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Williams M, Kingston Miller A, Loizaga-Velder A, Files N, Lafrance A. "Getting to the Root": Ayahuasca Ceremony Leaders' Perspectives on Eating Disorders. J Psychoactive Drugs 2023; 55:425-433. [PMID: 36171638 DOI: 10.1080/02791072.2022.2113484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 10/14/2022]
Abstract
Given the mortality, chronicity, and treatment drop-out rates observed among individuals with eating disorders (EDs), innovative approaches are needed. Ayahuasca, a psychedelic plant medicine from the Amazon, is currently being investigated. This study expands on prior exploratory research by describing the perspectives of ayahuasca ceremony leaders regarding their conceptualizations of EDs and the potential therapeutic mechanisms of action of ayahuasca for individuals with EDs. Qualitative content analysis of interviews with 15 ayahuasca ceremony leaders produced two main categories, with relevant subcategories. The first category encompassed the leaders' theories of EDs from a shamanic perspective, including that EDs are symptomatic of an underlying concern, serve a function and affect health in multiple domains. The second category described leaders' perspectives on the potential mechanisms of action of ayahuasca for EDs, including that ayahuasca facilitates "energetic healing"; helps identify, process, and integrate the "root" of the ED; promotes holistic healing; and enhances and/or reorganizes relationships. From the perspectives of ceremony leaders and consistent with previous exploratory research, ceremonial ayahuasca use may offer a potentially useful, novel and complementary intervention for EDs.
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2
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Kiely L, Conti J, Hay P. Conceptualisation of severe and enduring anorexia nervosa: a qualitative meta-synthesis. BMC Psychiatry 2023; 23:606. [PMID: 37596588 PMCID: PMC10439651 DOI: 10.1186/s12888-023-05098-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/09/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Severe and enduring anorexia nervosa (SE-AN) is amongst the most impairing of all mental illnesses. Collective uncertainties about SE-AN nosology impacts treatment refinement. Qualitative research, particularly lived experience literature, can contribute to a process of revision and enrichment of understanding the SE-AN experience and further develop treatment interventions. Poor outcomes to date, as evidenced in clinical trials and mortality for people with SE-AN (1 in 20) demonstrate the need for research that informs conceptualisations and novel treatment directions. This interpretative, meta-ethnographic meta-synthesis aimed to bridge this gap. METHODS A systematic search for qualitative studies that explored the AN experiences of people with a duration of greater than 3 years was undertaken. These studies included those that encompassed phenomenology, treatment experiences and recovery. RESULTS 36 papers, comprising 382 voices of SE-AN experiences informed the meta-ethnographic findings. Four higher order constructs were generated through a synthesis of themes and participant extracts cited in the extracted papers: (1) Vulnerable sense of self (2) Intra-psychic processes (3) Global impoverishment (4) Inter-psychic temporal processes. Running across these meta-themes were three cross cutting themes (i) Treatment: help versus harm, (ii) Shifts in control (iii) Hope versus hopelessness. These meta-themes were integrated into conceptualisations of SE-AN that was experienced as a recursive process of existential self-in-relation to other and the anorexia nervosa trap. CONCLUSIONS The alternative conceptualisation of SE-AN proposed in this paper poses a challenge to current conceptualisations of AN and calls for treatments to engage with the complex intra and inter-psychic processes of the SE-AN, more fully. In doing so, clinicians and researchers are asked to continue to be bold in testing novel ideas that may challenge our own rigidity and attachment to dominant paradigms to best serve the individual person with SE-AN. The 'global impoverishment of self', found in this synthesis of AN experiences, should inform proposed diagnostic criteria for SE-AN.
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Affiliation(s)
- Laura Kiely
- School of Medicine, Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia.
| | - Janet Conti
- School of Psychology, Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| | - Phillipa Hay
- School of Medicine, Translational Health Research Institute, Western Sydney University. Mental Health Services, Camden and Campbelltown Hospitals, SWSLHD, Campbeltown, NSW, