Theories on Eating Disorders and its correlations with certain Personality Traits For some people food takes

on inordinate significance, and they find themselves enslaved to bizarre and unhealthy rituals that revolve around the process of eating. People with eating disorders struggle to control their disturbed attitudes and behaviours regarding food, and, to the distress of those who are close to them, many put their lives at risk. One of the primary influences on the development of eating disorder is societys attitudes toward eating and diet. There is perpetual idealization of a slim figure and individuals with such body types are positively labelled as beautiful & glamourizing. Individuals are increasingly becoming preoccupied with the way they are perceived by others, also known as the social self (StriegelMoore, Silberstein, & Rodin, 1993). Those individuals who feel inadequate about their appearance develop a social self that focuses inordinately on inadequacies of their body. This relationship between body image dissatisfaction and social anxiety presumably serves as one of the key basis from which eating disorders emerge. Body image, estimations of the importance of physical appearance, and self-esteem all have been proposed to play important roles in the development of eating disorders (Garner & Garfinkel, 1985). It has been argued and debated many times that this appearance based sensitivity might make an individual prone to eating disorders (EDs). AppearanceBased Rejection Sensitivity (Appearance-RS) is a personality-processing system characterized by anxious concerns and expectations about being rejected based on one's physical attractiveness. (Park, 2005) In a bid to be perceived as desirable, an individual feels compels to alter their physicality in an extreme fashion often detrimental to their lives. Such kind of body image disturbance is a core feature of anorexia nervosa. As anorexics look in the mirror, they see an obese person, rather than the skin and bones so evident to everyone else. In fact, family members of people with this disorder experience a great deal of frustration, because they are unable to convince them that they are actually horrendously thin. These kind of physical appearance related issues are not pervasive across genders. Males are not immune to the pressures to try to meet an ideal appearance standard as studies have indicated that between 28%-68% of adolescent boys are also trying to change their appearance (i.e., bulk-up and gain muscle in attempts to achieve the male ideal of muscularity; McCreary & Sasse, 2000). With such a high prevalence of body dissatisfaction, and given the central role that body image plays during the adolescent years, it is not surprising that a large portion of the adolescent population is at-risk for weight-related concerns. (Field, Camargo, Taylor, Berkey, & Graham, 1999) Society tells males they must be muscular and females that they must be thin to come close to these appearance-based ideals. (Giles, 2010) There have been various researches, studies and theories published which have correlated personality traits like sensation seeking and appearance based sensitivity with probability/existence of eating disorders amongst people. Some of the related findings have been enlisted below with a brief understanding. 1. The aim of the study that took place in Switzerland was to evaluate the role of sensation seeking in eating disorders (anorexia and bulimia), taking into account the subtypes (purging versus non-purging) and the concept of binge-eating disorder. The study involved 141 adolescent girls and young women, aged 14 to 25 years who lived in the French speaking part of Switzerland (79 clinical subjects with eating disorders according to DSM-IV criteria, and 62 control subjects without eating disorders from the general population). All the subjects completed the Sensation Seeking Scale (SSS, Zuckerman, 1971). The results showed that subjects with bulimic behaviours characterized by recurrent episodes of binge-eating, whatever their exact diagnosis and subtype, do not significantly differ from one another on the Sensation Seeking Scale. They all had higher scores than the control group especially on the Thrill and Adventure Seeking dimension. In contrast, restricting anorexics had lower

scores on the Sensation Seeking Scale than the control group, especially on the Experience Seeking dimension. (Rossier, V.; Bolognini, M.; Plancherel, B.; & Halfon, O, 2000) This study has brought about a clear demarcation distinguishing certain personality trait (Sensation Seeking) of bulimics that is almost non-existent among anorexics. The compulsivity of bulimics is correlational with their sensation seeking. 2. Another study in the USA, examined the influence of urgency, sensation seeking, lack of planning and lack of persistence and their relationship to bulimia, drinking and gambling in 246 college students. The 246 undergraduate student participants (50% males) ranged in age from 18 to 40 years. Self-report questionnaires of impulsivity and expectancies as well as binge eating, alcohol use and problem gambling behaviours were administered anonymously in a group format. The hypothesis was confirmed with the studies and found that sensation seeking was positively related to frequency of gambling and drinking. The first hypothesis was supported in that urgency was the impulsivity-related construct most highly associated with problematic drinking and symptoms of bulimia nervosa. For women, the expectancy that eating alleviated negative affect related more strongly to binge eating if they also scored high in urgency; however, this was not true for men. (Fischer & Smith, 2008) 3. A 2001 study by Boston psychologists Westen and Harnden-Fischer primarily aimed to study & examine the extent to which personality patterns account for meaningful variation within axis I eating disorder diagnoses. Like other DSM-IV axis I syndromes, eating disorders are diagnosed without respect to personality, which is coded on axis II. Prior to 2001, clinical observation had long suggested a link between personality and eating disorders. Research had consistently linked anorexia (particularly when the patient does not also have bulimic symptoms) to personality traits such as introversion, conformity, perfectionism, rigidity, and obsessive-compulsive features. (Here perfectionism can be inferred for Appearance Based Sensitivity) The picture for bulimia had been and still is more mixed. Traits such as perfectionism, shyness, and compliance have consistently emerged in studies of individuals with bulimia or with anorexia, although research has often found bulimic patients to be extroverted, histrionic, and affectively unstable. In this study, the first cluster of the sample was a high-functioning/perfectionistic group, who had high Global Assessment of Functioning Scale scores, a lower incidence of psychiatric hospitalization, and considerably less personality pathology than the other groups. These patients functioned well occupationally and interpersonally, although they were chronically self-critical and perfectionistic and tended to feel guilty and anxious. Their pathology appeared to be a blend of high-functioning obsessional and depressive features. These were the "good girl" eating disorder patients, whose anorexic and bulimic symptoms reflected efforts to regulate anxiety, guilt, competition, and problems with self-esteem. In this study group, such patients were more likely to be bulimic than anorexic or bulimicanorexic. Patients with bulimic symptoms (with or without a history of anorexia) were found to be more disturbed. They tended to be emotionally dysregulated, undercontrolled and impulsive. (These symptoms are interchangeable with those of Borderline Personality Disorder. One of the other symptoms of BPD is sensation seeking or impulsive behaviour). For these patients, eating-disordered symptoms appeared to be one more instance of impulsive behaviour designed to regulate poorly modulated affects. The data suggested that distinguishing subgroups of bulimic patients on the basis of degree of impulsivity limits the classification to only one aspect of a broader personality structure characterized by emotional dysregulation, intense and labile affect, interpersonal desperation, and impulsive efforts to escape distress and seek gratification. (Westen & Harnden-Fischer, 2001) 4. A much older study of 1994 also tried to draw parallels between ED and SS (Sensation Seeking). All dominant models of the eating disorders implicate personality variables in the

emergence of weight concerns and the development of specific symptoms such as bingeing and purging. Standardized measures of personality traits and disorders generally confirm clinical descriptions of restricting anorexics as constricted, conforming, and obsessional individuals. A less consistent picture suggesting affective instability and impulsivity emerged from this study with the assessment of SS with bulimia nervosa. Considerable heterogeneity existed within eating disorder subtypes, however, and a number of special problems complicated the interpretation of personality data in this population. These include young age at onset, the influence of state variables such as depression and starvation sequelae, denial and distortion in self-report, the instability of subtype diagnoses, and the persistence of residual problems following symptom control. (Vitousek & Manke, 1994) 5. A meta-analysis study in Canada reviewed literature examining the link between personality and EDs published during 1995 to 2005, and presented evaluations of the prevalence of personality disorders (PDs) in anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) as assessed by self-report instruments versus diagnostic interviews. AN and BN were found to be both consistently characterized by perfectionism and negative emotionality and other major traits associated with avoidant PD. Consistent differences that emerged between ED groups were high constraint and persistence and low novelty seeking in AN and high impulsivity, sensation seeking, novelty seeking, and traits associated with borderline PD in BN. The meta-analysis, which found PD rates of 0 to 58% among individuals with AN and BN, documented that self-report instruments greatly overestimated the prevalence of every PD. (Cassin & Von Ranson, 2005) 6. Not much later, in 2007, an American study explicitly drew strong correlations between appearance-based rejection sensitivity and EDs. In one of her studies, Park developed and validated an appearance-based rejection sensitivity scale (ARS scale) with 242 college students, to measure the extent to which people anxiously expected rejection from others based on their physical attractiveness. She found that those who scored high in appearancebased rejection sensitivity were likely to have low self-esteem, high levels of neuroticism, insecure attachment styles, to base their self-worth on their appearance and to rate themselves as physically unattractive. The study also showed that people who are highly sensitive to appearance-based rejection reported increased symptoms of disordered eating. Both men and women who reported being sensitive to appearance-based rejection were preoccupied with their body and weight in unhealthy ways. They avoided eating when they were hungry, exercised compulsively and engaged in binging and purging. People with high appearance-based rejection sensitivity also were more likely than people low in appearancebased rejection sensitivity to compare their physical attractiveness with others and to feel bad about themselves when making such comparisons. These results were found regardless of the subjects' levels of self-esteem, attachment style, general sensitivity to rejection, neuroticism, self-rated level of attractiveness and the degree to which they based self-worth on appearance. Interestingly, Park found that both appearance-based rejection sensitivity and basing self-worth on appearance independently predicted eating disorder symptoms and the tendency to make appearance-based comparisons. These findings suggested different pathways through which people may develop and maintain behaviours such as excessive dieting, compulsive exercising, binging and purging, and comparing one's attractiveness with others. According to the studys findings, Park said "Some people engage in such behaviours because they are ultimately worried about being rejected by others if they don't measure up to looking a certain way. (Park, 2007; additional source for quote: http://www.buffalo.edu/news/releases/2007/01/8383.html) 7. Even a British study from 1995 has underlined the preoccupation of adolescents girls with their physical body image and the relative vulnerability to develop EDs. As British adolescents of Asian origin appear at least as vulnerable to eating disorders, this study investigated these issues in preadolescent British Asian girls. Fifty-five Asian and 42

