Table of ContentsBrandy's BackgroundCausal ResearchTreatment ResearchReferencesBrandy is a college student who suffered from bulimia nervosa at the age of 21. Brandy's constant anxiety about how she appears to others leads to extreme levels of stress that she copes with by eating uncontrollably, characteristic of bulimia nervosa. She also displays other bulimic traits, such as purging after her binge sessions several times a day, for fear of gaining weight, even if her weight seems good. This research paper aims to discover the etiology of his disorder and the best method to treat it. Say no to plagiarism. Get a tailor-made essay on “Why Violent Video Games Should Not Be Banned”? Get the original essay Brandy's Background Throughout her life, Brandy struggled to maintain the high standards set for her by her parents. She believes the reason they expect so much from her is because of their disappointment in her older sister Sarah, who did poorly in school, became overweight, and rebelled against the family. Brandy thinks they want to fix their failed parenting by making Brandy more successful than Sarah. This can be seen when Brandy was in middle school and her parents forced her to serve in their church, take advanced classes, and be on the track team. Brandy didn't want to disappoint her parents like Sarah and she strived to be the best at these activities so that her parents would be proud. She insisted on being perfect in everything she did and felt anxiety when she made a minor mistake like receiving an A- on an assignment or placing second on a track, making her think that her parents wouldn't love him anymore. Brandy was reinforced for her perfectionist behavior because her parents constantly compared her to Sarah and said how proud they were of her whenever she reached a milestone. Brandy's intense focus on being perfect for her parents caused her so much stress that she could barely handle it. The opportunities to impress them increased as she got older. Causal Investigation The etiological factor for Brandy's bulimia nervosa is the perfectionistic trait she acquired as a child from trying to please her parents. This caused her to stress greatly about how she appeared to her parents and later to others, which transferred into almost every area of ​​her life as she grew up. The stress of trying and not being perfect led her to overeat to relieve it, which she then followed by purging so that her health could also remain perfect. These first two empirical studies examine and support how the perfectionistic trait can lead to bulimia nervosa. The first etiological study was conducted by Bardone-Cone, Boyd, and Weishuhn (2009), which aimed to examine the relationship between maladaptive and adaptive perfectionism and bulimia. symptoms among African American women who were college students. Another goal of this study was to use an interactive model to discover how different levels of perfectionism and weight perceptions interacted with each other and how they affected bulimic symptoms. To pursue these two goals, the researchers recruited 97 African American women from a Midwestern university, most of whom were midway through their bachelor's degrees and had an average age of 19 years. The study was designed by asking the 97 women to complete two questionnaires spaced 5 months apart, although only 70 women from the initial group responded to the second (Bardone-Cone et al., 2009). THEQuestionnaires were designed to determine each participant's traits of perfectionism and impulsivity, as well as other eating and substance abuse behaviors (Bardone-Cone, et al., 2009). The first test was used to determine the bulimic symptom status in the participants and the second test to assess and predict the change in their symptoms that it measures was used to test the objectives of this test. The research focused on complete participant demographics, levels of maladaptive and adaptive perfectionism, perceived weight status, BMI, and bulimic symptoms. The results of this study showed that only maladaptive perfectionism was related to bulimic symptoms and increased the likelihood that these symptoms would worsen, not adaptive perfectionism. The study also highlighted the detrimental effects of maladaptive perfectionism mixed with the woman's perception of being overweight, which predicted an increase in the development of more extreme bulimic symptoms the more she believed she was overweight. This shows that perfectionism, at least in its negative form, plays a crucial role in the risk of developing bulimia nervosa. Another finding that Bardone-Cone et al. (2009) found that higher levels of BMI interacting with maladaptive perfectionist women also contributed to bulimic symptoms, but they concluded that perceptions of being overweight mixed with maladaptive perfectionism were more consequential. Finally, Bardone-Cone et al. (2009) conclude that to reduce the bulimic symptoms of African-American women, it is essential to advise them on their negative perceptions of weight, but especially on reducing their maladaptive perfectionism, considered a major maintaining factor of eating disorders. diet in most women and constitutes the preferred target of advice. The second etiological study was carried out by Egan, Watson, Kane, McEvoy, Fursland, and Nathan (2013), which aimed to examine the extent to which anxiety is the mediator. between the empirically strong relationship between perfectionism and eating disorders, such as bulimia nervosa, anorexia nervosa, and other unspecified eating disorders. Egan et al. (2013) conducted this experiment after examining whether perfectionism plays an important role as a risk and maintenance factor for eating disorders, based on the large amount of empirical research provided in their study. To determine this and how anxiety plays a role in this strong relationship, they recruited 370 patients associated with a specialist eating disorder service in Australia, of whom 18% were diagnosed with anorexia nervosa, 41% bulimia nervosa and 41%. with unspecified eating disorders. Those who were excluded from the study were individuals who did not meet criteria for an eating disorder according to DSM-IV standards and those who had been diagnosed with binge eating disorder (Egan et al., 2013). The ages of these participants ranged from 16 to 71 years, with the average being 25.04 years (Egan et al., 2013). The study design called for participants to undergo eating disorder assessments from clinical psychologists over 2 to 3 sessions. Assessments included clinical interviews, self-reports, eating disorder examinations (EDE), Mini-International Neuropsychiatric Interviews (MINI), and measurement of participants' body mass index. The measures used for this study were diagnostic interviews such as the MINI and EDE which assessed perfectionism, anxiety, eating