Notes and Exam questions. Exemplar questions with answers. This document contains A03 and A01. There are notes based on eating behaviours that will get you top marks. Grade A work and revision notes. There are 16 mark questions that have the highest/ full marking scores as well as a structure.
Outline and evaluate the Family Systems Theory of Anorexia Nervosa
Salvadir Muchin in 1978 had developed a psychodynamic theory of anorexia within the family.
Interactions between family members have a tight structure in causing AND symptoms. This is identified
through the 4 main features in an anorexia family. Enmeshment is the involvement of family boundaries
being fuzzy from the result of poor leadership. For example, a daughter would be repressed and want to
gain independence within her own identity but the enmeshment stops her from doing so and she gains
independence by refusing to eat. Secondly, overprotectiveness is the family being over obsessively
nurturing leaving no room for independence. For example Mara palazolli in 1974 believed that the
mother would only make decisions based on the daughter but this is wrong when the daughter is to
blame for being anorexic. The rigidity explains the roles and coats in a family in structure. This is bad
when a structurally restricted family has a change, this causes a threat like a daughter gaining
independence, the status quo of a mother may quash this leaving no room for manoeuvre. conflict
avoidance is the experience of overseeing one's own self and behavior, people will AN to gain
independence through the dependency in control. Lastly, Hilde Bruch in 1978 had suggested that
anorexia is caused by the adolescent of daughters struggling to achieve autonomy which comes under a
distorted body image, inability to identity internal body states, e.g., hunger and overwhelming feeling of
loss of control, which makes up to anorexia.
One strength of this theory is that Brockmeyer et al studied female patients for a healthy control. The
findings have shown that AN patient had a greater desire to be autonomous which corresponds to the
earlier study of Ryann for females. They had a more controlling style and perceived poorer
communication within the family, causing disturbances of their autonomy. This is a strength as it has
shown that the desire for autonomy is presented in families with poor communications and the risk
factors have been affecting daughters specifically.
One limitation of the family theory of anorexia is that there is inconsistent evidence which prevents the
supports to identify the typical anorexic family. This is evidenced by Aragona et al who did a study on
Portuguese female participants. The fact that it's female could be a limitation based on gender bias. The
families were studied based on the enmeshment of rigidity of their family when compared to the control
group being the non - disordered family. The findings have shown that they didn't have these qualities
which is a failure as different reasons can be used to the reason of AN in families. This therefore, shows
the difficulty confirming the predictions as it is unclear on what's being fully measured. This may also be
because other reasons such as biological and cognitive pressures apply to an AN, not only due to
families as not all patients are affected by their family structure. This therefore, shows that it is not
reliable as a full explanation and therefore makes it inconsistent.
One limitation of this theory is that it does not support the view or give enough evidence on the cause
of anorexia. It would be a “perhaps” statement regarding the overprotectiveness or conflict features.
This argues that the issues and cause is irrelevant as the symptoms may become linked to family so in
order to find the cause, understanding will only help to search for an effective treatment.
Another strength of this theory is that there is evidence, with therapies, Robin et al tested the
effectiveness of AN suffers interacting with people outside their family. It was down by 11 females and
lasted over 16months, 6 patients were considered to have recovered, which compared favorably with
the outcome of individual therapy. Therefore, this is a strength as results have shown the effect of the
family's interactions with an AN sufferer. > 13/16
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