Perspectiva evolucionista de los trastornos de la conducta alimentaria

Abstract

Evolutionary theory has contributed with physiological, psychological and behavioral explanations to the comprehension and treatment of eating disorders (ED). The aim of this review is to analyze the relationship between ED and the attachment theory and natural selection based hypotheses (famine fl ight, reproductive suppression and intrasexual competition. Entre las diversas aproximaciones que han contribuido a la comprensión de estas patologías, la teoría evolucionista aporta una síntesis de explicaciones fi siológicas, psicológicas y conductuales que han permitido enriquecer su abordaje fenomenológico-clínico y terapéutico 2 , distinguiendo entre la causalidad próxima -suma de todos los procesos biológicos (bioquímicos, fi siológicos, etc.) y psicológicos que directamente producen el fenómeno-; y remota -el alcance de la participación de un rasgo o sistema de la aptitud reproductiva de un organismo en su medio ambiente natural (ancestral) 3 . El objetivo de este trabajo es describir los postulados evolucionaríos que se han aplicado a los TCA, desde la precursora teoría del apego planteada por Bowlby, reforzada por las experiencias de Harlow y Sptiz, hasta las clásicas hipótesis darwinianas basadas en el fenómeno de la selección natural: de la huída de la hambruna, relacionada principalmente con aspectos fi siopatológicos; de la supresión reproductiva referida a la dinámica familiar y de la competencia intrasexual concerniente a la perspectiva psicosocial de estas patologías. Con esta fi nalidad, se efectuó una búsqueda de evidencia sobre el tema en publicaciones, tanto en idioma inglés como español, de artículos originales, de revisión y de presentación de casuística, entre 1859 y 2010, en textos especializados y en las bases de datos Medline/PubMed, utilizando palabras claves como eating disorders, anorexia nervosa, bulimia nervosa, evolutionary, darwinian, attachment.

Eating Problems in Adolescents and Youths: Explanatory Variables

“…These results with regard to anxiety and depression support García-Villamisar et al's (2012) findings that in people with ED or AR-ED, depression indexes were Eating Problems 7 higher than in the general population, possibly because depression makes people more susceptible to developing ED. Differences between AR-ED and WR-ED patients on the variables accompanying the EDI were found in earlier studies, too, particularly ineffectiveness, perfectionism, maturity fears, interoceptive awareness, interpersonal distrust, and impulsivity (Behar, 2012;Lundahl et al, 2015;Sehm & Warschburger, 2015). However the present study found differences in all the accompanying variables, suggesting AR-ED participants display tremendous clinical alteration.…”

“…Differences between AR-ED and WR-ED patients on the variables accompanying the EDI were found in earlier studies, too, particularly ineffectiveness, perfectionism, maturity fears, interoceptive awareness, interpersonal distrust, and impulsivity (Behar, 2012; Lundahl et al, 2015; Sehm & Warschburger, 2015). However the present study found differences in all the accompanying variables, suggesting AR-ED participants display tremendous clinical alteration.…”

“…Lundahl, Wahlstrom, Christa, and Stoltenberg (2015) reported a strong association with ED in both sexes, whereas Fernández and Pritchard (2012) found impulsivity and anger were more strongly associated with male behaviors, while selective attention to one’s body and perfectionism were more closely associated with female behaviors. Some studies have reported that the prevalence of ED in females comes with a higher prevalence of asceticism, social insecurity, and interpersonal distrust (Behar, 2012).…”

“…2 C. Maganto et al prevalence of asceticism, social insecurity, and interpersonal distrust (Behar, 2012).…”

Mediators linking insecure attachment to eating symptoms: A systematic review and meta-analysis

“…Likewise, results of previous reviews did not reveal conclusive data on the existence of an association between specific attachment patterns and ED subtypes [2,3]. For instance, while some authors [79,80] have found an association between avoidant attachment and AN, and anxious attachment and BN, others claim that most people with ED have either an avoidant attachment [81] or an anxious insecure attachment [82]. In light of these findings, further research should perform mediating analyses distinguishing between different diagnoses of ED, as the indirect effect of specific mediating mechanisms might be different regarding the nature of the symptomatology (e.g., emotion dysregulation might have a greater impact on bulimic symptoms).…”