Skip to main content
SpringerLink
Log in
Book cover

Comprehensive Handbook of Cognitive Therapy pp 367–384Cite as

Cognitive and Behavioral Approaches to the Treatment of Anorexia Nervosa

  • Chapter

Abstract

Anorexia nervosa can be a devastating illness resulting in physical impoverishment and grossly impaired psychosocial functioning. It is characterized primarily by a refusal to eat a sufficient amount of food to sustain an adequate level of nourishment (Slade, 1982). One diagnostic criterion is the maintenance of weight at least 25% below the norm for one’s age (American Psychiatric Association, 1980). Such extensive weight loss plays havoc with a body that is often already under the physiological stress of puberty. Disturbed attitudes toward eating, manifested in preoccupations with food and peculiar patterns of handling food, is another noted feature of the disorder (Cooper & Fairburn, 1984; Garner, 1986; Garner & Bemis, 1982; Halmi, 1982; McFarlane, Bellissimo, & Upton, 1982; Muuss, 1985). Other features include intense fears of weight gain, behaviors directed toward weight loss, excessive physical activity, disturbances in body image, and, in females, amenorrhea (Halmi, 1982; Kissel & Arkins, 1973; Minuchin, Rosman, & Baker, 1978; Muuss, 1985; Slade, 1982).

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   219.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   279.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   279.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Agras, S., Barlow, D. H., Chapin, H. N., Abel, G. G., & Leitenberg, H. (1974). Behavior modification of anorexia nervosa. Archives of General Psychiatry, 30, 279–286.

    Article  Google Scholar 

  • Agras, W. S., & Kraemer, H. C. (1983). The treatment of anorexia nervosa: Do different treatments have different outcomes? Psychiatric Annals, 13, 928–935.

    Article  Google Scholar 

  • Agras, W. S., & Werne, J. (1978). Behavior therapy in anorexia nervosa: A data-based approach to the question. In J. P. Brady & H. K. H. Brodie (Eds.), Controversy in psychiatry (pp. 655–675 ). Philadelphia: W. B. Saunders.

    Google Scholar 

  • American Psychiatric Association. (1980). Diagnostic and Statistical Manual of Mental Disorders ( 3rd ed. ). Washington, DC: Author.

    Google Scholar 

  • Bachrach, A. J., Erwin, W. J., & Mohr, J. P. (1965). The control of eating behavior in an anorexic by operant conditioning techniques. In L. P. Ullman & L. Krasner (Eds.), Case studies in behavior modification (pp. 153–163 ). New York: Holt, Rinehart & Winston.

    Google Scholar 

  • Bandura, A. (1978). The self-system in reciprocal determinism. American Psychologist, 33, 344–358.

    Article  Google Scholar 

  • Beck, A. T. (1970). Role of fantasies in psychotherapy and psychopathology. Journal of Nervous and Mental Disease, 150, 3–17.

    Article  Google Scholar 

  • Beck, A. T. (1976). Cognitive therapy and the emotional disorders. New York: International Universities Press.

    Google Scholar 

  • Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression: A treatment manual. New York: Guilford.

    Google Scholar 

  • Bemis, K. M. (1978). Current approaches to the etiology and treatment of anorexia nervosa. Psychological Bulletin, 85, 593–613.

    Article  Google Scholar 

  • Berglas, S., & Levendusky, P. G. (1985). The Therapeutic Contract Program: An individual-oriented psychological treatment community. Psychotherapy, 22, 36–45.

    Article  Google Scholar 

  • Bhanji, S., & Thompson, J. (1974). Operant conditioning in the treatment of anorexia nervosa: A review and retrospective study of 11 cases. British Journal of Psychiatry, 124, 166–172.

    Article  Google Scholar 

  • Blinder, B. J., Freeman, D. M. A., & Stunkard, A. J. (1970). Behavior therapy of anorexia nervosa: Effectiveness of activity as a reinforcer of weight gain. American Journal of Psychiatry, 128, 77–82.

    Google Scholar 

  • Bmch, H. (1962). Perceptual and conceptual disturbances in anorexia nervosa. Psychosomatic Medicine, 24, 187–194.

    Article  Google Scholar 

  • Bruch, H. (1974). Perils of behavior modification in the treatment of anorexia nervosa. Journal of the American Medical Association, 230, 1419–1422.

    Article  Google Scholar 

  • Cinciripini, P. M., Kornblith, S. J., Turner, S. M., & Hersen, M. (1983). A behavioral program for the management of anorexia and bulimia. Journal of Nervous and Mental Disease, 171, 186–189.

    Article  Google Scholar 

  • Clarke, M. G., & Palmer, R. L. (1983). Eating attitudes and neurotic symptoms in university students. British Journal of Psychiatry, 142, 299–304.

    Article  Google Scholar 

  • Cooper, P. J., & Fairburn, C. G. (1984). Cognitive behaviour therapy for anorexia nervosa: Some preliminary findings. Journal of Psychosomatic Research, 28, 493–499.

    Article  Google Scholar 

  • Crisp, A. H. (1983). Treatment and outcome in anorexia nervosa. In R. K. Goodstein (Ed.), Eating and weight disorders (pp. 91–104 ). New York: Springer.

    Google Scholar 

  • Crisp, A. H., Palmer, R. L., & Kalucy, R. S. (1976). How common is anorexia nervosa? A prevalence study. British Journal of Psychiatry, 128, 549–554.

    Article  Google Scholar 

  • Dickstein, L. J. (1985). Anorexia nervosa and bulimia: A review of clinical issues. Hospital and Community Psychiatry, 36, 1086–1092.

    PubMed  Google Scholar 

  • Dooley, C. P., Landau, R. J., & Levenduskly, P. G. (In press). Integrated treatment protocol: A comprehensive approach to the treatment of anorexia nervosa. Manuscript submitted for publication.

    Google Scholar 

  • Eckert, E. D., Goldberg, S. C., Halmi, K. A., Casper, R. C., & Davis, J. M. (1979). Behavior therapy in anorexia nervosa. British Journal of Psychiatry, 134, 55–59.

    Article  Google Scholar 

  • Ellis, A. (1962). Reason and emotion in psychotherapy. ( Secaucus, NJ: Lyle Stuart.

    Google Scholar 

  • Erwin, W. J. (1977). A 16-year follow-up of a case of severe anorexia nervosa. Journal of Behavior Therapy and Experimental Psychiatry, 8, 157–160.

    Article  Google Scholar 

  • Fundudis, T. (1986). Anorexia nervosa in a pre-adolescent girl: Multimodal behaviour therapy approach. Journal of Child Psychology and Psychiatry, 27, 261–273.

    Article  Google Scholar 

  • Garfinkel, P. E., & Garner, D. M. (1982). Anorexia nervosa: A multidimensional perspective. New York: Brunner/Mazel.

    Google Scholar 

  • Garfinkel, P. E., Moldofsky, H., & Garner, D. M. (1977). The outcome of anorexia nervosa: Significance of clinical features, body image, and behavior modification. In R. A. Vigersky (Ed.), Anorexia nervosa (pp. 315–329 ). New York: Raven.

    Google Scholar 

  • Garner, D. M. (1986). Cognitive therapy for anorexia nervosa. In K. D. Brownell & J. P. Foreyt (Eds.), Handbook of eating disorders (pp. 301–327 ). New York: Basic Books.

    Google Scholar 

  • Garner, D. M., & Bemis, K. M. (1982). A cognitive-behavioral approach to anorexia nervosa. Cognitive Therapy and Research, 6, 123–150.

    Article  Google Scholar 

  • Garner, D. M., & Bemis, K. M. (1985). Cognitive therapy for anorexia nervosa. In D. M. Garner & P. E. Garfinkel (Eds.), Handbook of psychotherapy for anorexia nervosa and bulimia (pp. 107–146 ). New York: The Guilford Press.

    Google Scholar 

  • Garner, D. M., & Garfinkel, P. E. (1980). Socio-cultural factors in the development of anorexia nervosa. Psychological Medicine, 10, 647–656.

