Anorexia nervosa in the Kibbutz: Factors influencing the development of a monoideistic fixation

Abstract

Among the diverse psychiatric entities with stagnating monothematic thoughts, anorexia nervosa occupies a significant place as a typical example of a “monoideistic” illness. The dominant idea (about food, dieting, weight loss, and body shape), repeated mentally over and over again and deeply rooted in family and other interpersonal transactions, can engender an hyponotic‐like state. Our interest in anorexia nervosa as one of the most typical monoideistic diseases gained in strength as we noted that in the course of the past 15 years there was an ever‐growing stream of referrals to the Kibbutz Clinic of adolescent girls with anorexia nervosa. For this reason we opened an anorexia nervosa treatment unit and have been able to carry out prospective followups on 66 kibbutz anorectic patients (40 restricters and 26 bulimics) over periods from 4 to 10 years. We were particularly interested in the answer to the question of whether the nosogenesis of the monoideistic pattern, the family and sociocultural factors, and the course and the outcome of the illness are different in the kibbutz population as compared with other settings.

Eating disorders and disordered eating in Israel: An updated review

“…EDs were considered extremely rare in the Kibbutzim until the mid 1960s. However, assessment of the change in the annual incidence of AN among female Kibbutz members from the mid 1960s to the late 1980s yielded an overall increase of 800%, an increase considered significantly greater compared to the general Israeli society (Kaffman & Sadeh, 1989). The trend towards high rate of disturbed eating attitudes and behaviours in the Kibbutz in the 1980s and early 1990s was also described in non-clinical populations.…”

“…Apter et al (1994), who assessed Israeli schoolgirls of different residential settings in the late 1980s, found that more than 25% of Kibbutz girls had pathological EAT-26 scores, a significantly higher rate than that found in other groups of Israeli schoolgirls. Kaffman and Sadeh (1989) relate the increase in full-blown AN to changes in the structure of the Kibbutz, particularly in terms of an increase in food availability and consumption, and to changes in women's perception of their gender role. Apter et al (1994) attribute their finding to the unique situation of Kibbutz female adolescents in the 1980s, who are caught in a severe role conflict between the traditional nurturing female and the independent, sexually liberated 'new Kibbutz woman'.…”

“…From a different perspective, Kibbutz members have always tended towards greater use of medical services in general and mental health services in particular compared with the general Israeli population (Apter et al, 1994;Kaffman & Sadeh, 1989). A recent study has shown this trend to be present also in the case of EDs, namely the proportion of patients from the Kibbutzim seeking ambulatory treatment in the largest ED clinic in the north of Israel (16%) has been found to be considerably greater than their overall rate in the general Israeli population (1.8%), although Kibbutz members are not overrepresented in inpatient ED treatment facilities.…”

“…This decrease in the rate of maladaptive eating-related preoccupations and behaviours can also be the result of a recent implementation of an ED prevention programme in the Kibbutzim (Latzer & Shatz, 1999), as a response to the increase in the rate of EDs during the 1970s and 1980s. Thirdly, the high availability and high standards of medical services in the Kibbutzim (Blank, 1995;Shlaski, 1997) combined with high awareness of health care and positive attitudes towards seeking professional help may have also potentially contributed to the decrease in the prevalence of EDs in the Kibbutzim (Apter et al, 1994;Kaffman & Sadeh, 1989;Latzer, Vander, & Gilat, 2008).…”

Hypnotizability, Attitudes toward Eating, and Concern with Body Size in a Female College Population

“…It could be speculated that different aspects of hypnotizability might relate to both the etiology and maintenance of extreme attitudes towards eating and weight regulation. Waking suggestibility might be a factor in the transmission of shared beliefs ("be thin") within a person's family and culture (Schumaker & Groth-Marnat, 1988;Swartz, 1985), and the dissociative aspect of hypnotizability might relate to the perceptual distortions and dissociative phenomenon frequently reported in populations with extreme concern with food regulation (Bliss, 1982(Bliss, , 1983Kaffman & Sadeh, 1989). In particular, the family is likely to be a significant factor in the formation of attitudes towards eating and weight regulation.…”