The Developmental Psychopathology of Eating Disorders: Implications for Research, Prevention, and Treatment

The Developmental Psychopathology of Eating Disorders: Implications for Research, Prevention, and Treatment

The Developmental Psychopathology of Eating Disorders: Implications for Research, Prevention, and Treatment

The Developmental Psychopathology of Eating Disorders: Implications for Research, Prevention, and Treatment

Synopsis

Although eating problems--ranging from body dissatisfaction and dieting to anorexia nervosa or bulimia nervosa--can begin and typically have their roots in childhood, theory and research in developmental psychopathology and developmental psychology have not received substantial attention in eating disorders research. This book provides crucial background material from both fields, and then makes direct applications to numerous aspects of the field of eating disorders including theory, research, treatment, and primary prevention.

This book was born out of a transaction between frustration and optimism. The frustrations reflected the limitations of current knowledge about eating problems and disorders. Etiological "causes" which are sensitive and specific to eating disorders have been elusive. Although there is some understanding of risk factors, little is known about protective factors. This has made prevention, among other things, difficult. Furthermore, the mechanisms underlying the association between risk factors and disordered eating are poorly understood. For example, it is known that women are at greater risk than men are, but clinicians are hard- pressed to get beyond gender-based speculations and demonstrate why this is true.

The optimism grows from familiarity with the field of developmental psychopathology. It seems evident that this approach has much to offer the field of eating disorders. This book is an early step in the integration of developmental psychopathology into theorizing, research, treatment, and prevention of eating disorders. It addresses four specific goals:

• to introduce the principles and methodologies of developmental psychopathology,

• to review the work of developmental psychologists in several major areas of behavior relevant to understanding the causes, treatment, and prevention of eating disorders,

• to apply developmental psychopathology principles to the area of eating disorders, both in the form of theoretical models and in specific areas/issues raised by developmental psychopathology, and

• to discuss the implications of developmental approaches for prevention programs and treatments.

Excerpt

This book was born out of a transaction between frustration and optimism. The frustrations reflected the limitations of current knowledge about eating problems and disorders. Etiological "causes" that are sensitive and specific to eating disorders have been elusive. Although there is some understanding of risk factors, very little is known about protective factors. This has made prevention (among other things) difficult. Furthermore, the mechanisms underlying the association between risk factors and disordered eating are poorly understood. So, for example, it is known that women are at greater risk than men are, but experts in the field remain hard-pressed to move beyond gender-based speculations and to demonstrate why this is true.

The optimism grows from familiarity with the field of developmental psychopathology. It seems evident to us that this approach has much to offer the field of eating disorders. We hope that this book is an early step in the integration of developmental psychopathology into theorizing, research, treatment, and prevention of eating disorders.

THE EATING DISORDERS

Before we can effectively discuss how developmental psychopathology and psychology might be particularly valuable in examining eating disorders, it is important to define the field. Eating disorders include anorexia nervosa (AN) and bulimia nervosa (BN). Table 1 shows the definitions provided in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV; American Psychiatric Association, 1994). These definitions are more stringent (i.e., will probably lead to fewer diagnoses of the disorders) than the earlier DSM-III and DSM-III-R versions that have been used in most of the existing research. Probably about 0.5% of women meet the diagnostic criteria for AN (Walters & Kendler, 1995) and 1% to 2% of adult women meet BN diagnostic criteria (Fairburn & Beglin, 1990). The rate may be higher among adolescents (Striegel-Moore & Marcus, 1995).

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