1. Theories of Motivation Hunger Motivation Eating Disorders
Intro Psych
Module 26
Nov 2-6, 2009
Classes #28-30

2. Motivation
The underlying processes that initiate, direct and sustain behavior in order to satisfy physiological and psychological needs or wants

3. Theories of Motivation
Instinct Theory
Drive Reduction Theory
Arousal Theory
Optimal Level Hypothesis
Incentive Theory

4. Instinct Theory Instinct Do humans have instincts?
Complex unlearned response triggered by a stimulus or complex stimulus
Do humans have instincts?
Early Darwinian Theory (1800’s) proposed the idea of instinct, arising from genetic endowment
William James (1890) proposed an instinct theory in humans
Instincts were goal directed predispositions to behavior

5. Instinct Theory Paradox in Psychology:
As others were showing that animal behavior could be modified by learning (Thorndike), James was proposing that much of human behavior was unlearned
William McDougall (1908) followed…
Suggested their were 18 instincts

6. Instinct Theory
McDougall (1908) theorized that motivated behaviors are instinctual:
Unlearned
Uniform in expression (do not change with practice)
Universal (all members of a species show the same behavior)

7. Too many limitations…
By 1924 instinct theory was becoming obsolete as there were several criticisms:
Too many instincts
Researchers came up with 5759 of them
Logic was circular
i.e. the only evidence that an instinct exists was the behavior it supposedly explained
He’s an “overachiever” because he’s “hard-working”
She’s “hard-working” because she’s an “overachiever”
Just meaningless labels with no explanations

8. Drive Reduction Theory (Hull, 1943)
Supporters of this theory believe that when a need requires satisfaction, it produces drives
These are tensions that energize behavior in order to satisfy a need
Thirst and hunger are, for instance, drives for satisfying the needs of eating and drinking, respectively

9. Drive Reduction Theory
Drives have been generally established as primary and secondary…
Primary drives satisfy biological needs and must be fulfilled in order to survive
Homeostasis is the motivational phenomenon for primary drives that preserves our internal equilibrium. This is true, for example, for hunger or thirst
Secondary drives satisfy needs that are not crucial to a person's life 

10. Criticism
Critics felt that this theory was inadequate in explaining secondary drives

11. Arousal Theories
Optimal Level Hypothesis

12. Optimum Arousal Theory: Hebb (1955) and Zuckerman (1984)
This theory argues that we all have optimal levels of stimulation that we try to maintain…
Optimal Level Hypothesis
we seek an optimal level of arousal
too little stimulation, we seek an increase
too much, we seek to decrease

13. Eysenck (1967) Extraversion-Introversion
Introverts were over-aroused individuals therefore they try to keep stimulation to a minimum
Extroverts were under-aroused individuals, therefore they tried to increase stimulation

14. Eysenck (1967) Cortical Arousal Differences
Eysenck suggests that the difference between introverts and extroverts depends on the ascending reticular activating system (ARAS)
Causes introverts to be “stimulus shy”
Causes extroverts to be “stimulus hungry”

15. Cortical Arousal Differences
Geen (1984)
Introverts and extraverts choose different levels of stimulation, but equivalent in arousal under chosen stimulation
Extroverts chose to hear louder noises than introverts
After put in their chosen environment their HR’s are the same
This seems to suggest that being at their preferred level of stimulation results in the same overall level of arousal for both groups

16. Geen (1984) Researcher tested four other groups:
Introverts placed in environment that other introverts had chosen (II)
Introverts placed in environment that extroverts had chosen (IE)
Extroverts placed in environment that other extroverts had chosen (EE)
Extroverts placed in environment that introverts had chosen (EI)

17. Geen (1984) II = similar HR as free choice introverts
IE = higher HR than free choice introverts when forced to listen to extroverts’ noise
EE = similar HR as free choice extroverts
EI = lower HR than free choice extraverts when forced to listen to introverts’ noise

18. Geen (1984) Performance on a learning task was also affected:
Introverts did best in introvert-selected environment
Extraverts did better in extravert-selected environment
Practical implications:
Roommates?
Mate Selection?

