Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-23T20:47:09.009Z Has data issue: false hasContentIssue false
  • English
  • Français

Socio-cultural factors in the development of anorexia nervosa

Published online by Cambridge University Press:  09 July 2009

David M. Garner  and
Paul E. Garfinkel
David M. Garner*
Affiliation:
Psychosomatic Medicine Unit, Clarke Institute of Psychiatry, Department of Psychiatry, University of Toronto, Canada
Paul E. Garfinkel
Affiliation:
Psychosomatic Medicine Unit, Clarke Institute of Psychiatry, Department of Psychiatry, University of Toronto, Canada
*
1Address for correspondence: Dr D. M. Garner, Clarke Institute of Psychiatry, 250 College Street, Toronto, Canada, M5T 1R8.
Get access Rights & Permissions [Opens in a new window]

Synopsis

A population of professional dance (N = 183) and modelling (N = 56) students, who by career choice must focus increased attention and control over their body shapes, was studied. Height and weight data were obtained on all subjects. In addition, a questionnaire that is useful in assessing the symptoms of anorexia nervosa, the Eating Attitudes Test (EAT), was administered. Results of these tests were compared with those of normal female university students (N = 59), patients with anorexia nervosa (N = 68), and music students (N = 35).

Anorexia nervosa and excessive dieting concerns were overrepresented in the dance and modelling students. Twelve cases (6·5%) of primary anexoria nervosa were detected in the dance group. All but one case developed the disorder while studying dance. Within the dance group those from the most competitive environments had the greatest frequency of anorexia nervosa. These data suggest that both pressures to be slim and achievement expectations are risk factors in the development of anorexia nervosa. The influence of socio-cultural determinants are discussed within the context of anorexia nervosa as a multidetermined disorder.

Type
Research Article
Information
Psychological Medicine , Volume 10 , Issue 4 , November 1980 , pp. 647 - 656
Copyright
Copyright © Cambridge University Press 1980

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Bemis, K. M. (1978). Current approaches to the etiology and treatment of anorexia nervosa. Psychological Bulletin 85, 593–617.CrossRefGoogle Scholar
Boskind-Lodahl, M. (1976). Cinderella's step-sisters: a feminist perspective on anorexia nervosa and bulimia. Signs: Journal of Women in Culture and Society 2, 342–356.CrossRefGoogle Scholar
Bruch, H. (1973). Eating Disorders. Basic Books: New York.Google Scholar
Bruch, H. (1978). The Golden Cage. Harvard University Press: Cambridge, Mass.Google Scholar
Canadian Average Weights for Height, Age and Sex (Pamphlet) (1954). Nutrition Division of the Department of National Health and Welfare: Ottawa, Canada.Google Scholar
Casper, R. C. & Davis, J. M. (1977). On the course of anorexia nervosa. American Journal of Psychiatry 134, 974–978.Google ScholarPubMed
Crisp, A. H. (1965). Some aspects of the evolution, presentation and follow-up of anorexia nervosa. Proceedings of the Royal Society of Medicine 58, 814–820.CrossRefGoogle ScholarPubMed
Crisp, A. H. (1967). The possible significance of some behavioural correlates of weight and carbohydrate intake. Journal of Psychosomatic Research 11, 117–131.CrossRefGoogle ScholarPubMed
Crisp, A. H. (1970). Anorexia nervosa. ‘Feeding disorder’, nervous malnutrition or weight phobia? World Review of Nutrition 12, 452–504.Google ScholarPubMed
Crisp, A. H. (1977). Some psychobiological aspects of adolescent growth and their relevance for the thin/fat syndrome (anorexia nervosa). International Journal of Obesity 1, 231–238.Google ScholarPubMed
Crisp, A. H. & Toms, D. A. (1972). Primary anorexia nervosa or weight phobia in the male: report on 13 cases. British Medical Journal i, 334–338.CrossRefGoogle Scholar
Crisp, A. H., Harding, B. & McGuinness, B. (1974). Anorexia nervosa. Psychoneurotic characteristics of parents: relationship to prognosis. Journal of Psychsomatic Research 18, 163–173.Google ScholarPubMed
Crisp, A. H., Palmer, R. L. & Kalucy, R. S. (1976). How common is anorexia nervosa? A prevalence study. British Journal of Psychiatry 218, 549–554.CrossRefGoogle Scholar
Dally, P. J. (1969). Anorexia Nervosa. Grune and Stratton:New York.Google Scholar
Derogatis, L., Lipman, R., Rickels, K., Uhlenhuth, E. H. & Covi, L. (1974). The Hopkins Symptom Checklist(HSCL):a self report symptom inventory. Behavioral Science 19, 1–15.CrossRefGoogle Scholar
Dubois, A., Gross, H. A., Ebert, M. H. & Castell, D. O. (1979). Altered gastric emptying and secretion in primary anorexia nervosa. Gastroenterology 77, 319–323.CrossRefGoogle ScholarPubMed
Duddle, M. (1973). An increase of anorexia nervosa in a university population. British Journal of Psychiatry 123, 711–712.CrossRefGoogle Scholar
Duncan, D. B. (1955). Multiple range and multiple F tests. Biometrics 11, 1–42.CrossRefGoogle Scholar
Dwyer, J. T. & Mayer, J. (1970). Potential dieters: who are they? Journal of American Dietetic Association 56, 510–514.CrossRefGoogle Scholar
Feighner, J. P., Robins, E., Guze, S. B., Woodruff, R. A., Winokur, G. & Munoz, R. (1972). Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry 26, 57–63.CrossRefGoogle ScholarPubMed
Fenwick, S. (1880). On Atrophy of the Stomach and on the Nervous Affections of the Digestive Organs. Churchill:London.Google Scholar
Fries, H. (1977). Studies on secondary amenorrhoea, anorectic behaviour, and body image perception: importance for the early recognition of anorexia nervosa. In Anorexia Nervosa (ed. Vigersky, R. A.), pp. 163–176. Raven Press:New York.Google Scholar
Garfinkel, P., Moldofsky, H. & Garner, D. (1977). Prognosis in anorexia nervosa as influenced by clinical features, treatment and self perception. Canadian Medical Association Journal 117, 1041–1045.Google ScholarPubMed
Garner, D. M. & Bemis, K. M. (1980). A cognitive-behavioral approach to anorexia nervosa. (Submitted for publication.)Google Scholar
Garner, D. M. & Garfinkel, P. E. (1978). Sociocultural factors in anorexia nervosa. Lancet ii, 674.CrossRefGoogle Scholar
Garner, D. M. & Garfinkel, P. E. (1979). The Eating Attitudes Test: an index of the symptoms of anorexia nervosa. Psychological Medicine 9, 273–279.CrossRefGoogle ScholarPubMed
Garner, D. M., Garfinkel, P. E., Stancer, H. C. & Moldofsky, H. (1976). Body image disturbances in anorexia nervosa and obesity. Psychosomatic Medicine 38, 327–336.CrossRefGoogle ScholarPubMed
Garner, D. M., Garfinkel, P. E. & Moldofsky, H. (1978). Perceptual experiences in anorexia nervosa and obesity. Canadian Psychiatric Association Journal 23, 249–263.CrossRefGoogle ScholarPubMed
Garner, D. M., Garfinkel, P. E., Schwartz, D. & Thompson, M. (1980). Cultural expectations of thinness in women. Psychological Reports 47, 483–491.CrossRefGoogle ScholarPubMed
