiple psychological disorders may be found in one person, in these cases, a lot of

factors can be reasons for these.


Schizophrenia

Schizophrenia is a chronic mental disorder or illness which is not easy to diagnose, but

once diagnosed accurately, there treatments available to reduce its affects to a controllable

situation. The term schizophrenia means the splitting of psychic functions. “The term was coined

in the early years of the 20th century to describe what was assumed at that time to be the primary

symptom of the disorder: the breakdown of integration among emotion, thought, and action”.

Schizophrenia is a mental disorder associated with madness, it affects of about 1% of individuals

all races and cultural groups, typically beginning in adolescence or early adulthood. According to

Pinel, J. (2009), the author said in his book concerning Schizophrenia “The major difficulty in

studying and treating schizophrenia is accurately defining it (Heinrichs, 2005; Krueger &

Markon, 2006). Its symptoms are complex and diverse; they overlap greatly with those of other

psychological disorders, and they frequently change during the progression of the disorder. Also,

various neurological disorders (e.g., complex partial epilepsy; …) are associated with symptoms

that might suggest a diagnosis of schizophrenia. In recognition of the fact that the current

definition of schizophrenia likely includes several different brain diseases, some experts prefer to

use the plural form to refer to this disorder: the schizophrenias (Wong & VanTol, 2003).

Schizophrenia and the Brain Area Affected

Since Schizophrenia is said to be a psychiatric illness and also psychological disorder,

most experts believe that since the brain the controls all thought and mind processes, looking the

brain may produce an insight what goes on the mind of schizophrenic patient. Hence, the

question “is Schizophrenia caused by a physical abnormality in the brain”. Experts, researchers


and scientist, neurologists, biospychologist have used advanced neuroimaging technology to

probe the inside and outside of the brain. According to findings and I quote, they said, “There

have been dramatic advances in neuroimaging

technology that permit scientists to study brain structure and

function in living individuals. Many studies of people with

schizophrenia have found abnormalities in brain structure

(for example, enlargement of the fluid-filled cavities, called

the ventricles, in the interior of the brain, and de creased size of certain brain regions) or function

(for example, decreased metabolic activity in certain brain regions). It should be emphasized that

these abnormalities are quite subtle and are not characteristic of all people with schizophrenia,

nor do they occur only in individuals with this illness. Microscopic studies of brain tissue after

death have also shown small changes in distribution or number of brain cells in people with

schizophrenia. It appears that many (but probably not all) of these changes are present before an

individual becomes ill, and schizophrenia may be, in part, a disorder in development of the brain.

Developmental neurobiologists funded by the National Institute of Mental Health

(NIMH) have found that schizophrenia may be a developmental disorder resulting when neurons

form inappropriate connections during fetal development. These errors may lie dormant until

puberty, when changes in the brain that occur normally during this critical stage of maturation

interact adversely with the faulty connections. This research has spurred efforts to identify

prenatal factors that may have some bearing on the apparent developmental abnormality.

In other studies, investigators using brain-imaging techniques have found evidence of early

biochemical changes that may precede the onset of disease symptoms, prompting examination of

http://www.schizophrenia.com/research/schiz.brain.htm

http://www.schizophrenia.com/research/schiz.brain.htm


the neural circuits that are most likely to be involved in producing those symptoms. Meanwhile,

scientists working at the molecular level are exploring the genetic basis for abnormalities in brain

development and in the neurotransmitter systems regulating

brain function”.

Is Schizophrenia Associated With A Chemical Defect In

The Brain?

There are studies and research going on about

whether there are chemicals in the brain somehow work to affect the neurotransmitters in the

brain, however, according scientists,“ … knowledge about brain chemistry and its link to

schizophrenia is expanding rapidly. Neurotransmitters, substances that allow communication

between nerve cells, have long been thought to be involved in the development of schizophrenia.

