Littérature scientifique sur le sujet « Anorexia nervosa Etiology »

Two cases of anorexia nervosa in blind patients are reported. They demonstrate that blind children experience many developmental problems which are thought to be important in the etiology of anorexia nervosa. Similarly, blind children are unusually susceptible to misperceive their body size and weight. The apparent absence of a strong association between congenital blindness and anorexia nervosa challenges the presumed aetiological link between disturbed body image and identity diffusion, and anorexia nervosa.

A grand mal seizure occurred in a young woman in the weight gain phase of treatment of anorexia nervosa. The etiology of this seizure is explored and suggestions are made for the avoidance of this potential hazard in behavioural reward programs based on contingent weight gain.

The incorrect belief that anorexia nervosa is predominantly genetic is maintained in the psychiatric literature by a series of misquotations and misrepresentations of research data. An example of this type of scholarship is as an editorial in The American Journal of Psychiatry. Data from family and twin studies referenced in the editorial provide compelling evidence that the genetic contribution to the etiology of anorexia nervosa is small. The incorrect belief that anorexia nervosa is predominantly genetic is maintained, in addition, by statistical procedures such as heritability estimates. The incorrect belief that anorexia nervosa is predominantly genetic should not be endorsed by the American Psychiatric Association, in either its journals, in its published books, or in DSM–V.

Anorexia Nervosa (AN) is a young-onset psychiatric illness, for which the etiology remains unknown and presents a high heritability. Thus, the genetic component is estimated to be 70%. To identify the vulnerability genes to AN, different approaches of molecular genetic are performed, including linkage analysis, the candidate gene association study and, the Genome-Wide Association Study (GWAS). Some polymorphisms of candidate genes, such as the BDNF gene that encodes for the brain-derived neurotrophic factor, were found associated with AN in several studies. In addition to the DNA polymorphisms, there are several other changes around the DNA information, like methylation or the histone modifications, named epigenetic, that modulate the transcription of genes. Thus, first descendents after the Dutch famine in the Second World War have showed a higher risk of impaired glucose tolerance in adulthood. And women exposed to famine in utero presented DNA methylation differences but without link of cause or consequence between famine event and epigenetic changes. To date, only few events of methylation in specific candidate genes have been investigated in AN. Thus, an hypermethylation of the DRD2 gene's promoter was found associated with a downregulation of this gene expression in AN compared to healthy control women (HCW), using leucocytes. While a hypermethylation of the DAT1 promoter was observed correlated with an upregulation of this gene expression. Another study has showed no difference of the methylation level of the Proopiomelanocortin (POMC) promoter between the goups of HCW, underweight AN (acAN) and weight-recovered AN (recAN). But, the expression of POMC was significantly higher in acAN compared to recAN and HCW, and correlated with the leptin levels. These studies suggest that both the etiology and the pathologic consequences of AN could be derived by epigenetic factors, such as the methylation.

Objective: To examine several early Canadian descriptions of anorexia nervosa (AN) in light of modern understanding of the disorder. Method: Two clinical reports of AN from the late 19th century and early 20th century in Canada are cited and summarized. These original case descriptions are then compared with late 20th century knowledge of the disorder. Results: Both of these early descriptions contain many astute and prescient observations on the etiology and sequelae of AN and reveal a compassionate approach to patient care. Conclusions: Canadian contributions to the medical literature on AN prior to 1970 merit both careful scrutiny and appreciation in the world literature on this disorder.

Measures of dissociation and depression were obtained from 26 women with anorexia nervosa, 18 with bulimia nervosa, and 31 non eating disordered controls using the Questionnaire of Experiences of Dissociation (Riley, 1988) and the Beck Depression Inventory (Beck, Ward, Mendelson, Mock & Erbaugh, 1961). Eating disordered subjects scored significantly higher on both dissociation and depression than non eating disordered subjects. A moderate positive correlation was found between dissociation and depression in both the anorexia nervosa and bulimia nervosa groups. The data are discussed in terms of previous research and possible future studies. The necessity for further enquiry of the role of dissociation in the etiology of eating disorders is underscored.

The eating disorders anorexia nervosa (AN) and bulimia nervosa (BN) continue to demand significant attention from health care professionals, both due to their high prevalence, mortality, and severe morbidity. Despite nearly 3 decades of investigation, much still remains to be learned about the etiology of the conditions, and there is only a moderate consensus about appropriate treatments. This review article reviews generally accepted models of etiology, modes of assessment, and treatment options for AN and BN, commenting on the empirical basis for the various treatments reviewed The role of social work in these illnesses is reviewed, and some directions for the future are considered.

