Adolescence:
Change and ContinuityAdolescence:
Change and Continuity
Definition of psychosocial problems:
Referring to development, it is the way an individual goes through various stages of development that are both psychological and social in nature, where conflict structures each stage (Steinberg, 1993).
What are some specific psychosocial problems?
Definition of Stress
Stress is your physical, emotional, and mental response to change, whether or not the change is positive or negative. It also has been defined as the extreme physiological and emotional arousal a person experiences when confronted with threatening situations--the body's reaction to a noxious stimulus (Vecchio 1991).
Signs of Stress*
Some short-term ways to handle stress include: relaxing where you are, taking a break, asking yourself whether it's worth being upset over the situation, and listing all the things you think you need to do right away.
Here's a list of long-term ways to handle stress:
For additional information on stress
contact Health Works at the Pennsylvania State University at (814)863-5200, or check out these additional sites:
Adolescents share the adult concept of death as a universal, inevitable
process by life as we know it terminates (Morin&Welsh,1996). Losing
a loved one, is by far, one of the most horrific tragedies that a young
adult has to face. According to a recent survey of thirty-two adolescents,
70.6% first encountered death when an older relative passed away, 25% when
a parent died and 8.3% first encountered death through violence (Morin&Welsh,1996).
Every adolescent has a different perception of death which may influence
their reactions. Whatever the circumstance may be, adolescents have individual
ways of coping with loss by expressing a variety of emotions and reactions.
Teenagers need to realize that these reactions are normal and need to be
expressed.
Common reactions to losing a loved one:
| Emotional | Physical | Behavioral |
| depression | crying | lack of concentration |
| withdrawal from society | insomnia | confronting one's own death |
| loneliness | exhaustion | |
| denial | chills | |
| hatred | numbness |
In order to deal with death effectively, adolescents utilize many coping techniques to help them eliminate their pain. These techniques are often used in combination. Some of the most common ones used are talking about the loss, keeping busy, developing new interest, time itself and most of all through social support systems such as family, friends and counselors ( LaGrand, 1988). Coping with the loss of a loved one can strengthen an individual and enhance one's knowledge about death. Adolescents who experience such a loss can offer support to those who are going through a similar situation.
Understanding grief
Grief is the process by which one "works through" or experiences emotion after a significant loss has taken place (LaGrand,1988). It is typically associated with all of the individual responses that are experienced in coping with massive change. Adolescents should express their grief immediately so they can adapt to death and accept it as a part of life. Grief can be a short or long process depending on the individual and the type of loss that occurred.
Helping others deal with death
Helping someone deal with death can be extremely difficult, especially when an adolescent thinks noone knows how they feel. If you know someone who recently lost a loved one, the best advice is to let them express what they feel. If they need someone to talk to, let them know that you will always be there for them. Some adolescents do not feel comfortable expressing their emotions and would rather be alone. Seeking professional help can be an alternative if the person is experiencing additional problems or if they are in any type of danger. Professional help could include a school counselor, a mental health center, clergy, teachers and doctors.
References:
What is depression?
Depression is a psychological disturbance characterized by low self-esteem, decreased motivation, sadness, and difficulty finding pleasure in formerly enjoyable activities(Steinberg,1996).
Causes of depression
There are internal causes of depression. These are causes that are psychologically oriented. They tend to be feelings, emotions and/or self interpretations. Here are some possible internal causes of depression:
The effects of depression often appear physically as well as emotionally. Here are some effects that may be apparent in a depressed individual:
Unfortunately, severe symptoms of depression have a risk in resulting in either direct suicide or the attempt of suicide. 1of 3 adolescents has contemplated suicide, and 1 in 6 has attempted suicide(Steinberg 1996). Here are some warning signs that you could look for in identifying the risk of suicide in an individual:
Warning signs of suicide
(Chart: This chart appeared in Steinberg, 1990 and was cited by National Adolescent Student Health Survey, U.S. Department of Health and Human Service, cited in Gans, 1990)
Related Links . . .
What is Addiction?
Addiction, or dependence, is defined as "a cluster of three of more symptoms listed below occurring at any time in the same 12-month period" (American Psychiatric Association (APA), 1994, p. 176). Those symptoms are (1) tolerance, or needing more and more of a substance to achieve the same effect; (2) withdrawal, which involves unpleasant symptoms when the body is deprived of the substance, resulting in more frequent use to alleviate the negative symptoms; (3) taking the substance for a longer period of time or in larger amounts than originally intended; (4) unsuccessful desire to minimize use of the substance; (5) much time spent to obtain, use, or recover from the effects of the substance; (6) social, occupational, or recreational activities are missed because of substance abuse; and (7) substance use is continued despite knowledge of causing a problem. If neither tolerance nor withdrawal are present, then at least three of the remaining symptoms must be present (APA).
Did You Know?
There is no singular cause of adolescent alcohol and drug addiction. Research certainly shows that there can be a genetic predisposition to alcoholism; that is, the tendency to become alcoholic can be inherited (Weber & McCormick, 1992). However, most researchers seem to be in agreement that environment has the largest effect on whether or not a teenager will become addicted. The biggest indicator that a child will become addicted is whether or not they live in an "addicted family" (Weber & McCormick). This means that the child grows up in a family where at least one person, usually a parent, is either an alcoholic or addicted to some other substance (Merikangas, Rounsaville, & Prusoff, 1992). Other contributing factors are lack of effective parenting, whether or not their friends use drugs, whether they smoke or already use other substances in moderation, and if they have other psychosocial problems (Weber & McCormick; Hundleby & Mercer, 1987).
Can addiction be treated?
There are several successful treatments for addiction. It goes without saying that the earlier the addiction is treated, the easier it will be to control. Some of the most effective treatments for addiction are 12-step programs, such as Alcoholics Anonymous and Narcotics Anonymous (Weber & McCormick, 1992). Other treatments include individual and family therapy, group therapy, educational programs, and self-esteem building and anger management workshops (Emener, 1993).
Can addiction be prevented?
When Weber & McCormick (1992) asked adolescents who particiapted in Alateen (a program for teens whose lives have been affected by someone else's addiction), as well as some adolescents who did not participate in the program, what they would like to see in educational and prevention programs, they responded that they would like to see programs offer a message of successful treatment and hope for alcoholics, as well as an understanding of the effects of addiction and how to recognize early warning signs. Most of all, they stressed that there are more effective coping skills than turning to addiction, and that increased knowledge of coping strategies may prevent addiction from beginning.
Where to look for more information:
What is codependency?
Operationally defined, it is "a pattern of relating to others characterized by an extreme focus outside the self, lack of open expression of feelings, and attempts to derive a sense of purpose through relationships" (Spann & Fischer, 1990, p. 27). But it is the adolescent who displays a high level and consistent pattern of these traits that results in their not being able to function in life that makes it a problem (Cermak, 1986a).
What are the traits of codependency? (Greenberg, 1994; Cermak, 1986b)
Studies have shown that family experiences and parenting styles that have great strain and stress play an important role in the development of codependency in adolescents (Crothers & Warren,1996; Fischer & Crawford, 1992; Prest & Protinsky, 1993). Adolescents growing up in a family under great emotional strain have learned to become codependent as a means of survival. Because the adolescent has lived with and only seen this type of relationship, they see it as being normal (Cermak, 1986b).
These patterns are then passed on during adolescence when they begin forming intimate relationships with others. The adolescent uses the codependent style to relate and form relationships with others (Fischer & Crawford, 1992).
What might indicate that an adolescent is codependent? (Collins & Benjamin, 1993)
Co-Dependents Anonymous, PO Box 33577, Phoenix, AZ 85067-3577, 1-602-944-0141
Beattie, M. (1989). Beyond Codependency, and getting better all the time. New York, NY: Harper & Row.
Subby, R. (1990). Healing the Family Within. Deerfield Beach, FL: Health Communications Inc.
Yoder, B. (1990). The Recovery Resource Book. New York, NY: Simon & Schuster Inc.
What is schizophrenia?
The word schizophrenia means "split mind". This split is between perception and reality. The schizophrenic's view of reality is often distorted. The popular idea that schizophrenia refers to multiple personality disorder is incorrect. Multiple personality disorder is very rare, while schizophrenia is a far more common disorder (Tsuang, 1982).
Schizophrenia affects one in every one hundred persons (or 1% of the population) worldwide. Although cases have been reported in children as young as age 5, schizophrenia is a disease that often begins in adolescence. Onset of the disease commonly occurs between the ages of 16 and 30. Because the disease may exhibit varying sets of symptoms in different individuals, schizophrenia is often called a "group of diseases". Diagnosis is performed by identifying basic groups of symptoms and planning treatment accordingly (Tsuang, 1982).
How can the onset of schizophrenia be recognized?
Symptoms of schizophrenia commonly begin with the observation of personality and behavior changes by the patient and those closest to them. Often, symptoms are at first considered to be related to adolescent growth and change and do not seem remarkable to the patient or family. The patient may withdraw from contact with friends and family and refuse to participate in formerly favorite activities at home and at school. Parents, siblings, and friends often notice differences in the patient's ability to cope and interact. Teachers may notice that the child has developed an inability to concentrate on schoolwork. As the disease progresses, personality change and unusual behavior increase. Symptoms are usually most severe during times of stress (Wasow, 1982).
What are some of the symptoms of schizophrenia?
Because the exact causes of schizophrenia remain obscure, research has not yet yielded a cure for the disease. Effective treatment results have been noted with various drug therapies combined with individual and family counseling (Wenar, 1982; Robbins, 1993). A new Clozapine drug therapy has proven effective with adolescents (Burke, Josephson, Sebastian, & Schulman, 1995).
What can I do to help someone who has schizophrenia?
Educate yourself about the disease and encourage the patient and family to be earnest in seeking treatment which fits their special situation. Many patients are very concerned about losing their closest relationships. Be warm and supportive and encourage the patient to maintain contact with others. Most importantly, do not be critical or rejecting. Help the patient to participate in activities that reduce stress and promote accomplishment (Wenar, 1982; Wasow, 1982; Seeman, Littman, Plummer, Thornton, & Jeffries, 1982).
For additional information:
What is it?
Obsessive-compulsive disorder is the recurrence of obsessions, compulsions, or both that are distressful or interfere in one's life (American Psychiatric Association (APA), 1994). There are several forms of OCD. Typically, a patient exhibits one or two behavior patterns at a given time (De Silva &Rachman 1992). Behavior patterns include washing, checking, cleaning, hoarding, repeating, ordering and pure obsessing.
Obsessions
Obsessions are intrusive, persistent thoughts or images that produce anxiety. The most common obsessions of adolescents involve dirt, germs, disease, death, or danger to self or loved ones. A young woman, for example, had a recurrent intrusive thought that she would be contaminated with germs. Such obsessions can create great distress for the adolescent and interfere with academic and social activities. Adolescents may become withdrawn and may feel as though they are going crazy. Adolescents often realize that their thoughts are irrational, however, they cannot prevent the thoughts from occurring.
Compulsions
Compulsions are repetitive, ritualistic behaviors which the person feels compelled to perform. Some common compulsions include excessive or ritualized washing, repeating rituals such as going in and out of doors, or checking behaviors. A good illustration of ritualistic washing involved a young woman who repeatedly and extensively washed her hands to get rid of germs. The washing was done in an elaborate ritual, six times without soap, six times with soap. If behaviors are not performed in a certain manner or a specific number of times, the individual will become overwhelmed with anxiety. The compulsive behaviors seem to have magical qualities, as if their correct performance wards off danger (Sue, Sue, Sue, 1997). The behaviors, therefore, serve to alleviate anxious discomfort or to prevent a dreadful event.
Who does it effect?
OCD is far more common than once thought. About one in every 200 teenagers is affected by OCD (Flament, M., Whitaker, A., Rapoport, J., Davies, M., Berg, C., Kalikow, K., Sceery, W., & Shaffer, D. 1988). The majority of OCD patients are relatively normal people. The disorder has been found to be equally common in both men and women, however, it is more prevalent among the young. OCD usually appears in adolescence or early adulthood.
Treatment and Management
OCD is generally thought to be caused by a chemical imbalance. Drug and behavioral therapies, either alone, or in combination, are used to treat OCD. Because OCD has been linked to the neurotransmitter serotonin, a class of drugs called SSRI's (Selective Serotonin Reuptake Inhibitors) have been shown to be effective in the treatment of OCD. On average, 30-40% of symptoms can be reduced with drug therapy alone. When combined with behavioral therapy, up to 90% of patients improve (Jenike 1991). Medication decreases both obsessions and compulsions. Behavioral therapy, on the other hand, is used in combination to provide long term treatment.
Conclusion
It is common for people to have minor obsessions and/or rituals. The behaviors of an adolescent suffering from OCD, however, become exaggerated and counterproductive. The point at which the thoughts and behaviors are serious enough to require help, therefore, is not always clear-cut. In general, if you suspect that the behaviors of you or someone you know are interfering with daily functioning, seek the help of a mental health professional. OCD can be a very debilitating disorder for adolescents as well as their families. Finally, because behaviors may be embarrassing, it is important to be supportive and caring toward the adolescent.
For additional information . . .
Many adolescents today are concerned about their physical appearance.
Most girls want to have bodies like models- tall and thin. People have
to learn new eating habits to keep their weight down and their bodies trim.
If adolescents think they're the least bit fat, they may decrease their
food intake. If this doesn't work they could turn to starvation and/or
binging to keep the weight off. It is estimated that one third of teenage
girls go on diets in the U.S today. Unsuccessful dieting is often followed
by an eating disorder. An eating disorder is defined as chronic binging
or starvation of oneself and is usually the result of an altered body perception.
Eating disorders are not illnesses in themselves. They become illnesses
when they interfere with the person's physical or mental abilities; or
if they are likely to produce severe medical complications; or so distort
her or his life that close relatives are also disturbed and help is sought
(Abraham, pg.9 1989). The two most common eating disorders are Anorexia
Nervosa and Bulimia.
Anorexia Nervosa
Anorexia Nervosa is a serious eating disorder that is characterized by purposeful malnutrition or starving oneself. It affects females fifteen times more than it affects males. It usually begins during adolescence or in early adulthood, but hardly ever occurs in women past the age of twenty-five. The disorder affects one teenager in every two hundred among adolescents aged between sixteen and eighteen. " The criteria for anorexia nervosa given by the most recent diagnostic system includes: intense fear of becoming obese, which does not diminish with the progression of weight loss; disturbance of body image, feeling "fat" even when emanciated; refusal to maintain body weight over a minimal weight for age and height; weight loss of 25 percent of original body weight or 25 percent below the expected weight based on standard growth charts; and no known physical illness that would account for the weight loss"( Field and Domangue, p.31 1987).
Bulimia
Bulimia can be associated with Anorexia Nervosa. In the past it was actually considered to be a part of the disorder. Most anorexics develop bulimia in the course of their illness. Unlike anorexia, bulimia affects three to seven percent of women aged between fifteen and thirty-five. Bulimia is defined as a syndrome in which gorging on food alternates with purging by forced vomiting, fasting, or laxatives (Field and Domangue p.32 1987). The effects on people who suffer from doing this include guilt, depression and disgust with oneself. Bulimics know that their eating habits are unhealthy but fear not being able to stop eating voluntarily.
Both Anorexia Nervosa and Bulimia are very serious disorders that can have severe consequences for those affected by them. It is important that people realize these disorders exist and what the signs are. People with these disorders can be helped, but it is important to recognize that a person is affected by the disorders. People afflicted by Anorexia or Bulimia often have a hard time helping themselves defeat their problem. But, with help from friends and relatives, people affected by these disorders can overcome them.
References:
What is bulimia and anorexia?
Bulimia is a Greek word meaning "ox" and "hunger" because the sufferer eats like a hungry ox. A bulimic eats in unrestrained eating sprees. One major characteristic of bulimia is binge eating, in which he/she can consume between 10,000 to 20,000 calories. These binge eating episodes are usually followed by episodes of purging, This purging is accomplished by the either of the following methods: vomiting, laxatives, diuretics, enemas, compulsive exercising, weight-reducing drugs, and intermittent periods of strict dieting.
Anorexia is an eating disorder that involves the relentless pursuit of thinness through starvation. The anorexic usually appears gaunt and emaciated, and he/she may lose up to 35% of their premorbid weight. The anorexic usually avoids eating and participates in compulsive exercise to lose weight, and he/she is very consumed with calorie counting and fat content in foods.
What are the similarities between bulimia and anorexia?
Although anorexia and bulimia are two different eating disorders, they do share some similarities. Both disorders carry an obsession with weight and body image, and both are usually found in white, middle-upper class females. These females usually have the characteristics of being perfectionists, high achievers, often academically or vocationally successful, and have a great need to please others.
In treating these eating disorders, all of the following are recommended for both anorexia and bulimia: hospitalization, focusing on nutritional rehabilitation; individual, group, and family therapy; behavior therapy; and drug therapy, usually through anti-depressants.
What are the differences between bulimia and anorexia?
In discussing the differences between anorexia and bulimia, these differences usually are of the methods used in achieving the goal of the anorexic or bulimic. For the anorexic, his/her goal is to lose weight by eating very few calories and eating foods low in calories. Anorexics try to gain control of their lives through controlling their food intake. The onset of anorexia is usually in early adolescence.