It is likely, although not yet certain, that the disorder is associated with some imbalance of the

complex, interrelated chemical systems of the brain, perhaps involving the neurotransmitters

dopamine and glutamate. This area of research is promising”

Symptoms and diagnosis

The following are common symptoms of schizophrenia, but none of them appears in all

cases. Indeed, the recurrence of only two of these symptoms for one month is grounds for the

diagnosis of schizophrenia ( Tamminga & Holcomb, 2005; Walker et al., 2004):

● Delusions. Delusions of being controlled (e.g., “Martians are making me think evil thoughts”),

delusions of persecution (e.g., “My mother is trying to poison me”), delusions of grandeur (e.g.,

“Michael Jordan admires my sneakers”).


● Inappropriate affect. Failure to react with an appropriate level of emotionality to positive or

negative events (Keltner, Kring, & Bonanno, 1999; Kring, 1999).

● Hallucinations. Imaginary voices telling the person what to do or commenting negatively on

the person’s behavior.

● Incoherent thought. Illogical thinking, peculiar associations among ideas, or belief in

supernatural forces.

● Odd behavior. Long periods with no movement (catatonia), a lack of personal hygiene,

talking in rhymes, avoiding social interaction, echolalia. Only one symptom is necessary for a

diagnosis of schizophrenia if the person exhibits delusions that are particularly bizarre or

hallucinations that include one voice providing a running commentary or two voices

conversing”.

Factors that contribute Schizophrenia

Genetics and hereditary is one of the factors that contribute the effects of having

schizophrenia in individuals, according to statistics, “occurring in a close biological relative (i.e.,

in a parent, child, or sibling) of a schizophrenic is about 10%, even if the relative was adopted

shortly after birth by a healthy family (e.g., Kendler & Gruenberg, 1984; Rosenthal et al., 1980).

Then, it was discovered that the concordance rates for schizophrenia are higher in identical twins

(45%) than in fraternal twins (10%)—see Holzman and Matthyse (1990) and Kallman (1946).

Finally, adoption studies have shown that the risk of schizophrenia is increased by the presence

of the disorder in biological parents but not by its presence in adoptive parents (Gottesman &

Shields, 1982). The list of logical genetic connections by offspring’s of combination of different

types of twins and mixed parents are possible candidate for this list. However, the truth is other


causes also exist, which includes It is clear that schizophrenia has multiple causes. Several

different genes have been linked to the disorder (see Harrison & Weinberger, 2005; Ross et al.,

2006). However, the mechanisms by which these genes contribute to schizophrenia have yet to

be determined. Also, a variety of early experiential factors have been implicated in the

development of schizophrenia—for example, birth complications, early infections, autoimmune

reactions, toxins, traumatic injury, and stress. These early experiences are thought to alter the

normal course of neurodevelopment, leading to schizophrenia in individuals who have a genetic

susceptibility (see Lenzenweger, 2006; McGrath et al., 2003).

Drugs and psychotherapy support for treatment for schizophrenia

Antipsychotics and psychotherapy and support are some methods used for the

treatment of schizophrenia. Experts believe that Antipsychotics with a balance mix of

psychotherapy, and care support depending of course on the diagnosis of the patients is a more

effective mix for the treatment of schizophrenia . They said, “they are quite effective at treating

the positive symptoms of schizophrenia, but relatively less successful for negative symptoms,

with one notable exception (see clozapine,). Every person reacts a little differently to

antipsychotic drugs, so a patient may need to try several before finding the one that works best. It

is also important to continue the treatment even after symptoms get better, because there is a

high likelihood that psychosis will return without medication, and each returning episode may be

worse. Newer medications called "atypical" antipsychotics usually are tried first. They are as

effective as older medications at treating the psychotic symptoms of schizophrenia, and they also

may be a little better at treating cognitive symptoms. These medications include risperidone

(Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), ziprasidone (Geodon) and aripiprazole

(Abilify). Concerning psychotherapy other experts also said , and I quote, Antipsychotic drugs


aren’t the only treatment people with schizophrenia need. Psychotherapy and support are also

key. With proper treatment, some individuals with schizophrenia can recover. About a quarter of

young people with schizophrenia who get treatment get better within six months to two years,

research has found. Another 35 to 40 percent see significant improvements in their symptoms

after longer-term treatment—enough to let them live relatively normal lives outside hospitals

with only minor symptoms. Antipsychotic drugs play a crucial role in treatment. These drugs

don’t cure schizophrenia. Instead, they reduce symptoms such as delusions and hallucinations.

The drugs can have side effects, such as physical agitation and muscle spasms. In addition, their

long-term use causes permanent neurological damage. Reduced symptoms don’t necessarily

mean individuals are able to function effectively outside a hospital, however. Psychosocial

support can help make that possible. Psychotherapy can help individuals learn how to function

in appropriate, effective and satisfying ways. By teaching individuals how to cope,

psychotherapy can help people overcome dysfunction and regain their lives. Individuals may

also need training in social skills or vocational counseling and job training. Family education,

family psychotherapy and self-help groups are also beneficial.

Side effects of Drugs for the treatment of schizophrenia

“The most serious side effect of these newer drugs is weight gain, which increases the

risk for developing diabetes or high cholesterol. Older antipsychotic medications, such as

chlorpromazine (Thorazine) and haloperidol (Haldol), are still quite effective and worth trying if

atypical antipsychotics do not provide enough relief. However, the older medications can cause

sedation, muscle spasms or rigidity, restlessness, dry mouth, constipation, weight gain or

changes in blood pressure. With long-term use, there is a risk of developing involuntary muscle

http://www.bettermedicine.com/topic/cholesterol/

http://www.bettermedicine.com/topic/diabetes/


movements (called tardive dyskinesia). Clozapine (Clozaril) is a unique antipsychotic that is

effective not just for positive symptoms, but also the negative symptoms of schizophrenia.

However, it has a potentially dangerous side effect. About 1 in 100 people who take this drug

lose the capacity to produce the white blood cells needed to fight infection. Anyone taking this

drug must have regular tests to check blood counts. Other side effects include changes in heart

rate and blood pressure, weight gain, sedation, excessive salivation and constipation. On the

positive side, people do not develop the muscle rigidity or the involuntary muscle movements

seen with older antipsychotics. Because clozapine may be the best overall treatment for

schizophrenia symptoms, some people may decide that the potential benefit of taking it is worth

the risks. Because other disorders can either mimic the symptoms of schizophrenia or

accompany schizophrenia, other medications may be tried, such as antidepressants and mood

stabilizers. Sometimes anti-anxiety medications help to control anxiety or agitation”.

Anxiety Disorders

Introduction

Anxiety disorder is a psychology which affects a patient in form of a false of sense fear

or feeling of fear and anxiety or unfounded anxiouness. However, sometimes anxiety has a

positive and negative sides, positive, when it motivates an individual to anticipate events and

helps effective coping behaviors. Anxiety becomes very negative, when the severity of it leads to

disruptive normal functioning of activities of daily living; becomes a psychological or mental

problem, this time, experts says, “It is referred to as an anxiety disorder. All anxiety disorders are

associated with feelings of anxiety (e.g., fear, worry, despondency) and with a variety of

physiological stress reactions—for example, tachycardia (rapid heartbeat), hypertension (high

http://www.bettermedicine.com/topic/anxiety/

http://www.bettermedicine.com/schizophrenia/


blood pressure), nausea, breathing difficulty, sleep disturbances, and high glucocorticoid levels.