Goldblatt, P. B., Moore, M. E. & Stunkard, A. J. (1965). Social factors in obesity. Journal of American Medical Association 192, 97–102.CrossRefGoogle ScholarPubMed
Halmi, K. A. (1974). Anorexia nervosa: demographic and clinical features in 94 cases. Psychosomatic Medicine 36,18–25.CrossRefGoogle ScholarPubMed
Hollingshead, A. B. (1965). Two Factor Index of Social Position. Yale Station: New Haven, Connecticut.Google Scholar
Hsu, L., Crisp, A. H. & Harding, B. (1979). Outcome of anorexia nervosa. Lancet i, 61–65.CrossRefGoogle Scholar
Huenemann, R. L., Shapiro, L. R., Hampton, M. C. & Mitchell, B. W. (1966). A longitudinal study of gross body composition and body conformation and their association with food and activity in a teenage population. American Journal of Clinical Nutrition 18, 325–338.CrossRefGoogle Scholar
Ikemi, Y., Ago, Y., Nakagawa, S., Mori, S., Takahashi, N., Suematsu, H., Sugita, M. & Matsubara, H. (1974). Psychosomatic mechanism under social change in Japan. Journal of Psychosomatic Research 18, 15–24.CrossRefGoogle ScholarPubMed
Jakobovits, C., Halstead, P., Kelley, L., Roe, D. A. & Young, C. M. (1977). Eating habits and nutrient intakes of college women over a thirty-year period. Journal of the American Dietetic Association 71, 405–411.CrossRefGoogle Scholar
Kalucy, R. S., Crisp, A. H. & Harding, B. (1977). A study of 56 families with anorexia nervosa. British Journal of Medical Psychology 50, 381–395.CrossRefGoogle ScholarPubMed
Katz, J. L., Boyar, R., Roffwarg, H., Hellman, L. & Weiner, H. (1978). Weight and circadian luteinizing hormone secretory pattern in anorexia nervosa. Psychosomatic Medicine 40, 549–567.CrossRefGoogle ScholarPubMed
Kendell, R. E., Hall, D. J., Hailey, A. & Babigian, H. M. (1973). The epidemiology of anorexia nervosa. Psychological Medicine 3, 200–203.CrossRefGoogle ScholarPubMed
Keys, A., Brozek, J., Hanschel, A., Mickelsen, O. & Taylor, H. L. (1950). The Biology of Human Starvation. University of Minnesota Press: Minneapolis.CrossRefGoogle Scholar
King, A. (1963). Primary and secondary anorexia nervosa syndromes. British Journal of Psychiatry 109, 470–479.Google ScholarPubMed
Lowenkopf, E. & Vincent, L. (1979). The student ballerina and anorexia. Presented at the annual meeting of the American Psychiatric Association,Chicago, Illinois.Google Scholar
Minuchin, S., Rosman, B. & Baker, L. (1978). Psychosomatic Families, Anorexia Nervosa in Context. Harvard University Press: Cambridge, Mass.CrossRefGoogle Scholar
Morgan, H. G. & Russell, G. F. M. (1975). Value of family background and clinical features as predictors of long- term outcome in anorexia nervosa: four year follow-up study of 41 patients. Psychological Medicine 5, 355–372.CrossRefGoogle ScholarPubMed
Nylander, I. (1971). The feeling of being fat and dieting in a school population: epidemiologic interview investigation. Acta sociomedica scandinavica 3, 17–26.Google Scholar
Palazzoli, M. P. (1974). Anorexia Nervosa. Chaucer: London.Google Scholar
Russell, G. F. M. (1970). Anorexia nervosa: its identity as an illness and its treatment. In Modern Trends in Psychosomatic Medicine Vol. 2 (ed. Price, J. H.), pp. 131–164. Butterworth:London.Google Scholar
Russell, J. A. O. (1972). Psychosocial aspects of weight loss and amenorrhea in adolescent girls. In Psychosomatic Medicine in Obstetrics and Gynecology (ed Morris, N.), pp. 593–595. S. Karger: Basel.Google Scholar
Slade, P. D. & Russell, G. F. M. (1973). Awareness of body dimension in anorexia nervosa: cross-sectional and longitudinal studies. Psychological Medicine 3, 188–199.CrossRefGoogle ScholarPubMed
Smart, D. E., Beumont, P. J. V. & George, G. C. W. (1976). Some personality characteristics of patients with anorexia nervosa. British Journal of Psychiatry 128, 57–60.CrossRefGoogle ScholarPubMed
Sours, J. A. (1969). Anorexia nervosa: nosology, diagnosis, developmental patterns and power control dynamics. In Adolescence: Psychosocial Perspectives (ed. Caplan, G. and Lebovici, S.), pp. 185–212. Basic Books: New York.Google Scholar
Stunkard, A. J. (1975). From explanation to action in psychosomatic medicine: the case of obesity. Presidential Address – 1974. Psychosomatic Medicine 37, 195–236.CrossRefGoogle ScholarPubMed
Theander, S. (1970). Anorexia nervosa: a psychiatric investigation of 94 female patients. Acta psychiatrica scandinavica Suppl. 214, 1–194.Google ScholarPubMed
Ushakov, G. (1971). Anorexia nervosa. In Modern Perspectives in Adolescent Psychiatry, Vol. 4 (ed. Howells, J. G.), pp. 274–289. Oliver & Boyd: Edinburgh.Google Scholar
Warren, W. (1968). A study of anorexia nervosa in young girls. Journal of Child Psychology and Psychiatry 9, 27–40.CrossRefGoogle ScholarPubMed