Psychological explanations for anorexia nervosa: family systems theory,…

The idea

Three psychological explanations for anorexia nervosa exist. Minuchin's family systems theory locates the illness in family dynamics: boundaries blur into enmeshment (e.g. a parent answering for a child), and refusing food becomes a bid for autonomy and control by someone feeling ineffective. Social learning theory focuses on the media, modelling of thin ideals, and direct or vicarious reinforcement (e.g. praise for weight loss). Becker's Fiji study provides evidence, showing disordered eating increased after television was introduced. Cognitive theory looks inward, distinguishing between perceptual distortions (overestimating body size) and irrational beliefs (e.g. 'one biscuit means I have failed completely').

What earns the marks

• Explain family systems theory by detailing enmeshment (blurred boundaries) and how food refusal is an attempt to gain autonomy and control.
• Apply social learning theory by explaining the modelling of thin ideals from the media, and reinforcement (e.g. vicarious reinforcement from seeing models praised).
• Outline cognitive theory by distinguishing perceptual distortions (misperceiving body size) from irrational beliefs (e.g. dichotomous thinking about food).
• Evaluate family systems theory by discussing its socially sensitive nature, as it potentially blames parents and relies on retrospective clinical observations.
• Evaluate social learning theory by noting it struggles to explain why most media-exposed individuals do not develop anorexia, suggesting a biological vulnerability is also required.
• Evaluate cognitive theory by questioning whether cognitive distortions and irrational beliefs are symptoms rather than underlying causes, though CBT's success supports their role in maintenance.

Common mistakes and how to put them right

• Defining enmeshment loosely as 'a close family' rather than as blurred boundaries where members speak and feel for one another.

• Assuming that describing media effects without a named study earns no credit.

  Put it right: Explaining the mechanism of media influence (modelling and reinforcement) is valid knowledge even without citing Becker.

• Blurring the three explanations into one undifferentiated psychological account instead of separating family, learning and cognitive claims.

• Confusing perceptual distortion of body size with irrational beliefs about eating.

  Put it right: The specification names both and they are distinct concepts.

Exam tips

• The specification names eight specific terms across the three theories (enmeshment, autonomy, control, modelling, reinforcement, media, distortions, irrational beliefs), so be prepared to define and apply each one.
• When evaluating psychological explanations, use the biological account as a counterweight and argue for an interactionist position rather than declaring a single winner.
• In scenario questions, quote the stem: if a mother answers questions put to her daughter, explicitly name that as enmeshment before explaining it.