Includes bibliographical references (leaves [287]-309). Concerned with a group of people's everyday experiences of anorexia. The fieldwork on which the thesis is based was conducted in multiple sites (Vancouver, Edinburgh, and Adelaide) over 15 months (August 1998-October 1999) and deals with 44 women and 3 men ranging in ages from 14-55. Primarily concerned with the processes that propelled them towards and away from this phenomenon: the desires, connections, disconnections, practice, contested performances and struggles of becoming and unbecoming 'anorexic'.

Chow Yuet-ming.<br>Thesis (M.Phil.)--Chinese University of Hong Kong, 2000.<br>Includes bibliographical references (leaves 254-262).<br>Abstracts in English and Chinese, appendix in Chinese.<br>Abstract --- p.i<br>Acknowledgement --- p.iv<br>Chapter Chapter 1: --- Introduction --- p.1<br>Chapter 1.1 --- Rationale for Selecting this Research Topic --- p.1<br>Chapter 1.2 --- Research Objectives --- p.4<br>Chapter 1.3 --- Research Questions --- p.5<br>Chapter 1.4 --- Overview of the Present Thesis --- p.5<br>Chapter Chapter 2: --- Literature review --- p.7<br>Chapter 2.1 --- Anorexia Nervosa in Western Countries --- p.7<br>Chapter 2.1.1 --- Historical Perspective --- p.8<br>Chapter 2.1.2 --- Biomedical Perspective --- p.10<br>Chapter 2.1.2.1 --- Physiological manifestation of anorexia nervosa patients --- p.10<br>Chapter 2.1.2.2 --- Behavioral manifestation of anorexia nervosa patients --- p.12<br>Chapter 2.1.3 --- Psychological Models --- p.14<br>Chapter 2.1.3.1 --- Bruch ´ةs view --- p.14<br>Chapter 2.1.3.2 --- Minuchin´ةs view --- p.16<br>Chapter 2.1.3.3 --- Palazzoli 's view --- p.17<br>Chapter 2.1.4 --- Sociological Perspective --- p.24<br>Chapter 2.1.5 --- Summary of Part I (2.1) --- p.30<br>Chapter 2.2 --- Psychology of Self-development --- p.33<br>Chapter 2.2.1 --- "Erikson ,s identity formation" --- p.33<br>Chapter 2.2.2 --- Women self-development --- p.38<br>Chapter 2.2.3 --- Bowen's differentiation of self --- p.42<br>Chapter 2.2.4 --- Summary of Part II (2.2) --- p.46<br>Chapter 2.3 --- Anorexia Nervosa in Hong Kong Context --- p.48<br>Chapter 2.3.1 --- The notion of self in traditional Chinese family --- p.49<br>Chapter 2.3.2 --- Women position in Hong Kong --- p.55<br>Chapter 2.3.3 --- Related research in Hong Kong --- p.62<br>Chapter 2.3.4 --- Summary of Part III (2.3) --- p.69<br>Chapter Chapter 3: --- Theoretical framework --- p.71<br>Chapter 3.1 --- Theoretical Framework as Summarized from the Literature Review --- p.71<br>Chapter 3.2 --- Definition of Terms --- p.77<br>Chapter 3.2.1 --- Anorexia nervosa --- p.77<br>Chapter 3.2.2 --- Family --- p.78<br>Chapter 3.2.3 --- Family interaction --- p.79<br>Chapter 3.2.4 --- Family rule --- p.79<br>Chapter 3.2.5 --- Family myths --- p.80<br>Chapter 3.2.6 --- Family myths as quest for meaning --- p.80<br>Chapter 3.2.7 --- Meaning --- p.80<br>Chapter 3.2.8 --- Power --- p.81<br>Chapter 3.2.9 --- Power struggle --- p.81<br>Chapter 3.2.10 --- Differentiation of self --- p.81<br>Chapter Chapter 4: --- Research Methodology --- p.83<br>Chapter 4.1 --- General Overview --- p.83<br>Chapter 4.2 --- Research Methodology of this Study --- p.88<br>Chapter 4.2.1 --- Rationale in Selecting Qualitative Method --- p.88<br>Chapter 4.2.2 --- Research Design --- p.89<br>Chapter 4.2.3 --- Unit of Analysis --- p.90<br>Chapter 4.2.4 --- Sampling --- p.90<br>Chapter 4.2.5 --- Methods of Data Collection --- p.92<br>Chapter 4.2.5.1 --- Direct Observation of the Family Interviews of AN families --- p.92<br>Chapter 4.2.5.2 --- Participant Observation in an AN Mutual Support Group --- p.94<br>Chapter 4.2.5.3 --- Summary of the Case Study Protocol of this Study --- p.96<br>Chapter 4.2.6 --- Time Frame for Data Collection --- p.96<br>Chapter 4.2.7 --- Method of Analysis --- p.97<br>Chapter 4.2.8 --- Validity and Reliability of this Study --- p.97<br>Chapter 4.2.9 --- Summary of Chapter --- p.98<br>Chapter Chapter 5: --- Results of the Study :Data Gathered from Family Interview Sessions --- p.100<br>Chapter 5.1 --- Case History --- p.100<br>Chapter 5.2 --- Results Gathered from Family Interview Sessions --- p.104<br>Chapter 5.2.1 --- Having difficulties in differentiating from the family and self- starvation as a means of asserting the personal boundariesin the families --- p.104<br>Chapter 5.2.2 --- Being triangulated in the parents' marital discords and self- starvation as a means of diluting their conflicts --- p.122<br>Chapter 5.2.3 --- Self-sacrificing for the family interest --- p.131<br>Chapter 5.2.4 --- "Being helpless and powerless in the families, self-starvation as a means of empowering the mothers in the families " --- p.134<br>Chapter Chapter 6: --- Results of the Study:Data Gathered from Mutual Support Group Sessions --- p.138<br>Chapter 6.1 --- Case History --- p.138<br>Chapter 6.2 --- Results Gathered from Mutual Support Group sessions --- p.140<br>Chapter 6.2.1 --- Having difficulties in handling peer relationship --- p.140<br>Chapter 6.2.2 --- Having difficulties in resisting their mothers intrusiveness to their personal boundaries and self-starvation as a means of exerting their personal boundaries --- p.143<br>Chapter 6.2.3 --- Being triangulated in their parents marital discords and self- starvation as a means of diluting the marital conflicts --- p.149<br>Chapter 6.2.4 --- Acting for their mothers in the families --- p.149<br>Chapter 6.3 --- Cross-checking of findings with group members and worker --- p.161<br>Chapter Chapter 7: --- Discussions and Conclusion --- p.163<br>Chapter 7.1 --- Research Findings of this Study --- p.163<br>Chapter 7.2 --- Contributions of this Study --- p.173<br>Chapter 7.3 --- Limitations of this Study --- p.174<br>Chapter 7.4 --- Recommendation --- p.175<br>Chapter 7.4.1 --- Future Research --- p.175<br>Chapter 7.4.1.1 --- Proposed Theoretical Framework for Future Study --- p.175<br>Chapter 7.4.1.2 --- Proposed Methodology --- p.179<br>Chapter 7.4.2 --- Management of AN patients --- p.179<br>Chapter 7.4.3 --- Prevention of AN --- p.181<br>Appendix I: The Chinese verbatim of family interview sessions --- p.183<br>Appendix II: The Chinese verbatim of mutual support group sessions --- p.234<br>List of Figures:<br>Figure 1: Summary of the framework from western literature --- p.75<br>"Figure 2: Interplay among individual, family and society " --- p.76<br>Figure 3: Socio-demographic characteristics of the AN patients and their families of the family interview sessions --- p.91<br>Figure 4: Socio-demographic characteristics of the AN patients and their families of the mutual support group --- p.92<br>Figure 5: Summary of the proposed theoretical framework of Understanding self-starvation in Hong Kong --- p.178<br>Bibliography --- p.254

Includes bibliographical references (leaves [287]-309).<br>vii, 309 leaves : col. ill. ; 30 cm.<br>Title page, contents and abstract only. The complete thesis in print form is available from the University Library.<br>Concerned with a group of people's everyday experiences of anorexia. The fieldwork on which the thesis is based was conducted in multiple sites (Vancouver, Edinburgh, and Adelaide) over 15 months (August 1998-October 1999) and deals with 44 women and 3 men ranging in ages from 14-55. Primarily concerned with the processes that propelled them towards and away from this phenomenon: the desires, connections, disconnections, practice, contested performances and struggles of becoming and unbecoming 'anorexic'.<br>Thesis (Ph.D.)--University of Adelaide, Dept. of Anthropology and Social Inquiry, 2002