Anxiety disorders are the most prevalent of all psychological disorders. A meta-analysis of 46

studies found that about 17% of people suffers from an anxiety disorder at some point in their

lives and that the incidence rate is about twice as great in females as in males (Somers et al.,

2006)”. There are other major classes of Anxiety Disorders, they includes, the five major types:

There generalized anxiety disorders, phobic anxiety disorders, panic disorders, obsessive-

compulsive disorders, and posttraumatic stress disorder. Generalized anxiety disorders are

characterized by stress responses and extreme feelings of anxiety that occur in the absence of any

obvious precipitating stimulus. Phobic anxiety disorders are similar to generalized anxiety

disorders except that they are triggered by exposure to particular objects (e.g., birds, spiders) or

situations (e.g., crowds, darkness). Panic disorders are characterized by rapid-onset attacks of

extreme fear and severe symptoms of stress (e.g., choking, heart palpitations, and shortness of

breath); they are often components of generalized anxiety and phobic disorders, but they also

occur as separate disorders. Obsessive-compulsive disorders are characterized by frequently

recurring, uncontrollable, anxiety-producing thoughts (obsessions) and impulses (compulsions).

Responding to them—for example, by repeated compulsive hand washing—is a means of

dissipating the anxiety associated with them. Posttraumatic stress disorder is a persistent pattern

of psychological distress following exposure to extreme stress, such as war or being the victim of

sexual assault (McNally, 2003; McNally, Bryant, & Ehlers, 2003; Newport& Nemeroff, 2000).

Clinical implications

Tom is an engineer, he is happily married, and he is the father of three bright, healthy

children. By all appearances, his life is stable and satisfying. Tom, however, suffers from


continual worry that he has a difficult time turning off. His anxiety may center on anything from

his perceived health problems (he has recently been to his doctor for a physical, but no health

issues were discovered) to money and job responsibilities. At times his anxiety peaks to the point

that it interferes with his ability to function on the job. Physical symptoms include muscle

tension, headaches, and hot flashes that often accompany Tom’s anxiety. Tom often feels

nauseated, and he becomes easily fatigued. When he feels anxious, Tom has difficulty

concentrating, he becomes irritable, and he has difficulty falling asleep at night. All of these

symptoms have been present for the last 6 months. Tom has tried to talk himself out of his

anxiety, but this has not worked for him. Tom's wife is supportive, but she does not know what

to do for her husband (Hauser, 2005).

Anxiety Disorder

Anxiety is an emotion characterized by feelings of tension, worried thoughts and

physical changes like increased blood pressure. People with anxiety disorders usually have

recurring intrusive thoughts or concerns. They may avoid certain situations out of worry. They

may also have physical symptoms such as sweating, trembling, dizziness or a rapid heartbeat.

Neural Bases of Anxiety Disorders

Thought, the likelihood of brain being to anxiety attacks is nonexistent and not evident

but, researchers are still looking into the areas of drugs effects in the brain, according recent and

I quote,. “Like current theories of the neural bases of schizophrenia and depression, current

theories of the neural bases of anxiety disorders rest heavily on the analysis of therapeutic drug

effects. The fact that many anxiolytic drugs are agonists at either GABAA receptors (e.g., the

benzodiazepines) or serotonin receptors (e.g., buspirone, Prozac, and Paxil) has focused attention


on the possible role in anxiety disorders of deficits in both GABAergic and serotonergic

transmission. Speculations about the brain structures involved in anxiety disorders have long

focused on the amygdala because of the role it plays in fear, but there has been recent interest in

the involvement of the prefrontal lobes and cognitive factors in anxiety (see Clarke et al., 2004;

van Veen & Carter, 2006). However, structural brain-imaging studies have not consistently

revealed damage in the amygdalas, prefrontal lobes, or other brain structures of patients suffering

from anxiety disorders. Although there have been some reports of functional brain changes in

patients suffering from anxiety disorders, none of the research

has been consistently replicated. You may have noticed that there seems to be a progressionin the

neuroscientific investigation of the three main classes of psychiatric disorders: a progression in

schizophrenia, affective disorders, and anxiety disorders from gross, easily documented brain

pathology to more subtle, difficult-to-document effects. Why have the neural correlates of

anxiety disorders been particularly difficult to identify?”, end of quote.

