Anorexia Nervosa and its Differential Diagnosis Summary

Hilde Bruch dissects the essence of anorexia in the article, “Anorexia Nervosa and Its Differential Diagnosis”. Bruch argues that the concept of the “pursuit of thinness” should separate anorexia from other psychiatric conditions concerning weight loss. The essential element is whether clinical evidence can support the need of separation from other psychiatric conditions. If so, what would be the diagnosis and treatment? Bruch contends that recognition and isolation of problems disturbing elemental living of individuals paired with assessment of coping methods is vital for diagnosis and treatment.

To support claims, Bruch conducts a study involving Forty-three male and female anorexia nervosa diagnosed patients from 1942 to 1960. The patients’ social classes, age, ethnicity, and religion varied. Two distinct types emerged due to the study. Thirty patients suffered from lack of control of identity losing a life threatening battle for thinness completed the first type. Within this group strange eating habits including binging and purging were noticed. The remaining thirteen patients formed the second type. This type’s weight loss revolved around unique issues discerning differently with each case. These patients suffered from various phobias, conversion hysteria, psychoneurosis, and schizophrenia when eating habits did not provide the desired attention.

Three areas of disordered psychological functioning were eminent in the first type. As a result, delusion regarding body image and proportion was the first symptom. Following delusions, was a disturbance in the accuracy of cognitive interpretation arising within the body. The most significant disturbance lied within the neglect of interpretation of hunger and nutritional needs. The final function was a sense of ineffectiveness. The patients lacked the ability to perform actions due to their own interests. These patients would only do what they were told to do.

Conclusively, Bruch established that using motivational interpretations was a useless treatment for the forty-three patients. On the other hand, using a “fact finding” approach worked substantially better. Finally, Bruch uses his study to find the issue within classifying anorexia nervosa. Psychiatric conditions involving weight loss should be separated from anorexia due to the difference of psychological emaciation.