For the bulimic, his/her goal is to eat without gaining weight. However, the bulimic does not have the same control the anorexic does in eating. The bulimic eats in binges, consuming a lot of food at one time. The bulimic looks normal in appearance, often very attractive, however there are many physical abnormalities. The onset of bulimia is usually late in adolescence.
Which is more severe?
Simply stated, both are the same in severity, and both can cause death, this is probably their biggest similarity.
References:
It is important for people to understand that adolescents suffering
from eating disorders, both male and female, may not appear to be underweight
(Schlundt, 1990.) Weight is only a physical sign of an eating disorder,
when in fact the adolescent is likely suffering from a deeper emotional
conflict that needs to be resolved. Eating disorders are only addictions
to a behavior and the obsession with food is only a symptom of deeper problems
such as low self-esteem, depression, poor self-image, and self-hate. Hilde
Bruch, a preeminent psychiatrist, describes the relentless pursuit of thinness
as an effort to mask underlying problems (Czyzewski, 1988.) The following
are some of the mental characteristics of adolescent males and females
suffering from eating disorders.
Perfectionism: Many adolescents suffering from eating disorders are perfectionists and high achievers. It is often the brightest and the most popular girls who find themselves in a competition to be the thinnest (Pipher, 1994.) Their desire to be the thinnest leads to destructive habits and attitudes towards food. These perfectionistic habits are often reinforced when the adolescent receives compliments on her appearance or weight (Czyzewski, 1988.) They strive to reach perfection in every aspect of their lives. They are eager to please and in the process lose their true selves. When they feel they have failed to reach perfection they often unrealistically blame themselves for their failure and attempt to punish themselves. Punishment often occurs in the form of starvation for anorexics and purging for bulimics. These methods of punishment pose serious threats to the adolescent's physical health, including dehydration, hormonal imbalance, the depletion of important minerals in the body, damage to vital organs and sometimes even death (AACAP webpage.)
Low self-esteem: Feelings of inadequacy are common among teens suffering from eating disorders. They have a poor self-image and perception of themselves. They irrationally believe they are fat regardless of how thin they become (AACAP webpage.) They experience a sense of inner emptiness, uncertainty and helplessness, and a lack of self-confidence and self-trust (Bruch, 1988.) Often they are afraid of being judged by others or thought of as being stupid. They feel confident if they are losing weight but suffer from feelings of worthlessness and guilt if they are not (Pipher, 1994.) It is also common for them to believe they do not deserve good things or to be happy.
Depression: Mood swings, feelings of hopelessness, anxiety, isolation, and loneliness are feelings common to sufferers of eating disorders. Bulimics experience a loss of control that leads to depression, whereas anorexics experience depression as a result of gaining weight (Schlundt, 1990.) Often both anorexics and bulimics are irritable, withdrawn, and indifferent especially with family members (Pipher, 1994.) They often feel worthless, put themselves down, and complain of being "too fat" or "not good enough" (Duker, 1988.)
Obsession: These adolescents deal with an intense obsession and pre-occupation with food, calories, fat grams, and weight. Weight becomes their most important and self-defining attribute. Eating disorders are considered addictions in which starvation,
bingeing, and purging are the addictive behaviors and food is the narcotic (Pipher, 1994.)
Guilt: Adolescents with eating disorders often feel guilty because they do not think they have met the expectations of others. They are striving for the perfect body and for a sense of control but in this process they start to feel guilty about their habit (Pipher, 1994.) Lying becomes essential. Lying about their food consumption or lack of it becomes an every day occurrence, as does the use of laxatives, diuretics, purging, excessive exercise, and fasting to induce weight loss (Schlundt, 1990.)
On the surface, eating disorders may appear to be nothing but a dangerous obsession with food and weight, but in fact for teenagers they are often the result of serious emotional issues. These issues lead to a psychiatric illness that is often the most difficult to treat and has the highest fatality rate.
References:
Eating Disorders Awareness and Prevention Inc. webpage. 1996. http://members.aol.com/edapinc/home.html
What is Anorexia Nervosa?
Anorexia Nervosa, a Greek word meaning loss of appetite, is an eating disorder that inflicts self-starvation on millions of females each year(Wenar, 1994). Further, this disorder allows adolescents to gain control by limiting food intake. Anorexics often obsess about thinness, need attention, lack individuality, and deny sexuality(Brooks & Gunn, 1993).
