Star Study: Psychological research into eating disorders ...



Star Study: Psychological research into eating disorders: Wonderlich et al (1996)

Read the introduction first and answer the following questions:

1. What is the prevalence of Bulimia nervosa according to this article?

2. What are the symptoms of bulimia?

3. Name 5 frequently identified risk factors

4. What do the authors think may also be an important risk factor?

5. What does existing research evidence suggest about this idea?

6. What do the authors think of this conclusion?

7. How do the authors propose to overcome the methodological problems of previous studies?

8. What was the general hypothesis and what further predictions are made? What are the reasons behind these predictions?

Aim

Wonderlich et al (1996) aimed to discover the extent to which …………………………………………… is a necessary risk factor for ………………………………. nervosa.

Previous research was ………………………………………. and many studies were flawed, e.g. used mixed samples of people with …………………………….. and bulimia, included Pps abused as ………………………. and included Pps who been abused ……………………….. (not typical of the type of childhood sexual abuse by family members).

Wonderlich et al aimed to overcome these ……………………………………….. problems and show that sexually abused women are be more likely to report …………………………….. and ………………………………behaviours (such as vomiting, laxative abuse, and extreme forms of dieting or exercise) and express …………………………………….. about body shape and weight.

Now read the method

1. What research method is used in this study?

2. Who were the sample? Number of Pps, age and culture

3. How as the data collected?

4. How were the symptoms of bulimia nervosa operationalised?

5. How was childhood sexual abuse operationalised?

Method

Wonderlich et al investigated the relationship between childhood sexual abuse and bulimia nervosa using a ………………………………….

The participants were ……………….. ………………………… women aged ………………….

………………………… interviewers conducted ……………-to-………………. interviews where the women were asked detailed questions about behaviours related to bulimia and sexual abuse.

Bulimia behaviours were operationalised according to the ………………………………………………………. and questions included whether Pps believed they were …………………………….. about body shape and weight than other people their age; whether they had ever eaten abnormally large amounts of food within a few hours at least ………………………. for ……………….. months or more; and whether they had ever engaged in ………………………………….. behaviours such as vomiting, laxative use, or severe dieting during such eating episodes.

Based on research by …………………………, childhood sexual abuse was defined as (1) any ………………………………… unwanted sexual activity before age ………. or that involved a family member …………. years older than the respondent; and any …………………………. unwanted sexual activity that occurred before age ……… or that occurred before age ……… and involved another person ……….. years older than the respondent.

Statistical techniques ensured that …………………………… variables such as age, ethnic group, and parents educational level were controlled for.

Results section

Now skip to the results section

1. What percentage were classified as having been sexually abused in childhood?

2. What was the relationship between binge eating, by itself or in combination with counteractive behaviours and childhood sexual abuse?

3. What was the relationship between heightened concerns about weight and body shape and childhood sexual abuse?

4. According to the statistical technique, ‘attributable risk analysis’, what percentage of cases of bulimia nervosa would not have occurred if women had not been sexually abused as children?

5. For what proportion of the sample was childhood sexual abuse apparently an essential precondition?

Findings

Following a longitudinal survey, Wonderlich et al found …………….% of their sample had been sexually abused in childhood and that binging and purging were ………………….. times more common in the abused group than the non-abused group.

However, such abuse was much ……………. relevant to women's odds of being highly concerned about their …………….. and ……………….

Using a technique called ‘……………………………….. analysis’, they also found that of the ………………… only group, …………….% would not have had these behaviours had they not been abused and that ……………% of the binge-purge group would have been free of these behaviours had they not been abused.

In summary, Wonderlich et al found that that in between one ……………….. and one ……………. of the more …………………… cases of bulimia behaviour childhood sexual abuse was apparently an essential ……………………………..

Now read the discussion section; don’t get bogged down in the reading; scan for the answers to the questions; much of the detail is not relevant.

Conclusions

1. What two conclusions do the authors suggest can be drawn from their study?

2. What possible reason for these findings are suggested?

3. The study provides support that which aspects are more likely to be linked to childhood sexual abuse –

• behavioural aspects of bulimia (binging and purging)

or

• cognitive aspects (excessive concern about body weight an shape)

4. These findings suggests that binging and purging have been found to be helpful in dealing with negative emotions associated with the abuse and are therefore a way of coping. Which principle from operant conditioning explains why these behaviours have become more common in these women.

• Positive reinforcement

• Negative reinforcement

• Positive punishment

• Negative punishment

5. Which model(s) of abnormality does this study support?

Conclusions

Following a study exploring the relationship between childhood sexual abuse and the prevalence of bulimic tendencies in later life, Wonderlich et al (1996) conclude that experiences of childhood sexual abuse alone are ………………………. to be ……………………… to cause bulimic behavior, however a large ………………………. of women who engage in binge eating and purging would not do so if they had not been sexually abused as children.

They suggest that the binge/purge cycle may have been …………………………. as it reduced negative affect associated with previous sexual abuse. This is an example of ………………………… reinforcement and supports the …………………………….. model of abnormality.

It can be concluded that psychological trauma in childhood may be associated more with the ……………………………….. aspects of bulimia than the …………………………… aspects since there was not a strong relationships between excessive concern about body shape and weight and childhood sexual abuse.

Criticisms

1. What yellow hat strengths does this study have, which add validity to the findings?

2. What evidence is there that the findings are reliable?

3. Why do the authors think that there may be many causes for bulimic behaviours that are unrelated to childhood sexual abuse?

4. What other factors do the authors suggests should be considered when trying to work out which victims of childhood sexual abuse will actually go on to suffer from bulimia?

5. What methodological flaw means that it is not possible to say that childhood sexual abuse preceded bulimic behaviour and may therefore have been a causal factor?

6. What is the term which describes the situation whereby interviewers may be more likely to unveil childhood sexual abuse in interviewees if they know or suspect that the interviewee has bulimic behaviour? How could this problem be overcome?

7. Why is it unlikely that interviewer bias played a part in this study?

8. What other reason does the article suggests that may mean that people with bulimia may be more likely to report sexual abuse? Why do the authors think that this was not a problem in this study?

9. The authors finally suggest that other family factors may make both bulimia nervosa and childhood sexual abuse more likely within a family thus making it appear that the two are related when in actually act both may be caused by problems within the family. What factors are cited?

Develop two criticisms of the study by Wonderlich et al (1996); don’t forget criticisms can be positive as well as negative. Make sure you build enough detail each criticism. You will also be able to use much of this activity in an essay of psychological causes of eating disorders.

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