Caucasian 9-year-olds completed assessments of dietary restraint, body esteem, body satisfaction, and body figure preferences. The study revealed a high priority for thinness in both the Asian and Caucasian girls. Their desire for thinness was present even though the Asian girls had a significantly lower body weight than their Caucasian peers. Both groups of high restraint girls expressed body shape discontent and lower body esteem. In addition, an association was found in the Asian sample between reported dieting and the cultural orientation of their family. These results demonstrated the wide appeal of thinness, which in combination with intercultural and intra-familial conflict, may strongly influence eating and contribute to the development of eating disorders. (Hill & Bhatti, 1995) 8. A 2005 study by Australian psychologists aimed to explore the role of peer influences in the development of body dissatisfaction and dieting awareness in young girls. The study involved a sample of 81 girls (aged 58 years), recruited from the first 3 years of formal schooling. Girls were individually interviewed. Body dissatisfaction was assessed by means of figure rating preferences, and dieting awareness by responses to a brief scenario. A number of sources of peer influence were also assessed. The results found the 2nd Year girls to display significantly greater body dissatisfaction than the younger girls. All girls, irrespective of age, preferred a similar thin ideal figure. Year level constituted the only significant predictor of dieting awareness; with older girls demonstrating a greater understanding of dieting than the younger girls. Importantly, girls' perception of their peers' body dissatisfaction emerged as the strongest predictor of their own level of body dissatisfaction. From these findings and patterns it could be concluded that body dissatisfaction in girls first emerges during the junior primary school years, between ages 5 and 7 years, and appears to be a function of shared peer norms for thinness. (Dohnt & Tiggemann, 2005) 9. This study examined the relationship between college women's media use and two sets of variables (disordered-eating symptomatology and a set of related variables, including body dissatisfaction and drive for thinness) and assessed the relationship between college men's media use and their endorsement of thinness for themselves and for women. As expected, the relationship between mass media consumption and womens eating disorder symptomatology seemed to be stronger for magazine reading than for television viewing. Overall magazine reading was significantly and positively related. When consumption of thinness depicting and thinness promoting media was examined, the same pattern emerged. In other words, women who frequently read fitness magazines for reasons other than interest in fitness and dieting still scored higher on the disordered-eating inventory than women who rarely read fitness magazines. Two of the other variables tested to determine EDs connection to womens media consumption were body dissatisfaction and drive for thinness. Further data analysis revealed that television viewing was a significant predictor of body dissatisfaction. Viewing of heavy shows and the reading of fashion magazines were significantly related to body dissatisfaction. In contrast, magazine reading was a significant predictor of drive for thinness. Body dissatisfaction and drive for thinness have both been closely tied to eating disorders, yet they are distinct psychological vulnerabilities. Just as body dissatisfaction and drive for thinness are two distinct but highly related vulnerabilities, anorexia and bulimia are two distinct but highly related manifestations of disordered-eating behaviour. As expected, reading fitness magazines and viewing thin shows were significant positive predictors of anorexic behaviour. The relationship between fitness magazines and anorexic behaviour remained significant even when interest in fitness and dieting as magazine topics was partial. For men, magazine reading was a significant positive predictor of thinness and dieting for themselves. Viewing thinness depicting and thinness promoting shows was a significant predictor of mens endorsement of personal thinness and dieting. Overall magazine reading and the reading of mens entertainment magazines were significantly and positively

correlated with attitudes stressing the importance of a womans thinness. Compelling as they may be, some skepticism is warranted in the interpretation of these few correlations, given the non-significance of the relationship between media consumption and the reliable endorsement-of-thinness-in-women scale. In summary, it appears that media exposure, and especially exposure to thinness depicting media has a significant impact on mens perception of their appearance, and a possible but still undemonstrated impact on mens expected female appearance. Articles in magazines, have suggested that the appearance of certain waiflike models in the media sends a dangerous message about disordered eating to teenagers. In this study, however, the researchers found that reading whole fitness and fashion magazine genres and viewing thin shows primed people to be generally obsessed with their appearances. The individuals sensitivities to their physical appearances were related to disordered eating. The overall emphasis on feminine thinness exemplified by multiple media depictions of slender models and actresses should be considered for its possible influence on disordered eating. (Harrison & Cantor, 1997)

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