Medical Treatment of Anxiety Disorder ( Clinical Implication for Tom, Anxiety patient)

Tom could be treated with the following medications, after clinical diagnosis :

Experts recommend three categories of drugs that are effective against anxiety disorders. They

are, “benzodiazepines,serotonin agonists, and antidepressants. Benzodiazepines Benzodiazepines

such as chlordiazepoxide (Librium) and diazepam (Valium) are widely prescribed for the

treatment of anxiety disorders. They are also prescribed as hypnotics (sleep-inducing drugs),

anticonvulsants, and muscle relaxants. Indeed, benzodiazepines are the most widely prescribed

psychoactive drugs; approximately 10% of adult North Americans are currently taking them. The

benzodiazepines have several adverse side effects: sedation, ataxia (disruption of motor activity),

tremor, nausea, and a withdrawal reaction that includes rebound anxiety. Another serious


problem with benzodiazepines is that they are highly addictive. Consequently, they should be

prescribed only for short-term use (see Gray & McNaughton, 2000). The behavioral effects of

benzodiazepines are thought to be mediated by their agonistic action on GABAA

receptors. Serotonin Agonists The serotonin agonist buspirone is widely used in the treatment of

anxiety disorders. Buspirone appears to have selective agonist effects at one subtype of serotonin

receptor, the 5-HT1A receptor. Its mechanism of action is not totally understood, but it does not

function as an SSRI. The main advantage of buspirone over the benzodiazepines is its

specificity: It produces anxiolytic (anti-anxiety) effects without producing ataxia, muscle

relaxation, and sedation.

Side Effects of using Anxiety drugs

“common side effects of the benzodiazepines. Buspirone does, however, have other side

effects (e.g., dizziness, nausea, headache, and insomnia). Antidepressant Drugs One of the

complications in studying both anxiety disorders and depression is their comorbidity (their

tendency to occur together in the same individual)—in one study of depressed patients, both

unipolar and bipolar, over half had also been previously diagnosed with an anxiety disorder

(Simon et al., 2004). The comorbidity is thought to exist because both disorders involve a

heightened emotional response to stress (Morilak & Frazer, 2004). Consistent with this

relationship is that antidepressant, such as the SSRIs, are often affective against anxiety

disorders, and anxiolytics (anti-anxiety drugs) are often effective against depression”.


Other side non-medical related effects

Anxiety and sadness may increase on anniversary of a traumatic event

April 16 marks the most deadly school shooting in United States history. As the anniversary of

the Virginia Tech shootings nears, survivors, victim’s families, classmates, first responders and

the extended community of Blacksburg, Virginia, may re-experience many of the same feelings

they felt before.

Treating Anxiety Disorders with Therapy

Tom can also benefit from individual counseling from a psychology a medical and

clinical after showing some improvement or when discharge from the hospital if admitted.

Anxiety Disorder could also be treated with therapy (also called counseling) is often a

helpful treatment for anxiety disorders. With therapy, a specially trained professional (therapist)

helps an individual face and learn to manage anxiety. Therapy can be short-term or long-term

depending on individual needs. For Tom’ s case, I believe, he will really benefit from a lot of

counseling and cognitive Therapy to help him get back to his work and family life. In some

cases, medication may also be prescribed with therapy. It may take time before he notices some

needed improvement, but continuation is progressive. With therapy, he and get feel better. With

therapy however, it can be in two parts or group, depending on the recommendation of the

psychologicaltics or psychologist, the two parts of therapy are Cognitive behavioral Therapy

(CBT), Behavioral Therapy or Group Therapy.

http://www.bettermedicine.com/topic/anxiety/treating-anxiety-with-therapy

http://www.apa.org/helpcenter/anniversary.aspx


Anorexia

Introduction

According Pinel, J. (2009), the author said, concerning the same disorder, “Anorexia

nervosa is a disorder of under-consumption anorexia nervosa is a disorder of under-consumption