disorder pathology, binge eatingobjective and purging behaviors among participants (Egan, et al., 2013). After comparing the study results in partially and fully mediated models used to determine the magnitude of the role of anxiety, and finally choosing the data from the partially mediated model as evidence over the others, the results of the study showed that the strong relationship between perfectionism and diet. Eating disorders have a partial role played by anxiety in mediating both instead of a larger role. Egan et al. (2013) conclude that treating perfectionism and anxiety is important for effectively treating eating disorders, and that by specifically treating perfectionism, it can reduce not only eating disorders like bulimia nervosa but also disorders linked to anxiety and eating pathologies. Egan et al. (2013) come to this conclusion even though anxiety was the focus of their research, which turned out to be a small factor for eating disorders, and instead discovered how much perfectionism plays a role in both eating disorders and anxiety disorders. Research by Egan et al. (2013) conclude that perfectionism was much more important than previously thought and that it is a powerful transdiagnostic factor for many disorders, providing evidence for why perfectionism is such a large contributor to bulimia nervosa.Research on the treatmentTreatment Cognitive behavioral therapy, also known as CBT, is the therapy of choice for curing bulimia nervosa. This treatment is more effective than any type of medication used to treat eating disorders, such as antidepressants, and it is particularly effective for bulimia nervosa, leading to a better chance of improvement and eventual freedom from the disorder. . According to researchers Waller, Gray, Hinrichsen, Mountford, Lawson, and Patient (2014), CBT includes three main areas in the treatment of this disorder: education about the disorder, cognitive therapy, and coping strategies. For education, it focuses on teaching the physical consequences of bingeing and purging, the ineffectiveness of purging techniques, the bad effects of diets, and a solid eating plan that includes nutritious foods every day. three hours for approximately five to six meals (Waller, et al., 2014). For cognitive therapy, it aims to correct very dysfunctional thoughts, correct incorrect beliefs about weight and body shape and restructure the view of eating, as this contributes greatly to the disorder. Finally, for coping strategies, it focuses on learning to resist the disorder. impulse to binge and immediate desire to purge. This final stage is characterized by targeting the stressful cues that trigger binge eating and managing the anxiety and depression that result from binge eating in order to prevent the purging impulse (Barlow, et al., 2018) . These steps are addressed in sessions of approximately 20 hours, which can be increased or decreased depending on the patient's rate of improvement (Waller, et al., 2014). These next two research studies will analyze CBT and show its effectiveness in treating bulimia nervosa. The first treatment study was conducted by Waller, Gray, Hinrichsen, Mountford, Lawson, and Patient (2014), which aimed to examine whether or not CBT was effective. The effectiveness of using cognitive behavioral therapy (CBT) to treat bulimia nervosa in research trials can be transferred to everyday clinics for the same results. Waller et al. (2014) conducted this study becauseEvidence for the effectiveness of CBT for people with bulimia nervosa came only from highly controlled, specialized, and funded research studies, making them doubt the generalizability of these findings. The number of participants in this study was 78 women with bulimic disorder, of whom 55 had bulimia nervosa and 23 had eating disorder not otherwise specified (EDNOS), but who had bulimic behaviors such as purging and binge eating. It is also important to note that 9 of the women were taking antidepressants before undergoing CBT and that a large number of participants had comorbidity with other disorders. The average age of women was 27.8 years. The study design consisted of women undergoing CBT, completing assessments for eating pathology and depression, and recording in a diary the number of times they ate and purged throughout treatment. For CBT, Waller et al. (2014) conducted 20 one-hour supervised CBT sessions, the average being 19.2, with experienced clinical psychologists that involved cognitive restructuring, education about their behavior and the disorder, behavioral experiments to set strategies adaptation, a change in diet and treatment of the comorbidities they suffered from once they began to improve. The measures used for the study were the Eating Disorder Inventory, Beck Depression Inventory, and CBT treatment with analysis of participants' recovery from bulimia nervosa. The results of the study by Waller et al. (2014) are consistent with their hypothesis that CBT was an effective measure of treatment for bulimia nervosa and other forms of eating disorders, both in a clinical practice and in a research center. They showed that in everyday clinical settings, compared to research studies, CBT was equally effective for bulimic symptoms with a very low dropout rate, that only half of the participants were in remission and that there had a significant reduction in eating disorder and depression characteristics. They also showed that through CBT, participants improved their mood, food perceptions and behavior (Waller, et al., 2014). However, Waller et al. (2014) note that the weakness of this study was that the CBT administered to the participants was carried out by clinicians specialized in the pathology of eating disorders and with a high level of training for its treatment. The researchers conclude that this, along with the lack of a control group and therapeutic validation to determine whether clinicians were actually administering CBT, is due to the nature of the trial and that there was little they could do about it. remedy. Despite these limitations, their study helps solidify CBT as an effective treatment for bulimia nervosa, regardless of where it is administered. The second treatment study was conducted by Peterson, Berg, Crosby, Lavender, Accurso, Ciao, Smith, Klein, Mitchell, Crow, and Wonderlich (2017), which aimed to observe and compare how integrative cognitive-affective therapy ( ICAT) and enhanced cognitive behavioral therapy (CBT-E) indirectly affected patients with bulimia nervosa. To compare which was better for treating bulimia nervosa, Peterson et al. (2017) evaluated the impact of both treatments on patients' emotional regulation, coping strategies, and self-view. To test this, Peterson et al. (2017) recruited 80 participants with an average age of 27.3 years, with a BMI of approximately 23.9 kg and almost all.>