Advertisement

The Behavioral Treatment of Anorexia Nervosa

  • James Ferguson

Abstract

Anorexia Nervosa is one of the first physical disorders for which a psychological etiology was attributed. In his initial case report of Nervous Phthisis in 1684, Richard Morton described an 18-year-old patient who “fell into a total suppression of her monthly courses from a multitude of cares and passions of her mind.” Following this, “Her appetite began to abate, and her digestion to be bad; her flesh also began to be flaccid and loose, and her looks pale, with other symptoms usual in the universal consumption” (tuberculosis). By the time she applied to him for treatment, she was very thin. “I do not remember that I did ever in all my practice see one that was conversant with the living so much wasted with the greatest degree of consumption, (like a skeleton only clad with skin) yet there was no fever, but on the contrary a coldness of the whole body.” He describes her hyperactivity, vomiting, self-neglect, and the only temporary success of his prescriptions of various medications. Finally, “she beg’d that the whole affair might be committed again to nature, whereupon consuming every day more and more, she was after three months taken with a fainting fitt, and died” (39).

Keywords

Weight Gain Anorexia Nervosa Eating Disorder Behavioral Treatment Positive Reinforcement 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Agras, W. S., Barlow, G. H., Chapin, N. H., Abel, C. G., and Leitenberg, H. Behavior modification of anorexia nervosa. Arch. Gen. Psychiatry 30:279–286, 1974.PubMedCrossRefGoogle Scholar
  2. 2.
    Agras, S., and Werne, J. Behavior modification in anorexia nervosa, research foundation, in R. A. Vigersky (ed.), Anorexia Nervosa. New York: Raven Press, 1977, pp. 291–303.Google Scholar
  3. 3.
    American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, third ed. American Psychiatric Society, Washington, D.C., 1980.Google Scholar
  4. 4.
    Ayllon, T., Haughton, A., and Osmond, H. O. Chronic anorexia: A behavior problem. Can. Psychiat. Assoc. J. 9:147–154, 1964.Google Scholar
  5. 5.
    Bachrach, A. J., Erwin, W. J. and Mohr, J. T. The control of eating behavior in an anorexic by operant conditioning techniques, in L. P. Ullmann and L. Krasnor(eds.), Case Studies in Behavior Modification. New York: Holt, Rinehart and Winston, 1965.Google Scholar
  6. 6.
    Barchai, A. Lithium in adult anorexia nervosa: A pilot report on 2 patients. Acta Psychiat. Scandinavia 55:97–101, 1977.CrossRefGoogle Scholar
  7. 7.
    Bernstein, I. C. Anorexia nervosa treated successfully with electroshock therapy and subsequently followed by pregnancy. Am. J. Psychiatry 120:1023–1024, 1964.PubMedGoogle Scholar
  8. 8.
    Bhanji, S. Operant conditioning in anorexia nervosa. Curr. Psychiat. Ther. 15:59–64, 1975.PubMedGoogle Scholar
  9. 9.
    Bhanji, S., and Thompson, J. Operant conditioning in the treatment of anorexia nervosa: A review and restrospective study of 11 cases. Br. J. Psychiatry 124:166–172, 1974.PubMedCrossRefGoogle Scholar
  10. 10.
    Blinder, B. J., Freeman, D. M., and Stunkard, A. J. Behavior therapy of anorexia nervosa: Effectiveness of activity as a reinforcer of weight gain. Am. J. Psychiatry 126:1093–1098, 1970.PubMedGoogle Scholar
  11. 11.
    Bliss, S. L., and Branch, C. H. Anorexia Nervosa. Paul B. Hoever, New York: Medical Book Division, Harper & Row, 1960.Google Scholar
  12. 12.
    Browning, C. H., and Miller, S. F. Anorexia Nervosa: A study in progress and management. Am. J. Psychiatry 124:1128–1132, 1968.Google Scholar
  13. 13.
    Bruch, Hilde. The Treatment of Eating Disorders, Mayo Clinic Proceedings, vol. 51:266–272, 1976.PubMedGoogle Scholar
  14. 14.
    Bruch, Hilde. Perils of behavior modification in treatment of anorexia nervosa. JAMA 230:1419–1422, 1974.PubMedCrossRefGoogle Scholar
  15. 15.
    Bruch, Hilde. Eating Disorders. New York: Basic Books, 1973.Google Scholar
  16. 16.
    Caplan, H., Ginsberg, J., and Beaconsfield, T. Glycerol and treatment of anorexia. Lancet 1(7798):319, 1973.CrossRefGoogle Scholar
  17. 17.
    Crisp, A. H. Anorexia nervosa: Feeding disorder, nervous malnutrition, or weight phobia? World Review of Nutrition and Dietetics 12:452–504, 1970.PubMedGoogle Scholar
  18. 18.
    Crisp, A. H., and Kalucy, R. S. The effect of leucotomy in intractable adolescent weight phobia. Postgrad. Med. J. 49:883–893, 1973.PubMedCrossRefGoogle Scholar
  19. 19.
    Crisp, A. H., Plamer, R. L., and Kalucy, R. S. How common is anorexia nervosa? A prevalence study. Br. J. Psychiatry 128:549–554, 1976.PubMedCrossRefGoogle Scholar
  20. 20.
    Dally, P., and Sargent, W. Treatment and outcome of anorexia nervosa. Br. Med. J. 2:793–795, 1966.PubMedCrossRefGoogle Scholar
  21. 21.
    Duddel, May. An increase of anorexia nervosa in a university population. Br. J. Psychiatry 123:711–712, 1973.CrossRefGoogle Scholar
  22. 22.
    Elkin, T. E., et al. Modification of caloric intake in anorexia nervosa: An experimental analysis. Psychol. Rep. 32:75–78, 1973.PubMedCrossRefGoogle Scholar
  23. 23.
    Garfinkel, P. E., Moldofsky, H., and Garner, D. M. The outcome of anorexia nervosa: Significance of clinical features, body image, and behavior modification, in R. A. Vigersky (ed.), Anorexia Nervosa. New York: Raven Press, 1977, pp. 315–329.Google Scholar
  24. 24.
    Ghafour, Pik, et al. Treatment of anorexia nervosa with chlorpromazine and modified insulin therapy. J. Assoc. Physicians India 17:369–372, 1969.Google Scholar
  25. 25.
    Goldberg, S. C., Halmi, K. A., Casper, R., et al. Pretreatment predictors of weight change in anorexia nervosa, in R. A. Vigersky (ed.), Anorexia Nervosa. New York: Raven Press, 1977, pp. 31–54.Google Scholar
  26. 26.
    Groen, J. J., and Feldman-Toledano, Z. Educative treatment of patients and parents in anorexia nervosa. Br. J. Psychiatry 112:671–681, 1966.PubMedCrossRefGoogle Scholar
  27. 27.
    Gull, W. W. Anorexia Nervosa. Lancet 1:516–517, 1868.Google Scholar
  28. 28.
    Hallsten, E. A. Jr. Adolescent anorexia nervosa treated by desensitization. Behav. Res. and Ther. 3:87–92, 1965.CrossRefGoogle Scholar
  29. 29.
    Halmi, Katherine A. Anorexia nervosa: Demographic and clinical features in 94 cases. Psychosom. Med. 36:18–26, 1974.PubMedGoogle Scholar
  30. 30.
    Halmi, K., Broadland, G., and Loney, J. Prognosis in anorexia nervosa. Ann. Int. Med. 78:907–909, 1973.PubMedGoogle Scholar
  31. 31.
    Halmi, K. A., Powers, P., and Cunningham, S. Treatment of anorexia nervosa with behavior modification: Effectiveness of formula feeding and isolation. Arch. Gen. Psychiatry 32:93–96, 1975.PubMedCrossRefGoogle Scholar
  32. 32.
    Hasan, M. K., and Tibbetts, R. W. Primary anorexia nervosa (weight phobia) in males. Postgrad. Med. J. 53:146–151, 1977.PubMedCrossRefGoogle Scholar
  33. 33.
    Johanson, A. J., and Knorr, N. J. L-Dopa as treatment for anorexia nervosa, in R. A. Vigersky (ed.), Anorexia Nervosa. New York: Raven Press, 1977, pp. 363–372.Google Scholar
  34. 34.
    Kay, D. W. K., and Leigh, D. The natural history, treatment and prognosis of anorexia nervosa on a study of 38 patients. J. Mental Science 100:411–431, 1954.Google Scholar
  35. 35.
    Kellett, J., Trimble, M., and Thorley, A. Anorexia nervosa after the menopause. Br. J. Psychiatry 128:555–558, 1976.PubMedCrossRefGoogle Scholar
  36. 36.
    Lasègue, C. Hystère Anorexic Arch. Gen. Med. 21:385, 1873.Google Scholar
  37. 37.
    Leitenberg, H., Agras, W. S., and Thomson, L. E. A sequential analysis of the effect of selective positive reinforcement in modifying anorexia nervosa. Behav. Res. and Ther. 6:211–218, 1968.CrossRefGoogle Scholar
  38. 38.
    Moore, D. C. Amitriptyline in anorexia nervosa. Am. J. Psychiatry 134:1303–1304, 1977.PubMedGoogle Scholar
  39. 39.
    Morton, Richard. Opera Medica, Liber Primus Phthisiologiae. Donatum Donati, Amstelodami, 1696. (Translation in Reverence No. 17, Chapter 12.)Google Scholar
  40. 40.
    Needleman, H. L., and Waber, D. The use of amitriptyline in anorexia nervosa, in R. A. Vigersky (ed.), Anorexia Nervosa, New York: Raven Press, 1977, pp. 357–362.Google Scholar
  41. 41.
    Pertschuk, M. Behavior therapy: Extended follow-up, in R. A. Vigersky (ed.), Anorexia Nervosa. New York: Raven Press, 1977, pp. 305–313.Google Scholar
  42. 42.
    Plantey, F. Pimozide in treatment of anorexia nervosa. Lancet 1(8021): 1105, 1977.PubMedCrossRefGoogle Scholar
  43. 43.
    Rosman, B. L., Minuchin, S., Baker, L., and Liebman, R. A family approach to anorexia nervosa: Study, treatment and outcome, in R. A. Vigersky (ed.), Anorexia Nervosa. New York: Raven Press, 1977, pp. 341–348.Google Scholar
  44. 44.
    Rowland, Christopher Z. Jr. Anorexia nervosa: A survey of the literature and review of 30 cases. Anorexia and Obesity, International Psychiatry Clinics 7:37–137, 1970.PubMedGoogle Scholar
  45. 45.
    Russell, G. F. M. General management of anorexia nervosa and difficulties in assessing the efficacy of treatment, in R. A. Vigersky (ed.), Anorexia Nervosa. New York: Raven Press, 1977, pp. 227–289.Google Scholar
  46. 46.
    Selvini-Palazzoli, Mara. Self Starvation: From the Intrapsychic to the Transpersonal Approach to Anorexia Nervosa. London: Human Context Books, Chaucer Publishing Company, 1974.Google Scholar
  47. 47.
    Sifneos, P. F. A case of anorexia nervosa treated successfully with leucotomy. Am. J. Psychiatry 109:356–360, 1952.PubMedGoogle Scholar
  48. 48.
    Thoma, H. Anorexia Nervosa. Tr. G. Brydone. New York: International Universities Press, 1967.Google Scholar
  49. 49.
    Vigersky, R. A. The effect of cyproheptadine in anorexia nervosa: A double blind trial, in Vigersky, R. A. (ed.), Anorexia Nervosa. New York: Raven Press, 1977, pp. 349–356.Google Scholar

Copyright information

© Spectrum Publications, Inc. 1981

Authors and Affiliations

  • James Ferguson

There are no affiliations available

Personalised recommendations