History Taking Strategy: Anorexia Nervosa
Eating disorders have been popularized by society's fascination with weight and a thin body. These disorders can be grouped in to three categories: refusing to maintain a minimally normal body weight (anorexia nervosa), eating in binges and then purging (bulimia nervosa), and bingeing without purging. The Merek Manual defines anorexia nervosa as a disorder characterized by a distorted body image, and extreme fear of obesity, refusal to maintain a minimally normal body weight and in women, the absence of menstrual periods. The University of California Los Angeles states that "certain personality traits such as perfectionism may contribute to anorexia." (UCLA, 2006); it is also thought that cultural and psychological factors may contribute as well. This body image and eating disorder usually begins in adolescence, and primarily affects people in middle and upper socioeconomic classes. In the United States it is approximated that up to 1% of young American women have such an eating disorder. The following is a scenario demonstrating history taking techniques of a 16 year old female patient recently diagnosed with anorexia nervosa, taking into account the patients age and education level, such an assessment would be more effective in a comfortable environment that complimented the patients age and knowledge. Leslie is a 16 year old female student currently just starting her sophomore year in high school; she is well groomed and meticulous in her studies as well as in her extra curricular activities. She enjoys school, holding a GPA of 4.0 and has made the deans list multiple times; currently she is taking advanced placement English and history and plans to continue with her AP studies with the hopes of graduating early and studying medicine in college. She's active with various clubs, including the president of the Christian club as well as the Asian American club. Aside from her academic studies she excels in sports;...
References: Berkow, R. (1997). The merck manual of medical information. Eating disorders,
(pp. 451- 454). New York, NY: Merck & Co.
Jarvis, C. (2004). Physical examination & health assessment (4th Ed.). St. Louis, MO: Saunders.
UCLA health and medicine news (April, 04, 2006): UCLA researchers seek relatives with anorexia nervosa for international genetic study of eating disorder. Retrieved May 10, 2006, from http://healthsciences.ucla.edu/news/detail?rad_id=6947
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