What are the Signs and Symptoms of Anorexia Nervosa?
Anorexics may display the following qualities: perfectionist personality, depression, the need to control self and others, desire to read about and cook food, excessive exercise, loss of 15% normal body weight, loss of menstruation, mood swings, isolation, high anxiety, fatigue, ritualistic exercise habits, and cognitive food obsessions(Sigman & Flannery, 1992). Anorexic individuals consume below 1,200 calories per day(Wenar, 1994).
What are the Stages of Recovery?(Reiff&Reiff, 1992)
www.psych.med.umich.edu/web/psychref/disorder/eating.htm
What is anorexia nervosia?
Anorexia affects 1-3% of American girls today (Carlson, 1996). It is a disease in which the person literally starves themselves to try and lose extra imaginary weight that they see as real.
The disease itself can have many different symptoms, but a few of the most reported are
Often times the patient enters treatment against their will if it is caught in time. If not caught in time, death may result due to the abuse the body is put through during starvation processes.
Treatment usually entails
We know that our society feeds many adolescents beliefs that thin is powerful and beautiful. Many magazine and television ads try to sell the concept that to be everything beautiful, you must be thin whatever the cost. On top of that there are products and gimics on the market that can be bought to reach this irrational and usually unattainable weight if only we are willing to give up our money and our time.
We need to put more of an emphasis on educating our children to accept who we are and how our bodies develop. We need to start teaching our kids that trying just about anything to look "perfect" is an irrational and unacceptable behavior. Unfortunately, the thinness and high activity levels of most people suffering from early stages of anorexia are very desirable qualities in our society. Because of this, we usually do not realize the severity of the disease until too late.
What we need is
What is bulimia? Is your adolescent suffering from it?
Bulimia is an eating disorder characterized by a pattern of episodic binge-eating. Patients with this disorder are aware that their eating pattern is abnormal , but they feel unable to stop eating voluntarily. Their binge eating is a solitary behavior frequently followed by depression and remorse. (Mitchell, 1985)
What are the behaviors and symptoms associated with bulimia?
Besides over-eating and vomiting, the following are a few of the behaviors/symptoms displayed by those suffering from bulimia.
Adolescence Directory On Line. http://education.indiana.edu/cas/adol.html
Mitchell, James E., a. (1985). Anorexia Nervosa and Bulimia: Diagnosis and
Treatment.
What is bulimia?
Bulimia is one of the most well known eating disorders that occur among teenage adolescents. It is characterized by repetitive periods of excessive eating, often with self-induced vomiting to prevent weight gain. Self-induced vomiting usually occur after the excessive eating behavior has become established. Individuals usually recall the delight at discovering induce vomiting because they believed they would then be able to eat as much as they liked without gaining weight. Bulimia is a psychological disorder and it has bad effects on our adolescents such as physical and mental problems, and it is caused by childhood experiences, family influences, and social pressures.
What are the physical effects of bulimia?
Excessive eating and self-induced vomiting have strong physical effects on the body. The effects include abdominal pain, swollen hands and feet, fatigue, nausea and headaches. Salivary glands may be swollen. Teeth require extensive dental treatment as a result of persistent self-induced vomiting. Menstrual irregularities are common and individuals often report episodes of amenorrhea. Epileptic seizures, renal complications, acute dialation of the stomach, symptoms of dehydration and chronic hoarseness of the voice also noted. Individuals who induce vomiting and/or abuse purgatives may have very low levels of serum potassium. All of these physical effects/complications result from the behaviors involved in this syndrome.
What are the psychological effects of bulimia?
It's hard to tell what the cause and effect of bulimia is. For example, it could be caused by a chemical imbalance in the brain from excessive eating and self-induced vomiting or just from the constant self-induced vomiting. Many bulimic adolescents have a higher reported incidence rate of other impulsive behaviors such as alcohol and drug abuse, sexual promiscuity, and kleptomania which could all be caused by the chemical imbalance in the brain.
This disorder also affects the person's personality and mood disturbances are relatively common. Some common mood disturbances include anxiety and tension, feeling of helplessness and failure and self-deprecatory thoughts. Bulimics are initially very secretive about their episodes of bulimia. They hide their eating patterns from their family and friends. Bulimic patients experience difficulty in coping with stressful situations and resort to binge eating at these times. Suicidal ruminations and attempts are often present following an episode of binge eating.