(see Klein & Walsh, 2004). Anorexics eat so little that they experience health threatening weight

loss; and despite their grotesquely emaciated appearance, they often perceive themselves as fat

(see Benninghoven et al., 2006)”. It is very serious condition because it may lead to death, and

it that mostly affects the female gender, though, male are known to be anorexic, and the numbers

are very insignificant as compared to females. Anorexia nervosa is directly related to bulimia

nervosa. Bulimia Nervosa is a disorder characterized by bingeing, which mean eating food and

instead of letting follow the normal digestive processes. Bulimics may be obese or of normal

weight. If they are underweight, they are diagnosed as bingeing anorexics.The individual

immediately eliminates by voluntarily purging or vomiting ; forcefully from the mouth or using

an overdose of laxatives to eliminate all the contents from the mouth or going to the lavatory.

Sometimes various other methods are used to eliminate the foods from the body like; vigorous

exercises. Anorexia nervosa is a very serious condition because it can lead to death—in

approximately 10% of diagnosed cases, complications from starvation result in

death(Birmingham et al., 2005), and there is a particularly high rate of suicide among anorexics

(Pompili et al., 2004).

The Relation between Anorexia and Bulimia

The author continued by saying, concerning on the question whether, Are anorexia

nervosa and bulimia nervosa really different disorders, as current convention dictates? In his


book, he said, “The answer to this question depends on one’s perspective. From the perspective

of a physician, it is important to distinguish between these disorders because starvation produces

different health problems than does repeated bingeing and purging. For example, anorexics often

require treatment for reduced metabolism, bradycardia (slow heart rate), hypotension (low blood

pressure), hypothermia (low body temperature), and anemia (deficiency of red blood cells)

(Miller et al., 2005). In contrast, bulimics often require treatment for irritation and inflammation

of the esophagus, vitamin and mineral deficiencies, electrolyte imbalance, dehydration, and acid

reflux. Although anorexia and bulimia nervosa may seem like very different disorders from a

physician’s perspective, scientists often find it more appropriate to view them as variations of the

same disorder. According to this view, both anorexia and bulimia begin with an obsession about

body image and slimness and extreme efforts to lose weight. Both anorexics and bulimics

attempt to lose weight by strict dieting, but bulimics are less capable of controlling their appetites

and thus enter into a cycle of starvation, bingeing, and purging (see Russell, 1979). The

following are other similarities that support the view that anorexia and bulimia are variants of the

same disorder (see Kaye et al., 2005):

● Both anorexics and bulimics ha educated females in affluent cultural groups (Lindberg &

Hjern, 2003).

● Both anorexia and bulimia are highly correlated with obsessive-compulsive disorder and

depression (Kaye et al., 2004; O’Brien & Vincent, 2003).

● Neither disorder responds well to existing therapies.

Short-term improvements are common, but relapse is usual.

Anorexia and Positive Incentives


The positive-incentive perspective on eating suggests that the decline in eating that

defines anorexia nervosa is likely a consequence of a corresponding decline in the positive-

incentive value of food. However, the positive-incentive value of food for anorexia patients has

received little attention— in part, because anorexic patients often display substantial interest in

food. The fact that many anorexic patients are obsessed with food—continually talking about it,

thinking about it, and preparing it for others (Crisp, 1983)—seems to suggest that food still holds

a high positive-incentive value for them. However, to avoid confusion, it is necessary to keep in

mind that the positive incentive value of interacting with food is not necessarily the same as the

positive-incentive value of eating food— and it is the positive-incentive value of eating food that

is critical when considering anorexia nervosa. A few studies have examined the positive-

incentive value of various tastes in anorexic patients (see, e.g., Drewnowski et al., 1987; Roefs et

al., 2006; Sunday & Halmi, 1990). In general, these studies have found that the positive-

incentive value of various tastes is lower in anorexic patients than in control participants.