    Article  Google Scholar 

  • Garner, D. M., & Garfinkel, P. E. (1985). Introduction. In D. M. Garner & P. E. Garfinkel (Eds.). Handbook of psychotherapy for anorexia nervosa and bulimia (pp. 3–6 ). New York: Guilford.

    Google Scholar 

  • Goldfried, M. R. (1971). Systematic desensitization as training in self-control. Journal of Consulting and Clinical Psychology, 37, 228–234.

    Article  Google Scholar 

  • Hallsten, Jr., E. A. (1965). Adolescent anorexia nervosa treated by desensitization. Behavior Research and Therapy, 3, 87–91.

    Article  Google Scholar 

  • Halmi, K. A. (1982). Pragmatic information on the eating disorders. Psychiatric Clinics of North America, 5, 371–377.

    Article  Google Scholar 

  • Halmi, K. A. (1983). Anorexia nervosa and bulimia. Psychosomatics, 24, 111–129.

    Article  Google Scholar 

  • Halmi, K. A. (1985). Behavioral management for anorexia nervosa. In D. M. Garner & P. E. Garfinkel (Eds.), Handbook of psychotherapy for anorexia nervosa and bulimia (pp. 147–159 ). New York: Guilford.

    Google Scholar 

  • Hauserman, N., & Lavin, P. (1977). Post-hospitalization continuation treatment of anorexia nervosa. Journal of Behavior Therapy and Experimental Psychiatry, 8, 309–313.

    Article  Google Scholar 

  • Hollon, S. D., & Beck, A. T. (1979). Cognitive therapy of depression. In P. C. Kendall & S. D. Hollon (Eds.), Cognitive-behavioral interventions: Theory, research and procedures (pp. 153–203 ). New York: Academic Press.

    Chapter  Google Scholar 

  • Hsu, L. K. G. (1980). Outcome of anorexia nervosa: A review of the literature (1954 to 1978). Archives of General Psychiatry, 37, 1041–1043.

    Article  Google Scholar 

  • Kissel, S., & Arkins, V. (1973). Anorexia nervosa reexamined. Child Psychiatry and Human Development, 3, 255–263.

    Article  Google Scholar 

  • Leitenberg, H. Agras, W. S., & Thompson, L. (1968). A sequential analysis of the effect of selective positive reinforcement in modifying anorexia nervosa. Behavior Research and Therapy, 6, 211–218.

    Google Scholar 

  • Levendusky, P. G., & Dooley, C. P. (1985). An inpatient model for the treatment of anorexia nervosa. In S. Emmett (Ed.), Theory and treatment of anorexia nervosa and bulimia-Biomedical, sociocultural and psychological perspectives (pp. 211–233 ). New York: Brunner/Mazel.

    Google Scholar 

  • Levendusky, P. G., Berglas, S., Dooley, C. P., & Landau, R. J. (1983). Therapeutic contract program: Preliminary report on a behavioral alternative to the token economy. Behavior Research and Therapy, 21, 137–142.

    Article  Google Scholar 

  • Mahoney, M. J., (1974). Cognition and behavior modification. Cambridge: Ballinger.

    Google Scholar 

  • Mavissakalian, M. (1982). Anorexia nervosa treated with response prevention and prolonged exposure. Behavior Research and Therapy, 20, 27–31.

    Article  Google Scholar 

  • McFarlane, A. H., Bellissimo, A., & Upton, E. (1982). “Atypical” anorexia nervosa: Treatment and management on a behavioral medicine unit. The Psychiatric Journal of the University of Ottawa, 7, 158–162.

    PubMed  Google Scholar 

  • Meichenbaum, D. (1974). Therapist manual for cognitive behavior modification. Ontario: University of Waterloo Press.

    Google Scholar 

  • Minuchin, S., Rosman, B., & Baker, L. (1978). Psychosomatic families: Anorexia nervosa in context. Cambridge: Harvard University Press.

    Book  Google Scholar 

  • Muuss, R. E. (1985). Adolescent eating disorder: Anorexia nervosa. Adolescence, 20, 525–536.