19. Does it explain the psychopathic behaviors???
Serial killer

20. Criticism of Optimum Arousal Theories
People differ greatly in the optimal level of arousal they seek…
These theories do not explain why

21. Incentive Theory
Viewpoint on motivation that is different than instinct, drive , and arousal theories
Suggests that behavior is pulled rather than pushed…
Emphasizes the role of environmental stimuli that can motivate behavior by pulling people toward them rather than pushing people to satisfy a need (as in the drive-reduction theory)
Suggesting that people act to obtain positive incentives and avoid negative incentives
Explains secondary drives much better than drive-reduction theory

22. Criticism
Some behaviors seem to be pushed as well

23. Abraham Maslow (1908-1970) Born in Brooklyn, NY
His parents were uneducated Jewish immigrants from Russia
Hoping for the best for their children – they pushed them hard towards education
He became very lonely as a youth and found his refuge in books
To satisfy his parents, he entered law school at CCNY and then Cornell

24. Abraham Maslow
Against his parents wishes, he married his first cousin and moved with her to Wisconsin where he became interested in psychology and gets his BA in 1930, MA in 1931, and Ph.D. in 1934 at the Univ. of Wisconsin
In 1935, he returns to NY and works with Thorndike at Columbia and eventually begins teaching full-time at Brooklyn College and then becomes chair of psych department at Brandeis where he begins his crusade for humanistic psychology

25. Maslow’s Hierarchy of Needs (1970)
Abraham Maslow proposed that there are five levels of motives, or needs, arranged in a hierarchy:
Physiological
Safety
Belongingness and love
Esteem
Self-actualization
We must satisfy needs or motives low on the hierarchy before we are motivated to satisfy needs at the next level

26. Physiological Needs
Physiological needs are basic, instinctual needs for air, food, water, and sex, among others. These needs must be at least partially met in order to ascend the hierarchy.
These needs can also be arranged in their own hierarchy.

27. Safety Needs
Safety needs include things such as shelter, security, and protection from physical and emotional harm.

28. Belonging Needs
These needs are met by having meaningful relationships, such as significant others, friends and children

29. Esteem Needs This level has two sub-levels
Low esteem needs are the needs for the respect of others – need for recognition, etc.
Higher esteem needs are the needs for self respect –to achieve, to be competent, to be independent, etc.

30. Self Actualization
Self actualization involves becoming the most complete person that you can be – your full potential

31. Criticisms Some critics felt that it is possible to skip levels
Others felt that they could not be applied universally

32. Theories of Hunger Motivation What triggers our motivation to eat?
Internal Factors
An empty stomach?
Body Chemistry
Hypothalamus
Set Point Theory
External Factors
Externality Hypothesis
Other Factors
Emotion
Habit
Attention

33. Internal Factors An empty stomach?
Early researchers thought that hunger pangs were important - caused by contraction of stomach
Cannon and Washburn (1912) tested the hypothesis that the contraction of the stomach is the cue to start eating
Tested this by having Washburn swallow a balloon and measuring contractions of the stomach by looking at contractions of the balloon (changes in air pressure go out stomach via tube to measuring device)

34. An empty stomach? Tsang (1938)
Removed rats stomachs and attached their esophagus to their small intestine
They still displayed actions associated with hunger

35. Body Chemistry Blood Glucose Insulin
This is a simple sugar used by most cells in the body for energy - most food ultimately gets converted to blood glucose
Decreasing blood glucose levels  sense of hunger
Insulin
This is a hormone that increases the flow of glucose into body cells, diminishing the amount of glucose in the blood by converting it into stored fat

36. Body Chemistry Glucagon
This hormone helps convert stored energy supplies (stored fat) back into blood glucose
Increasing blood glucose levels  hunger decreases

37. Lesions of Hypothalamus
The destruction or stimulation of the lateral and ventromedial areas causes animals to ravenously decrease or increase their weight
See picture on page 375 for example of increase

38. Set Point Theory Set point is the weight that your body wants to be…
It is a self-regulatory system that maintains your body weight
If you starve yourself the hypothalamus activates compensatory mechanisms, your metabolism slows so that energy stores are used more sparingly and the amount of insulin that is produced increases so that more of the food that you take in remains as fat (this makes it possible to maintain weight on a meager diet)

39. What triggers our motivation to eat?
External Incentives
Rodin (1981)
Like Pavlov’s dogs people learn to salivate in anticipation of appealing foods
Externality Hypothesis (Schacter, 1978)
Did research on obese humans
They argue that the difference between obese and normal weight subjects is that the obese are overly responsive to external stimuli (cues for eating)

