Survivor guilt in the pathogenesis of anorexia nervosa

Psychological Impact of Predictive Testing for Colonic Cancer

Advances in DNA technology have facilitated presymptomatic testing for an inherited predisposition to a number of autosomal dominant cancer syndromes. While testing is generally undertaken with informed consent and within a counselling protocol, there is still much to be learned about the psychological impact of DNA testing in a predictive setting. In this study, patients’ experiences were recorded using in-depth interview techniques following earlier testing for hereditary non-polyposis colorectal cancer which was coordinated through an hereditary cancer registry. Thematic analysis of the transcripts revealed consistent issues pertaining to identity as well as emotional responses to previous preventative strategies and ongoing cancer screening options.

Survivor guilt: analyzing the concept and its contexts

Survivor guilt, a concept associated with the interpersonal process of "surviving" harm while others do not, increasingly appears in nursing, medicine, and psychology literature. Paradoxically, the phenomenon is rarely defined and often poorly described. Combining Rodger's evolutionary concept analysis with a comprehensive literature review, we explain the attributes, antecedents, consequences, related concepts, and surrogate terms of survivor guilt. A new definition emerged from the evolving use of the concept in new contexts. Survivor guilt is a valid form of suffering for which effective interventions need to be developed. This analysis extends the concept, laying the foundation for comprehensive treatment strategies.

Social support and mental health among college students

This study is the first, to our knowledge, to evaluate the relationship between mental health and social support in a large, random sample of college students. A Web-based survey was administered at a large, public university, with 1,378 students completing the measures in this analysis (response rate = 57%). The results support our hypothesis that students with characteristics differing from most other students, such as minority race or ethnicity, international status, and low socioeconomic status, are at greater risk of social isolation. In addition, the authors found that students with lower quality social support, as measured by the Multidimensional Scale of Perceived Social Support, were more likely to experience mental health problems, including a sixfold risk of depressive symptoms relative to students with high quality social support. These results may help administrators and health providers to identify more effectively the population of students at high risk for mental illness and develop effective interventions to address this significant and growing public health issue.

Internalized anger, self-control, and mastery experience in inpatient anorexic adolescents

OBJECTIVES

To evaluate the implications of internalized anger, self-control and experience of mastery for adolescent girls with severe anorexia nervosa (AN).

METHODS

Internalized and externalized anger, internal and external control, mastery, use of methods for self-control, and severity of anorexic symptoms were measured by self-report questionnaires in inpatient anorexic teenagers (N=26), inpatient female adolescent psychiatric patients (N=24), and a normal female comparison group (N=29).

RESULTS

Internalized anger was significantly higher in both the anorexic and general psychiatric patients as compared to normal controls, but this difference was significant only for the anorexic patients. Anorexic and general psychiatric patients experienced significantly less mastery than normal controls, but again this difference was significant only in the anorexic group. Within the anorexic group, severity of symptoms correlated significantly with internalized anger, low mastery, and external locus of control, and negative significant correlations among control measures and anger were found. Total length of hospitalization correlated positively with internalized anger only for the anorexics.

CONCLUSION

The findings support the notion that internalized anger and defective experience of self-control are important factors in the psychopathology of adolescent anorexic inpatient females The results may have implications for the clinical management of patients with severe AN.

Death related themes in anorexia nervosa: a practical exploration

On the basis of an extensive literature review, Jackson and Davidson (1986) suggested that the theme of death may constitute an integral part of the psychodynamic aetiology of anorexia nervosa. This paper describes an attempt to explore this contention using a structured questionnaire in a group of adolescent patients to examine experiences, concepts of and attitudes concerning death. Comparison of the responses of this group with those of age matched school student controls and recovered patients revealed qualitative and quantitative differences which lent some support to the hypothesis. It is concluded that death related themes are of significance in the understanding and management of this illness.

Anorexia, psychoanalysis, and feminism: fantasy and reality

Two distinct trends inform current psychoanalytic and feminist approaches to anorexia: one focuses on its roots in the fantasy, the other in the reality of childhood and adolescent deprivation and abuse. In outlining these two approaches, this article shows how both increasingly attend to the place of the mother to the neglect of the father in the genesis of anorexia--a shift of perspective somewhat redressed by systemic family therapy.