    PubMed  Google Scholar 

  • Neuman, M., & Gaoni, B. (1975). Preferred food as the reinforcing agent in a case of anorexia nervosa. Journal of Behavior Therapy and Experimental Psychiatry, 6, 331–333.

    Article  Google Scholar 

  • Nylander, I. (1971). The feeling of being fat and dieting in a school population. Acta Socio-Medica Scandinavica, 3, 17–26.

    PubMed  Google Scholar 

  • Ollendick, T. H. (1979). Behavioral treatment of anorexia nervosa. Behavior Modification, 3, 124–135.

    Article  Google Scholar 

  • Peake, T., & Borduin, C., (1977). Behavioral and analytical approaches to the treatment of anorexia nervosa: A case study. Family Therapy, 4, 49–56.

    Google Scholar 

  • Pertschuk, M. J. (1977). Behavior therapy: Extended follow-up. In R. A. Vigersky (Ed.), Anorexia nervosa (pp. 305–314 ). New York: Raven.

    Google Scholar 

  • Powers, P. S., & Powers, H. P. (1984). Inpatient treatment of anorexia nervosa. Psychosomatics, 25, 512–527.

    Article  Google Scholar 

  • Ross, A. O. (1980). Psychological disorders of children: A Behavioral approach to theory, research and therapy ( 2nd ed. ). New York: McGraw-Hill.

    Google Scholar 

  • Salkind, M. R., Fincham, J., & Silverstone, T. (1980). Is anorexia a phobic disorder? A psychophysiological enquiry. Biological Psychiatry, 15, 803–808.

    PubMed  Google Scholar 

  • Schwartz, D. M., & Thompson, M. G. (1981). Do anorexics get well? Current research and future needs. American Journal of Psychiatry, 138, 319–323.

    Article  Google Scholar 

  • Scrignar, C. B. (1971). Food as the reinforcer in the outpatient treatment of anorexia nervosa. Journal of Behavior Therapy and Experimental Psychiatry, 2, 31–36.

    Article  Google Scholar 

  • Slade, P. (1982). Towards a functional analysis of anorexia nervosa and bulimia nervosa. British Journal of Clinical Psychology, 21, 167–179.

    Article  Google Scholar 

  • Vandereycken, W., & Meermann, R. (1984). Anorexia nervosa: A clinician’s guide to treatment. Berlin: Walter de Gruyter.

    Book  Google Scholar 

  • Whipple, S. B., & Manning, D. E. (1978). Anorexia nervosa: Commitment to a multifaceted treatment program. Psychotherapy and Psychosomatics, 30, 161–169.

    Article  Google Scholar 

  • Ziesat, H. A., & Ferguson, J. M. (1984). Outpatient treatment of primary anorexia nervosa in adult males. Journal of Clinical Psychology, 40, 680–690.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Mental Health Sciences, Hahnemann University, Philadelphia, Pennsylvania, 19102, USA

    Janet Sasson Edgette

  2. Institute for Graduate Clinical Psychology, Widener University, Chester, Pennsylvania, 19013, USA

    Maurice F. Prout

Authors
  1. Janet Sasson Edgette
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maurice F. Prout
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Center for Cognitive Therapy, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA

    Arthur Freeman  & Karen M. Simon  & 

  2. Department of Psychiatry, College of Medicine, University of Arizona, Arizona Health Sciences Center, Tucson, Arizona, USA

    Larry E. Beutler

  3. Department of Psychology, University of Arizona, Tucson, Arizona, USA

    Hal Arkowitz

Rights and permissions

Reprints and permissions

Copyright information

© 1989 Springer Science+Business Media New York

About this chapter

Cite this chapter

Edgette, J.S., Prout, M.F. (1989). Cognitive and Behavioral Approaches to the Treatment of Anorexia Nervosa. In: Freeman, A., Simon, K.M., Beutler, L.E., Arkowitz, H. (eds) Comprehensive Handbook of Cognitive Therapy. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-9779-4_19

Download citation

  • DOI: https://doi.org/10.1007/978-1-4757-9779-4_19

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4757-9781-7

  • Online ISBN: 978-1-4757-9779-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation