Abnormal Psychology

Eating Disorders 437

and food, and their thoughts and beliefs about these topics are usually illogical

or irrational, such as imagining that wearing a certain clothing size is “worse

than death.” Moreover, their feelings about themselves rise and fall with their

caloric intake, their weight, or how their clothes seem to fi t. If someone with

anorexia eats 50 more calories (for comparison, a single pat of butter provides

about 35 calories) than she had allotted for her daily intake, she may experi-

ence intense feelings of worthlessness. People who suffer from anorexia often

deny that they have a problem and do not see their low weight as a source of

concern.

3.Distortions of body image (the individual’s view of her body). People with

anorexia often feel that their bodies are bigger and “fatter” than they actually are

(see Figure 10.1).

Table 10.1 • DSM-IV-TR Diagnostic Criteria for Anorexia Nervosa

A. Refusal to maintain body weight at or above a minimally normal weight for age and height

(e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or failure

to make expected weight gain during period of growth, leading to body weight less than 85%

of that expected).

B. Intense fear of gaining weight or becoming fat, even though underweight.

C. Disturbance in the way in which one’s body weight or shape is experienced, undue infl uence

of body weight or shape on self-evaluation, or denial of the seriousness of the current low body

weight.

D. In postmenarcheal females [those who have already begun menstruating], amenorrhea,

i.e., the absence of at least three consecutive menstrual cycles. (A woman is considered to have

amenorrhea if her periods occur only following hormone, e.g., estrogen, administration.)

Source: Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Text Revision,

Fourth Edition, (Copyright 2000) American Psychiatric Association.

Amenorrhea

The suppression of menstruation;

this condition is diagnosed after three

consecutive missed menstrual cycles.

10.1 • Body Image Distortion With respect to body

image, women with anorexia may simply represent an extreme

end of “normal” distortions; many other women do not assess

their bodies accurately (Thompson, 1990). Here IDEAL is the

average fi gure that women rated as ideal. ATT MEN (“attractive

to men”) shows the average fi gure that women rated as most

attractive to men, whereas OTHER illustrates the average fi gure

that men selected as most attractive. THINK depicts the average

fi gure that women thought of as best matching their own, and FEEL

depicts the average fi gure that women felt best matches their own.

Source: Thompson, 1990.

Figure 10.1g

4.The suppression of menstruation, called amenorrhea, which is diagnosed after

three consecutive missed menstrual cycles in females who have already begun

menstruating. If a woman must take hormones to menstruate, she is consid-

ered to have amenorrhea. For children and adolescents who have not yet begun

menstruating, this criterion does not apply. Table 10.1 lists the DSM-IV-TR

diagnostic criteria for anorexia; additional facts about anorexia are provided in

Table 10.2, and Case 10.1 provides a glimpse of life with anorexia.