9. CULTURAL PRESENTATIONS OF ANOREXIA
Anorexia Nervosa in Blacks
Anorexia nervosa has been reported in
American Blacks [52, 53, 54, 55] and in Blacks of Afro-Caribbean
extraction from the West Indies . The incidence
of black anorexic patients in a total population of
patients with anorexia nervosa is less than five percent
. Case reports from lower socioeconomic groups of
West Indian patients living in England  and middle-to-upper-class
patients  are noted.
Anorexia Nervosa in Hispanics
Hispanic females, described by Silber
, experienced significant disruption moving from
South America to Washington, D.C. with resultant object
losses of friends and family, including grandparents.
The onset of anorexia nervosa in these cases was associated
with family disturbance and sexual abuse. Family dynamics
in the Hispanic cases included severe disruption, infidelity
by the father, alcoholism, depression, suicide attempts,
and parental separation, creating a chaotic environment
for the patient.
Silber  noted that the Hispanic
females had high personal ideals. Being raised in a
more traditional Latin culture, they may have had difficulty
when expected to assimilate into the American culture,
where thinness and academic achievement were highly
valued. In addition, they had to contend with contrasting
sexual attitudes, which may have exacerbated their own
conflicts. Development of anorexia nervosa, with its
regression to a prepubertal psychological structure,
served as a maladaptive attempt to cope with issues
of identity and cultural and sexual conflict.