Conclusion:
I hope that the clearer understanding we've gained of the effects of bulimia will change the way that we look upon victims of this eating disorder. The lessons that we need to learn are that no one can be the perfect size or weight, and that unconditional love can vanquish the negative mind-set that tortures victims of bulimia.
References:
What is bulimia?
Bulimia is an eating disorder, most commonly known as and linked to binge eating and purging. Binge eating is when a person eats a lot of Abad@ (fattening) foods at one sitting. Purging is a method of getting the food out of the body, so as not to gain weight, and the most common type is self-induced vomiting. There are a few types of treatment I have found in my research, and they include: cognitive-behavioral therapy and transpersonal psychology, which consists of several techniques. Cognitive-behavioral therapy seems to be to the most common type of therapy used to treat bulimia.
Cognitive-behavioral therapy
Cognitive-behavioral therapy in some form or another is the most widely used treatment in one way or another. This type of treatment involves having the patients address his/her beliefs, thoughts, and fears that contribute to his/her disorder and to change them (Brown, p.53). In this therapy, bulimic patients are taught to cognitively change the ways in which they view food, to not see it as frightening or forbidden. Behaviorally, the patients are taught to change the ways they eat, where they eat, and how they control themselves after they eat. Most bulimic people know before s/he begins his/her treatment that their behavior is abnormal (Peters, et al., p.187)
One example of this therapy is a study that was conducted by Leitenberg et al., (1988). His study used an exposure plus response prevention treatment. The exposure was allowing the patients to eat the foods they saw as frightening, in the presence of the therapist. The presence of the therapist was to prevent the patient from vomiting, the response prevention (p.535). Seventy-one percent of the subjects in his study showed to have an overall decrease of vomiting and increase in better eating habits. The other most common approaches of cognitive-behavioral therapy include: supportive therapeutic relationships, self-monitoring, nutritional counseling, self-control techniques, and educational programs (Brown, p.53).
Transpersonal psychology
This type of treatment examines the practice of meditation, yoga, psychic phenomena, etc. and attempts to distill an understanding of methods that have a positive effect on the human psyche (Brown, p.54). These techniques vary and are used for clients to overcome their resistance to change (Brown, p.55). The techniques included: deep relaxation, imaginal desensitization, and hypnosis.
Relaxation techniques are used to help begin change. It helps in getting the bulimic to unidentify him/herself from his/her dysfunctional patterns and behavior to more to more functional ones (Brown, p.55).
Imaginal Desensitization begins with a client describing some simulated scenes when s/he would carry out his/her bulimic behavior. The descriptions are then used to define feelings and reactions causing the need to binge. Clients are trained some relaxation techniques, and after s/he is relaxed, they must imagine his/her first simulated scene. This must be done for all the scenes, and has shown great improvement for many patients (Brown, p.56). This remembering of scenes while relaxed will teach the patient that s/he can be in a situation where they want to binge and/or purge but realize they do not have to B it desensitizes them to wanting to binge and purge.
During hypnosis, which is like relaxation, bulimics can be given suggestions to help them develop better eating habits and a more realistic body image. Hypnosis is a technique that the patient cam control and that help him/her be able to better control his/her own life. This leads to more patients learning self-hypnosis techniques (Brown, p.57)
Conclusion
These therapies have been shown to help bulimic patients, but one must remember that all people are different. This means that the cause and onset of the disorder varies for everyone who has it, and so is the outcome of treatments that are tried. As a result, a treatment that is right for one bulimic patient may not be right for all other bulimic people, so treatment possibilities must be carefully considered for a specific patient before being used.
References:
I am a concerned mother whose thirteen year old daughter has been
thinking about taking up gymnastics, but I have heard that a good percentage
of female gymnasts suffer from eating disorders. Why do eating disorders
strike so many gymnasts and how prevalent are they?
Reasons why eating disorders strike female gymnasts
One of the major reasons eating disorders are so prevalent among gymnasts is because of the pressure placed upon them by their coaches and the competitive environment itself to maintain a certain appearance and body weight. This appearance is a small boned, thin female, which helps her perform better because of speed and flexibility. It's ironic that female gymnasts fall into one of the highest risk groups for eating disorders because they generally tend to have slimmer figures and a lower percentage of body fat. While women in general are constantly exposed to society's values concerning beauty and attractiveness, gymnasts may experience unique, sport related pressures to achieve a certain ideal body size and shape. For example, according to Rosen and Hough (1995), two-thirds of female gymnasts have been told to lose weight by their coaches sometime in their careers, seventy-five percent of these gymnasts resorted to pathogenic weight control behaviors to accomplish weight loss. These behaviors that I am speaking of are anorexia nervosa and bulimia nervosa. Anorexia is the starvation of the body and bulimia is bingeing and purging through vomiting or laxatives. Both of these disorders may appear in gymnasts.
Prevalence of eating disorders among gymnasts
In two studies done on eating habits of female gymnasts the results were overwhelming. In a study done at the University of North Texas, 215 female gymnasts representing 21 national Collegiate Athletic Association Division 1 Universities from across the U.S. participated in the study.
The most important thing is that professionals who work with female gymnasts should be aware that serious eating disturbances exists even in the absence of diagnosable eating disorders, to conduct eating disorder screenings in a manner that allows identification of dangerous behavior and develop interventions that focus on early identification and treatment. Gymnastics is a wonderful sport, but there are precautions that need to be taken when participating in a sport that places such a strong emphasis on appearance and weight. To learn more about eating disorders please read other articles on this web page.
References
Author: Donald Franklin
This website contains information about childhood disorders. It discusses ADHD/ADD,
separation anxiety disorder, conduct disorder and oppositional defiant disorder.
The website also provides icons so that the reader can find additional information
concerning psychology information. This is related psychosocial problems in
adolescents because the website offers the reader many different types of disorders
that may arise during adolescents.
Journal of Abnormal Psychology.
This journal article is written about the conformity of conduct and depressive
problems of sixth graders. This site gives the reader insight about problems
that arise during adolescence and how the adolescent can deal with the problem.
A study was done to find the relationship between problems and conduct between
adolescence. Many references were provided to the reader and the site came from
a prestigious journal. The article corresponds to psychological problems in
adolescents by offering the reader direct information relevant to the topic.
Teenage Mental Health Problems: What are the Warning Signs
AUTHOR: The Center for Mental Health Services
This website contains information that provides the reader with information about the warning signs of a mental health problem teenagers might face. The website provides key traits that parents are caregivers should look out for if they suspect a psychological problem in their teen. Having a site that explains warning signs allows a parent to stop a problem before it really unhealthy. At the bottom of the site, the reader is given additional information such as contact numbers and references to help with any additional problems.
AUTHOR: The National Alliance for the Mentally Ill
This website contains information pertaining to teenage suicide. Basic facts, suicide statistics, and information about how to help with suicide and all topics listed in the site. Symptoms that pertain to teen suicide are also provided for the browser. The reader is also given information about support groups and organizations. The site is very educational because it provides the reader with reliable information.
Eating Disorders during Adolescence: Nutritional Problems and Interventions.
Author: Jane Mitchell Rees
This site describes how different types of eating disorders can affect the
adolescents. It explains the psychosocial effects that these disorders have
in the adolescents. It is divided into chapters that explain the causes for
anorexia and bulimia and how these disorders affect adolescents physically and
mentally. The site also explains how to treat these disorders.
The Relationship
of Self Esteem and Depression in Adolescence
Author: Dr. Kathie F. Nunley
This article gives a good background of how depression develops in adolescence and what its symptoms, causes and correlations are. It explains how depression affects self-esteem and how this could become a major problem. It also gives recommendations and explains for how to deal with depression. Rating: 5
Preventing
Antisocial Behavior in Disabled and At-Risk Students
Author: Appalachia Educational Laboratory
This site presents the general risk factors for antisocial behavior, including
individual, family, and school related factors. It also explains how to interfere
with this behavior and how to promote pro-social behavior and further explains
how to reduced the risks. And, It provides tables that analyze antisocial behavior.
Title: College
Students Suicide
Alan Lipschitz
This site explains the major causes of suicide in late adolescence. It discusses how college may change an individual’s health to the point that s/he could commit suicide. It explains how the suicide rate has increased. It also suggests some techniques that schools should adopt to lower these rates.
Suicide and the
School Recognition and intervention for suicidal students in the school setting
Author: Carol Watkins
Summary: This article explains the factors that lead to suicide, how to detect
them, and what to do when they are detected. It also provides ideas for what
should be done after the intervention. Teachers should read this article so
that they can have a better background of some situations they can confront
them in the classroom.
This site was produced by students taking HDFS 433: The Transition to Adulthood and HDFS 239: Adolescent Development at the Pennsylvania State University. Feedback can be sent to the individual authors or to Nancy Darling (darling@bard.edu).
Last updated 5/07/02.