Introduction
Emma is a 15 year old diagnosed with anorexia nervosa (AN). The aim of this report is to take a holistic approach to examining the impact of this diagnosis will have for Emma, encompassing the physical/ biological, intellectual, social, emotional and spiritual aspects of her life that will be affected .It will also examine the OT role and its ability to help Emma through intervention and the OT process. The report aims to examine what an OT, and do with a referral like Emma’s and the theory and evidence they would use to support their choice of intervention.
The name Anorexia Nervosa come from the Latin meaning a nervous inability to eat. Anorexia Nervosa can be described as a psychiatric disorder in which the unrealistic fear of weight gain leads to self-starvation and a distorted body image. It can seriously compromise health and can be fatal. Between 4-8% of those with anorexia literally starve themselves to death, others die from cardiovascular failure. (Cushing & Waldrop, 2010)
In January 2014, new statistics from the Health and Social Care Information Centre (HSCIC) showed a rise of 8% in hospital admissions relating to eating disorders, 91% of them were female. (HSCIC, 2014)
Three out of four admissions were for Anorexia Nervosa. It is interesting to note that the most common age for female admissions was 15 years old, as Emma too is 15 and her condition is deteriorating possibly due to the pressures of having to taking GCSE. For the purpose of this report, the occupational impact on family life, education and leisure will examined.
Between the ages of 6 and 12, children averagely included in weight by 6 pounds and grow 2-3 inches (Gabbard 2011). Girls carry slightly more fat than muscle than boys and grow faster, reaching 94% of their adult height (Tanner 1990). The frontal lobes of the cerebral cortex also experience a growth spurt, areas that govern logic and planning. An increased ability to concentrate through improved reticular formation also occurs at this age. (Wetzel, Widman, Berti et al 2006), as well as the ability to choose what to concentrate on.
The changes for Emmas stage of development are perhaps the most profound, bridging the gap between childhood and adulthood. The brain experiences another growth spurt affecting spatial perception and motor function (Spreech et al. 1995) Executive processing also improves.
Pertinent to Emma, the shape and proportions of the body change in puberty. These changes in particular could be one of the triggers for her illness as could puberty and sexual maturation.
Anorexia Nervosa will have a direct effect on Emmas physical wellbeing, in line with the symptoms of starvation. These in turn will impact on her occupations, both current and those she wishes to attain in the future. Anorexia Nervosa leads to lack of sleep, poor concentration, dizziness and fainting, that all of which will affect her chances of success at GCSE. Her periods will stop, she will feel cold and continually tired and weak. Stomach pains and swelling, constipation and/or diarrhoea and bone weakness are all implications if the Anorexia Nervosa is not controlled. (NHS)
Emma’s ambition is to go to college to study hair and beauty. Her diagnosis directly affects the possibility of this happening as she will simply be too unwell to cope with the demands both of college and her chosen career. The chemical imbalance caused by starvation can present as personality changes, disorientation, depression and mood swings (Hirst 2002). In an already tense family relationship with both her parents and younger sister, these symptoms can only exacerbate and inflame the family dynamics.
Intellectually, Anorexia Nervosa in adolescence is associated with ‘developmental and psychological regression and parental dependence’. At a point in her life where Emma should be forming new, more mature relationships outside her family, she remains frozen in an adolescent mindset. (Crisjo 1997)
In progression from