However, these studies grossly underestimate the importance of reductions in the positive-

incentive value of food in the etiology of anorexia nervosa, because the anorexic participants and

the normal-weight control participants were not matched for weight. Starvation normally triggers

a radical increase in the positive-incentive value of food. This has been best documented by the

descriptions and behavior of participants voluntarily undergoing experimental semi starvation.

When asked how it felt to starve, one participant replied: I wait for mealtime. When it comes I

eat slowly and make the food last as long as possible. The menu never gets monotonous even if it

is the same each day or is of poor quality. It is food and all food tastes good. Even dirty crusts of

bread in the street look appetizing. (Keys et al., 1950, p. 852)


Anorexia Nervosa: A Hypothesis

The dominance of set-point theories in research into the regulation of hunger and eating

has resulted in widespread inattention to one of the major puzzles of anorexia: Why does the

adaptive massive increase in the positive-incentive value of eating that occurs in victims of

starvation not occur in starving anorexics? Under conditions of starvation, the positive-incentive

value of eating normally increases to such high levels that it is difficult to imagine how anybody

who is starving—no matter how controlled, rigid, obsessive, and motivated—could refrain from

eating in the presence of palatable food. Why this protective mechanism is not activated in

severe anorexics is a pressing question about the etiology of anorexia nervosa. The answer will

have to explain how anyone can overcome food’s attraction enough to reach the level of

starvation characteristic of extreme anorexia. I believe that part of the answer lies in the research

of Woods and his colleagues on the aversive physiological effects of meals. At the beginning of

meals, people are normally in reasonably homeostatic balance, and this homeostasis is disrupted

by the sudden infusion of calories. The other part of the answer lies in the finding that the

aversive effects of meals are much greater in people who have been eating little (Brooks &

Melnik, 1995). Meals, which produce adverse, but tolerable, effects in healthy individuals, may

be extremely aversive for individuals who have undergone food deprivation. Evidence for the

extremely noxious effects that eating meals has on starving humans is found in the reactions of

World War II concentration camp victims to refeeding—many were rendered ill and some were

even killed by the very food given to them by their liberators (Keys et al., 1950; see also

Soloman & Kirby, 1990). So why do severe anorexics not experience a massive increase in the

positive-incentive value of eating, similar to the increase experienced by other starving

individuals? The answer may be meals—meals forced on these patients as a result of the


misconception of our society that meals are the healthy way to eat. Each meal consumed by an

anorexic may produce a variety of conditioned taste aversions that reduce the motivation to eat.

This hypothesis needs to be addressed because of its implication for treatment: Anorexic patients

—or anybody else who is severely undernourished—should not be encouraged, or even

permitted, to eat meals. They should be fed—or infused with—small amounts of food

intermittently throughout the day. I have described the preceding hypothesis to show you the

value of the new ideas that you have encountered in this chapter: The major test of a new theory

is whether it leads to innovative hypotheses. A few months ago, as I was perusing an article on

global famine and malnutrition, I noticed an intriguing comment: One of the clinical

complications that results from feeding meals to famine victims is anorexia (Blackburn,

2001).What do you make of this?”

A NOVEL APPROACH TO ANOREXIA

“The findings on anorexia are particularly bright because the disease--first identified in

1689 but not treated as a mental health or medical disorder until recently--has vexed clinicians

for decades. Anorexia affects about 1 percent of young women ages 12 to 25, and if left

untreated, may lead to osteoporosis, cardiac problems, infertility, depression, relationship

difficulties, suicide and death from medical complications. Men and boys fall prey to anorexia

nervosa and other eating disorders, too: Recent estimates find that as many as one in eight people

with eating disorders are male. Treatment for the disorder has stagnated, partly because patients

with the condition are difficult to treat and partly because insurance won't pay for long-term

treatment "This is an illness that has defied an awful lot of imaginative people," says Lock. "We

know a lot about how bad it is psychologically and medically, but we really haven't known what

to do about it."The anorexia treatment now showing promise and being studied by Lock was


developed by two British therapists, child psychiatrist Christopher Dare, MD, and child

psychologist and family therapist Ivan Eisler, PhD, of the Maudsley Hospital in London, well-

known for its eating disorders unit. The two designed the treatment based on the work of

innovative family therapists such as Philadelphia psychiatrist Salvador Minuchin, MD, and on

their own ideas. The treatment elicits the parents' aid in getting the patient to eat, gradually

returns control of eating to the client then works with the family to help the client navigate the

developmental challenges of adolescence, explains psychologist Daniel Le Grange, PhD. He

directs the Eating Disorders Program at the University of Chicago and is conducting studies on

the treatment. Clinicians who practice the treatment encourage parents to work together as a

team to address their child's health problem. They emphasize the severity of the illness, coaching

parents to assume the role of a nurse in an inpatient unit whose aim is to restore the girl's weight

to normal.”

Clinical Implications for Beth ( Anorexia patient)

Beth is a normal child raised in a well-balanced home by caring parents. As a teenager,

she began to experience an overwhelming fear of gaining weight and becoming fat. Her fear was

unfounded because Beth’s weight was normal for her height and age. Beth began to diet and

loses weight, but regardless of how much she weighed, she had a very poor self-image. Beth has

become dangerously thin, but she denies the seriousness of her condition. Regardless of how

much weight she loses, she feels like she needs to lose more. Beth has missed several menstrual

cycles and continues to severely restrict her food intake. Her weight continues to drop. Beth's

mother and father are deeply concerned, but they do not know how to help their daughter

(PsychCentral®, 2006).


Thinking Critically ( Clinical Analysis for Beth, Anorexia patient)

Concerning Beth, the reason, she is sick is because she eats, according to experts and I

quote am, “At the beginning of meals, people are normally in reasonably homeostatic balance,

and this homeostasis is disrupted by the sudden infusion of calories. The other part of the answer

lies in the finding that the aversive effects of meals are much greater in people who have been

eating little (Brooks & Melnik, 1995). Meals, which produce adverse, but tolerable, effects in

healthy individuals may be extremely aversive for individuals who have undergone food

deprivation. Evidence for the extremely noxious effects that eating meals has on starving humans

is found in the reactions of World War II concentration camp victims to refeeding—many were

rendered ill and ...(Keys et al., 1950; see also Soloman & Kirby, 1990)”. And because Beth is

starving herself and her bodies of needed desired food and nutrients , her bodies is deprived of

the needed nutrients, this adverse condition is making her body reject foods fed and hence

making her sick. She needs to see a medical doctor and foods disorder specialist for immediately

or her condition may get worse.

Clinical Treatment

Beth will benefit from a counseling and therapy session. The counseling will inform of a

kind of a family; it include a support group in which believes will help her regain consciousness

because she feels a low self-esteem and why she is not eating as much. Her mom, father and her

friends, she trust is a good recommendation for a start. Group meals are good start point too.


References and Citations

Pinel, J. (2009). Biopsychology, Chap., 18, Schizophrenia, Affective Disorders: Depression and, Anxiety Disorders,

Encyclopedia of Psychology Retrieved on the 25th day of march of 2012 march of 2012 from

-http://www.apa.org/topics/anxiety/index.aspx

Encyclopedia of Psychology , Retrieved on the 25th day of march of 2012 march of 2012 from

-http://www.apa.org/topics/schiz/treatment.aspx

http://www.bettermedicine.com/schizophrenia/what-is-schizophrenia/ symptoms-and-diagnosis/medications-for-

schizophrenia

http://www.bettermedicine.com/topic/anxiety/treating-anxiety-with-therapy

Tori DeAngelis, ( 2002), Vol., No 3, p. 38, Promising treatments for anorexia and bulimia, retrieved from on 25 day of march, 2012 from http://www.apa.org/monitor/mar02/promising.aspx ,

http://www.apa.org/pubs/books/4600100.aspx

http://www.apa.org/pubs/books/4600100.aspx

Analyzing Psychological Disorders in Brief

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