One psychological theory of Bulimia is the Cognitive
approach. Cooper et al. (2004) said that Bulimics usually had a trauma in early
life that leads them to feel unloved, worthless and not accepted. As these
people get older the get exposed to diets, ‘perfect’ body shapes and criticisms
of their own body. This leads to them thinking ‘fat = bad’ and therefore start
to diet to get accepted. This then sets of a vicious cycle where they feel
worthless and think binging would help which then makes them feel fat and
unaccepted leading them to purge and feel worthless again.
A study
was conducted to support the cognitive approach by Leung et al (2000) who found
that a lack of parental bonding was linked to dysfunctional beliefs which have
been linked to binging and purging. Wellar (2000) also found this and that
stress and loneliness can trigger binging. This supports the cognitive model as
it shows that the binging and purging linked to bulimia are triggered by a
thought process.
The
cognitive model is undermined by the fact that it should be treatable through
Cognitive behaviour therapy (CBT) but Fairburn et al (1995)found that this
wasn’t always the case after trying to treat Bulimics using CBT and finding
that only 50% were symptom free and 37% still fit bulimia criteria. This
undermines the cognitive model as an explanation for bulimia as it shows that
bulimia is not always treatable as a cognitive process.
Cognitive
explanations can be seen to be a reductionist approach to bulimia. This means
that some other factors that may contribute to Bulimia have been forgotten
about so that the cognitive approach can be focused on alone. It is likely that
other factors such as biological or evolutionary explanations play a part in
Bulimia as well and therefore it is probably more useful to have a more
well-rounded approach rather than a specific one. However saying it is
reductionist could be unfair as all scientific research has to be quite
specific to establish a cause and effect relationship.
Another psychological explanation
of Bulimia is the Relationship Process. This says that bulimia occurs because
women try to change themselves in order to meet a perceived idea of when men
find ‘attractive’. These people tend to be dissatisfied with their own physical
appearance, self-conscious about their body and worry they will not be accepted
by their partners and often about being self-conscious during sexual activity.
Schembri and Evans (2008)
conducted a study to support the relationship process as an explanation for
bulimia by having 225 women form intimate relationships answer questionnaires
on eating behaviours, themselves and their relationships. Around 8% of these
women were receiving professional help for eating disorders. They found that
the strongest predictor of bulimic symptoms was self-consciousness during
sexual activity. This would support the relationship process as an explanation
for bulimia as these women were showing bulimic symptoms most likely to try and
change themselves to be ‘accepted’ by both themselves and their partners to
reduce this self-consciousness.
This
study however was carried out using a self-report method and therefore answers
that the women thought were socially desirable could have been given instead of
truthful ones. This reduced the internal validity of Shembri and Evans’s study.
It is also very gender biased as it was carried out solely on women and the
results can therefore not be generalised to men reducing the study’s population
validity.
Studies
into Bulimia appear to have a heterosexual bias as well as a gender bias as
most of the research into bulimia is carried out only on heterosexual women
excluding any other groups who may also be vulnerable to bulimia. This has
occurred even though a study by Feldman and Meyer showed that gay and bisexual
men have the highest rates of suffering from an eating disorder with
heterosexual women having a much lower percentage. This could be due to the
fact that high expectations of physical appearance are often apparent in the
gay community.
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