Essay: Explore relationship between childhood abuse and anorexia and bulimia

Introduction
In brief, Anorexia Nervosa (anorexia) refers to a psychological eating disorder characterized by minimal consumption of food (Treasure and Alexander, 2013). Individuals who suffer from this condition exhibit extreme low body weight in relation to their height and body type. Similarly, Bulimia Nervosa (bulimia) is also a psychological eating syndrome. However, instead of someone starving himself, an individual suffering from bulimia eats abnormal quantities of food in a short span, then followed by efforts to avoid gaining weight by removing what was consumed (Frank, Shott, Hagman, and Mittal, 2013). Both of these conditions are life-threatening and can result in irreparable damages to the body. For instance, anorexia can lead to mild anemia, inflamed body joints, dehydration that causes constipation, dry skin, excessive thirst, slower thyroid functions, reduction in blood pressure rate and pulse, and damage to vital organs like brain and heart (Treasure and Alexander, 2013). Notably, bulimia can cause the heart to fail primarily due to loss of minerals like potassium. Besides, vomiting can cause other serious problems like the inflaming of the esophagus and the glands near the cheeks (Mehler, Krantz, and Sachs, 2015). In addition to the above, it is imperative to mention that apart from physical manifestations, people diagnosed with anorexia and bulimia are prone to psychological illnesses like anxiety, depression, and obsessive compulsory disorder (OCD) among others (Treasure and Alexander, 2013).
The above introduction stresses the fact that these two conditions ought to be accorded the gravity they deserve. Thus, the causes need to be thoroughly investigated to treat them before these conditions escalate. In line with this, most of the literature point to the fact that anorexia is caused by irregular hormonal functions, genetics, traumas, and type of profession. In contrast, the exact causes of bulimia have not yet been identified, but are theorized to consist of multiple factors like stressful life transformations and low self-esteem, and so on (Westmoreland, Krantz, and Mehler, 2016). Nonetheless, the information on the effects of childhood abuse on these conditions is scanty. The above overview forms the basis of the whole proposal. The following piece intends to explore the relationship between childhood abuse and anorexia and bulimia. However, before that, the next section will review previous literature on this issue.
Literature Review
In a bid to highlight the complications associated with anorexia and bulimia, Westmoreland, Krantz, and Mehler (2016) concluded that one of the causes of these life-endangering conditions is cultural ideals. They pointed out that the stereotypes of beauty and thinness are contributory factors to an eating disorder in vulnerable persons who have a chromosomal predisposition to anxiety and fastidiousness. At the same time, they noted that by starving or binge eating, one might be able to get rid of anxious feelings, and minimize the manias and urges through a serotonergic neural pathway.
Similarly, in developing a model for treating anorexia, Treasure and Schmidt (2013) theorized that predisposing factors like obsessive compulsion and anxiety enhanced the susceptibility to anorexia. Furthermore, they hypothesized that these factors contributed to the development of this condition since they cultivated pro-anorexia attitudes and behaviors. On the same note, they said that the above traits resulted in the highly visible eating disorders, which, in turn, make people react and propagate their poor eating habits (Treasure and Schmidt, 2013).
Also, in attempting to support the theory that some appetite regulatory hormones play a significant role in controlling the eating habits of people with anorexia, Eddy et al. (2015) carried out an experiment on a group of women, some of whom had anorexia, while those who did not acted as the control group. It is vital to mention that they hypothesized that behavioral phenotypes are often defined by a prevalent restricting factor or bingeing which is linked with a negative outcome. The results indicated that the women who had been diagnosed with anorexia had differently regulated anorexigenic hormones like peptide YY, brain-derived neurotrophic factor (BDNF), and leptin (Eddy et al., 2015). The interpretation of these findings is that these hormones are directly linked to the onset and development of anorexia.
Fitzsimmons‐Craft et al. (2014) undertook a study to link objective and subjective binge eating to self-esteem and other depressive symptoms. In brief, objective binge eating is a scenario where an individual can eat between 5,000 to 15,000 calories in a single episode (Brownstone et al., 2013). On the other hand, a subjective binge eater is one who eats moderate amounts of food which he had not planned to consume (Brownstone et al., 2013).
The authors discovered that the primary cause of binge eating which, in turn, leads to bulimia is the loss of control. In other words, the primary reason why an individual participates in binge eating is that he cannot control his eating patterns. Thus, in designing a treatment regimen, one has to factor in how patients can be made to be in control of their eating habits.
Kelly, Vimalakanthan, and Carter (2014) also conducted a study to comprehend the roles that self-worth and self-compassion play in the pathology of an eating disorder. The foundation of their research was based on prior literature which had established that high self-esteem safeguards against over eating, while low self-esteem makes one eat excessively. Self-worth or self-esteem is a positive evaluation of oneself. However, according to Kelly, Vimalakanthan, and Carter (2014), self-esteem is equally linked to other maladaptive qualities; thus, self-compassion is more connected to poor eating habits as compared to self-worth. Self-compassion refers to the inclination to respond own misery by embracing an approach of caring. Therefore, to summarize their experiment, Kelly, Vimalakanthan, and Carter (2014) discovered that individuals who developed self-compassion in the initial stages of treatment responded faster as opposed to those who had low levels.
The above review supports the notion that the primary causes of eating disorders are severe physical, biological, psychosocial, and psychological factors. In short, there are limited studies which link the aspect of childhood abuse and the two eating disorders. The most abundant studies taken on this subject are systematic reviews like the one this proposal intends to carry out. Therefore, this gap in information is what the following systematic review hopes to fill. In short, the review wants to link the act of child abuse and anorexia nervosa, as well as bulimia nervosa.
The Aim of the Study
The following study aims to undertake a systematic review looking at the relationship between childhood abuse and anorexia nervosa and bulimia nervosa.
Research Question
What is the relationship between childhood abuse and anorexia nervosa and bulimia nervosa?
Methods
The methodology of this study will be a systematic review of data which will be undertaken according to the guidelines of Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). A systematic review is a kind of literature review that employs well-structured methods to gather secondary data, critically evaluate and understand other research studies. In other words, such reviews select and synthesize studies which are directly related to the research question under investigation.
One of the reasons for using a systematic review in this exercise is because it is a kind of study that offers a definitive answer on a specific question. Besides, by going through large volumes of evidence, a systematic review can help busy researchers understand the latest developments in that particular field. On the same note, a review can illustrate how the discoveries can be applied in everyday practice in a process known as generalizability of findings. The rationale behind this is that the conclusions drawn from reviews are more consistent than those of individual studies. Moreover, by consulting a review, a researcher does not have to understand the variances between different items of the research.
Databases
The research will systemically look for articles which have no language restrictions and have been published between 2013 and 2018. The database sources will include PubMed, PsycINFO, Proquest, Embase, and Web of Science. Search phrases will combine thesaurus with free-search terms linked to various kinds of child abuse and eating disorder diagnoses. Besides, if possible, some authors will be contacted for any required additional information.
Search Terms
Some of the keywords that will be typed in the search engines of the databases mentioned above include child abuse, eating disorder anorexia nervosa, bulimia nervosa, and binge eating disorder.
Inclusion and Exclusion Criteria
The review will include observational studies that have a relative approximation on the rates of child abuse between individuals with and without eating disorders. Also, studies that define anorexia nervosa, bulimia nervosa, and binge eating disorder following the appropriate Diagnostic and Statistical Manual of Mental Disorders (DSM) will be included. Besides, subclinical bulimia nervosa will be considered; however, the relevant studies have to indicate clear rationales of the diagnostic criteria applied.
Studies that do not have suitable comparison groups, as well as those that are not clear on whether the abuse occurred before one turned 18 years will be excluded. In line with this, to minimize the danger of misclassification bias, only high-quality studies with explicit descriptions of the nature of abuse, as well as homogenous methods to evaluate the eating disorders will be included. For instance, a structured clinical interview for World Mental Health-Composite International Diagnostic Interview qualifies as a purposeful interview.
In addition, in case data from the same sample is available in different publications, this study will only retain the research that has more exhaustive information. Lastly, only researches that have been published on peer-reviewed journals will be considered. However, conference abstracts and dissertations will be excluded.
Assessment of Quality
After the articles shall have been identified, the author of this study will preliminarily review their titles and abstracts. After that initial screening, the studies will be retrieved in full and test their final eligibility, which is, ascertaining if the inclusion and exclusion criteria have been fulfilled. Then, if there is any discordance, unclear reported information, or if the statistical data cannot be derived by percentages, the writer of the piece will be contacted to clarify the issue. Lastly, after the data shall have been obtained, the extraction sheets for each of the researches will be cross-checked to look for consistencies, and any differences will be resolved by consulting authors of the article if they can be found.
Findings/Synthesis of Research
Thematic will be used to generate data with 95% confidence levels. The above method compares studies more evenly and is more suitable for data which is substantially heterogeneous. Thus, it will be employed to identify the recurrent themes of childhood abuse, anorexia, and bulimia. Then, the results will be summarized under thematic headings. After that, information will be arranged in tables to make it possible to identify themes which are pronounced, and also offer organized approaches for handling data in each theme.