Anorexia nervosa, as affects the female population
Anorexia nervosa is a psychiatric disease characterized by a restriction of energy intake that leads to dangerously low body weight, an intense fear of weight gain, alterations in body image and deficiencies in the perception of the potentially mortal implications of the Stateemaciated. In the current diagnostic and statistical manual of mental disorders, fifth edition (DSM-5), the nervous anorexia is classified in the ‘eating disorders and food ingestion section’, along with other conditions such as Pica, rumination disorder, restrictive food intake disorder, binge disorder and bulimia nervosa (American Psychiatric Association, 2013), (Phillipou, Castle & Rossell, 2018). It can affect people of all ages, sexes, sexual orientations, ethnic races and origins;However, adolescents and young adult women are older population at risk. Anorexia nervosa motivates severe dietary restrictions or other weight loss behaviors, such as purges or excessive physical activity. The quality of life is poor and the burden that falls on people, families and society is high. (Zipfel, Giel, Bulik, Hay & Schmidt, 2015)
The neurocognitive markers of anorexia nervosa include difficulties of the set of set, that is, difficulties in changing between different tasks and little central coherence, (preference for local processing, focused on details, on the global – overview). Both the stage of the disease and the duration and gravity affect daily performance (Lang, Lopez, Stahl, Tchanturia & Treasure, 2014), people with anorexia nervosa also have difficulties in socio -emotional processing, showing attention biases, recognition, regulation, regulationand expressiveness of deteriorated emotions, and a poor theory of mind. These difficulties are present both in the sick state and after recovery. Prospective longitudinal studies of children with a high family risk of eating disorders suggest that some neurocognitive and social cognitive vulnerabilities are present from an early age (Caglar-Nazali, Corfield, Cardi, Ambwani, Leppanen, Olabintan & Micali, 2014).
According to structural neuroimaging studies, the abnormalities of brain tissue are restored with weight recovery (van den eynde f, Suda, Broadbent, Guillaume, van den eynde m, Steiger & Treasure, 2012). An increase in the volume of gray matter of the medial orbito-frequent cortex is noticed both in adults with adults with nervous anorexia, which persists in the recovery. The Orbito-Frontal cortex evaluates the quality and value of reward stimuli, such as food, and is involved in the regulation of specific sensory satiety. In addition, participants with anorexia nervosa had increased the gray matter of the right insula compared to the controls. The right previous insula is associated with self-recognition and interoceptive consciousness. Longitudinal studies are needed in populations at risk to completely evaluate if these changes are biomarkers of the disease. (King, Geisler, Ritschel, Boehm, Seidel, Roschinski & Roessner, 2015), (Frank, 2015)
Based on neuroimaging studies findings, such as PET and Spect brain image studies, it is pointed out that some temperamental and personality features of childhood, such as anxiety, obsessions and perfectionism could reflect neurobiological risk factors for the development of the development ofAnorexia nervosa. Therefore, restrictive feeding could be a means to reduce the negative affection caused by the imbalance between serotonergic systems (aversive or inhibitors) and dopaminergic (reward) (Wierenga, Bischoff-Grethe, Melrose, Grenesko-Stevens, Irvine,Wagner & Kaye, 2014). The role of stress, fear, anxiety and change after compulsive or usual behaviors such as key factors in the persistence of the disease has also been highlighted. (Guardian, Schreyer, Boersma, Tamashiro & Moran, 2015), (Walsh, 2013), (Godier & Park, 2014)
Development risk factors include adverse adverse, perinatal and neonatal adverse events, such as dysmadurez or prematurity, (Tenconi, Santonstasaso, Monaco & Favaro, 2015), as well as food and sleeping difficulties in childhood. In childhood, emerging personality traits associated with anxiety, depression, perfectionism and autistic spectrum have been identified as risk factors for nervous anorexia (Jacobi, Hayward, Zwaan, Kraemer & Agras, 2004). Adolescence is characterized by deep changes and usually represents the period of first start of anorexia nervosa, which may be due to hormonal changes and deregulations of the functioning of neurotransmitters, cerebral maturity and genetic factors (Herpertz-Dahlmann, Seitz & Konrad,2011).
The female gender has proven to be a population of risk for anorexia nervosa. “The increase in nervous anorexia in low and medium -sized countries suggests that cultural transitions associated with industrialization, urbanization and globalization could be associated with environmental risk for disease, due to the adoption of western lifestyle, such as nutritional habits and the ideal ‘thin’ ”(Herpertz-Dahlmann, Seitz & Konrad, 2011), (Jacobi, Hayward, Zwaan, Kraemer & Agras, 2004).
It is also necessary. Food function is a central organizer of psyche. At birth, it is in a state of helplessness, so that its survival depends on another;whom the baby must ask through shout and crying to obtain the satisfaction of their needs. But that other is a speaking being;Within a symbolic system (words) and will force the baby (without language) to express their own needs in a significant way. Hunger is a phenomenon experienced by every human being that is perceived by each individual in a different way. The symbolic meaning of food can be among many others, a form of control, to attract attention or challenge towards parents. Food can serve as a defense in the process of assuming adulthood and responsibility. Sometimes it can mean a solution to emotional problems ”(Bárcena, 2004).
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