40. Externality Hypothesis
VMH-lesioned rats and obese humans are similar in interesting ways:
Both are more "finicky" than controls. Both are less willing to work for food
VMH-lesioned rats don't eat as much of a bad tasting food as do control rats
Obese humans don't drink as much of a bad-tasting milk shake as do control humans
VMH-lesioned rats don't bar-press for food on "lean" schedules as readily as do the control rats
Obese humans eat fewer peanuts than do control humans if they have to shell them, but more if they don't have to do this work

41. Externality Hypothesis
These findings support Schacter's conclusion that  both VMH-lesioned rats and obese humans are more sensitive to external cues related to food than to the internal cues provided by their bodies.
Obese humans are more likely to eat more when they are misled into thinking it's lunchtime than are control humans - again evidence of the influence of external cues
Social Factor is another external cue
Eating around others often increases food intake

42. Other Factors Emotion Habit Attention
Depressed people may eat too much or too little
Habit
Meal time - ancient Romans only ate two meals a day. We eat three - if we miss a meal, we feel hungry at that meal time
Attention
Awareness vs. non-awareness

43. Eating Disorders
Obesity
Anorexia Nervosa
Bulimia Nervosa

44. Obesity
Weight which is 20-40% above the normal standard for a person’s height (BMI over 30 kg/m2)
Rates of obesity are climbing and have risen from 12 to 20 percent of the population since 1991.
An ominous statistic which indicates that the epidemic of obesity may get even worse is that the percentage of children and adolescents who are obese has doubled in the last 20 years
Why is this happening?

45. Basal Metabolic Rate
Basal metabolic rate (BMR) is the amount of energy expended while at rest in a neutrally temperate environment, in the post-absorptive state (meaning that the digestive system is inactive, which requires about twelve hours of fasting in humans).
If you've noticed that every year, it becomes harder to eat whatever you want and stay slim, you've also learnt that your BMR decreases as you age. Likewise, depriving yourself of food in hopes of losing weight also decreases your BMR, a foil to your intentions.
M > W (more muscle)
Exercise increases BMR

46. Obesity
Weight which is 20-40% above the normal standard for a person’s height
Rates of obesity are climbing and have risen from 12 to 20 percent of the population since 1991.
Why is this happening?

47. Obesity Why do some people become seriously overweight?
Emotional problems
Depression
Anxiety
Sedentary lifestyle
Too much TV and not enough exercise
Genetics
Higher set point

48. What factors help prevent obesity?
Preventing obesity must begin in childhood
Breastfed children less obesity
Encouraging children to exercise and eat healthy foods
don’t use “special food” as a reward – Stanek et al. (1990)
children tend to be more interested in a “forbidden food” –– Mennella et al. (2001)
Limiting television watching
Problem with adult modeling, increase consumption of snacks low in nutrients and watching TV during meals increase consumption of salty snacks and pop and less fruit and vegetables – Goldberg et al. (2001)
Many ads have low-nutrient beverages and sweets – Story and Faulkner (1990)

49. How is obesity treated? Fad Diets
Exaggerated claims based on false theories
Potentially harmful
Weight Cycling
Set point theory?
Psychological ramification

53. Weight Cycling

54. Psychology of Weight Cycling

55. How is obesity treated? Eating less and eating smarter
Meals in US – much bigger portions than elsewhere
Physical Activity - Increasing exercise
Activity and BMR- activity increases BMR
Activity and appetite control
energy released from stores (plasma glucose normal)
digestive functions are suppressed
setting short-term goals
reminders or prompts
making behavior fit into daily schedule/ routine
Eating less

56. How is obesity treated? Operant conditioning approaches
Make small changes to behavior
Having the support of family members, and friends – social support
Other self-control approaches
Behavior and Attitude
stimuli   behavior   consequence
Awareness of behavior
why do I eat, when, where

57. Anorexia

58. Anorexia Nervosa Anorexia Nervosa
Self-starvation and severe weight loss
Usually starts as an innocent diet that went out of control
They eat less and exercise more
Often they come from high-achieving or over-protective families
At first, self-esteem was raised – “you look great”

59. Symptoms Of Inadequate Energy Intake
Physical health
Mental health
Concentration
Decisions
Irritability
Depression
Social withdrawal
Obsessiveness (food)
Amenorrhea
Cold hands/feet
Constipation
Dry skin/hair loss
Headaches
Fainting/dizziness
Lethargy
Anorexia

60. Anorexia Nervosa Complications Hypothermia may result
Results when the body’s natural isolation fat stores become non-existent and the victim becomes cold all the time
Some must be tube-fed to prevent death
Some will die from heart failure

61. Anorexia Nervosa Prognosis
With individual, group, and family therapy there is a good chance for improvement and hopefully recovery
Anti-depressants are often combined with these therapies
It is a life-long process though

62. Anorexia Nervosa (pursuit of thinness)
Successful Weight Loss – Hallmark of Anorexia
Defined as 15% below expected weight
Intense fear of obesity and losing control over eating
Anorexics show a relentless pursuit of thinness, often beginning with dieting
DSM-IV Subtypes of Anorexia
Restricting subtype – Limit caloric intake via diet and fasting
Binge-eating-purging subtype – About 50% of anorexics
Associated Features
Most show marked disturbance in body image
Most are comorbid for other psychological disorders
Methods of weight loss can have severe life threatening medical consequences

63. Anorexia: Facts and Statistics
0.5-5% year old females
Majority are female (90-95%) and white (> 95%), from middle-to-upper middle class families
Usually develops around age 13 or early adolescence
Tends to be more chronic and resistant to treatment than bulimia
3rd most common chronic illness in adolescents

65. Major Systems Affected
Metabolic
Hypometabolism/
Refeeding Syndrome
Cardiovascular
Arrhythmias
Musculoskeletal
Osteoporosis
Reproductive
Amenorrhea

66. Bulimia Nervosa (avoidance of obesity)
Associated Features
Most are within 10% of target body weight
Most are over concerned with body shape, fear gaining weight
Most are comorbid for other psychological disorders
Purging methods can result in severe medical problems

67. Bulimia Nervosa
Disorder characterized by repeated binge-purge episodes of overeating followed by vomiting or using a laxative
Again, mostly women in their early teens
These individuals can be thin, average in weight or even overweight – so this one is more likely to go unnoticed by family or friends

68. Bulimia Nervosa Symptoms of Bulimia Eating binges Purging Sore throat
Mouth and throat ulcers
Swollen salivary glands
Destruction of tooth enamel
Depression, obsessive-compulsive symptoms

69. Bulimia Nervosa Prognosis
With the long-term psychotherapy combined with group and family therapy the patient will likely improve
Often, anti-depressants are combined with therapy
Again, this is a life-long process

70. Bulimia: Facts and Statistics
Majority are female, with onset around 16 to 19 years of age
Lifetime prevalence is about 1.1% for females, 0.1% for males
5-10% of college women suffer from bulimia
Tends to be chronic if left untreated

71. Signs And Symptoms Of Vomiting Or Laxative Abuse
Physical health
Mental health
Weight loss
Electrolyte disturbance K
CO2
Dental enamel erosion
Hypovolemia
Knuckle calluses
Guilt
Depression
Anxiety
Confusion

72. At-Risk Groups for both AN and BN
Adolescent females with low self-esteem
Gymnasts
Dancers (ballet)
Wrestlers
Runners
When thinness is related to success

73. AN & BN: Engaging Parents in Treatment
Developmental framework (child  adult)
Discuss blame, fault, guilt openly
Realignment of roles in family
Positive framing of family attributes
Future orientation
Authority to treat, and empowerment of, professionals comes from parents

74. Problems Addressed In Mental Health Treatment
Low Self-esteem
Distorted body-image
Dysfunctional coping behaviors and habits
Depression
SSRIs for BN and weight recovered AN
Ineffective communication
Conflict resolution
Lack of assertiveness
Post-trauma recovery (sexual abuse, etc)

75. Indications for Hospitalization
Severe malnutrition: Weight for height <75%
Dehydration
Electrolyte disturbances
Cardiac dysrhythmia
Physiologic instability
Severe bradycardia or hypotension
Hypothermia
Orthostatic pulse changes
Now, let’s move on to inpatient issues. As previously noted, we published a list of indications for hospitalization that are summarized on the next two slides. It is important to note that these do not match those used by HMOs, such as Interqual criteria, but are based on a consensus of expert clinical opinion. Please feel free to cite these criteria as you discuss inpatient treatment with your HMO service providers. I have included the SAM webpage URL for the position paper if you were unable to get it all down before--unfortunately the background paper in which this is published is not on the web, but the journal is widely available in libraries.
Please note that the indications that are listed here are physiologic disturbances, an important issue when one is considering hospitalization on a pediatric unit. Even though we use the biopsychosocial approach, we emphasize the medical nature of the hospital care.

76. Indications for Hospitalization
Arrested growth and development
Failure of outpatient treatment
Acute food refusal
Uncontrollable bingeing and purging
Acute medical complication of malnutrition
Acute psychiatric emergencies
Comorbid diagnosis interfering with treatment
We also included some additional factors that relate specifically to younger patients who have ceased to grow or who have failed in outpatient treatment. Likewise, when there is either acute food refusal or uncontrollable binge eating and purging, hospitalization can be worthwhile. Acute changes, such as medical complications or psychiatric emergencies can also be reasons for hospitalization. However, the last two indications on this list are probably better served on a pediatric psychiatric unit.
(Fisher et al.,1995)

77. Eating Disorder, Not Otherwise Specified
All criteria for AN, except still menstruating
All criteria for AN, except normal weight
All criteria for BN, except frequency or duration
Compensatory weight control after small amounts of food
Chewing/spitting out, but not swallowing, large amounts of food
Binge eating disorder

78. Binge-Eating Disorder
Binge-Eating Disorder – Appendix of DSM-IV
Experimental diagnostic category
Engage in food binges, but do not engage in compensatory behaviors
Associated Features
Many persons with binge-eating disorder are obese
Most are older than bulimics and anorexics
Show more psychopathology than obese people who do not binge
Share similar concerns as anorexics and bulimics regarding shape and weight

79. Signs And Symptoms Of Binge Eating
Physical health
Mental health
Weight gain
Bloating
Fullness
Lethargy
Salivary gland enlargement
Guilt
Depression
Anxiety

80. How do biological factors lead to eating disorders?
Women who have close relative with an eating disorder are 2-3 times more likely to suffer from one
More likely to occur in both identical twins than fraternal twins (higher concordance)
Anorexa sufferers have higher levels of serotonin
Bulimia sufferers are less sensitive to serotonin

81. What psychological factors lead to eating disorders?
Cultural norms
Thinness norm is portrayed in media

82. Brazilian model Ana Carolina Reston…this 21-year-old anorexic model reportedly weighed just 88 pounds

83. What psychological factors lead to eating disorders?
Family dynamics
Families of women with eating disorders are particularly focused on weight and shape
Families of anorexics have potentially dysfunctional dynamics
Families of bulimics have more conflict, and less nurturance

84. What psychological factors lead to eating disorders?
Personality
The “perfect child” expectation in families
Anorexics: rigid, anxious, perfectionists, and obsessed with order and cleanliness
Bulimics: depressed, anxious, lack clear sense of self-identity, have negative self-views

85. What approaches help prevent eating disorders?
Interventions specifically targeting women with poor body images can be effective

86. Weight Gain
Rate  1 lb/week, Target weight >85% average, if low...
70% of weight gain is lean body mass (muscle)
Must eat adequately to gain lean body mass
 Lean body mass will result in
Higher metabolism
More energy
Fewer symptoms
Cognitive-behavioral therapy is used to design programs for weight gain

87. “But, I’m Not Hungry” Reframing for patient Physiologic Fact
Even if you’re not hungry, your body burns calories
Appetite  car’s gas gauge
Eating Disorder  broken gas gauge
If drive car with broken gas gauge can run out of gas
Fill car with gas based on miles driven & gas mileage
Fat has more energy than carbohydrate or protein and is a necessary body fuel
Body burns calories throughout life
Appetite  need to eat
Eating Disorder  Appetite 
If only respond to appetite, will not get enough energy
If eat on regular schedule, more likely to get energy
Higher energy fuel ensures greater likelihood of getting enough energy

88. Lingering issues… Is obesity really unhealthy?
“upper-body fat” is particularly bad
Can eating disorder prevention programs have dangerous effects?
Eating disorder prevention programs can sometimes lead to an increase in disordered behavior
Nova film, “Dying to be Thin” - emaciated women are triggering girls who want to be thin.
Instead… Show the videos: “Body Talk”, or “Killing Us Softly”. Shows being able to express their body image and resist media messages.

89. Credits
Some slides in this presentation prepared with the asistance of the following websites: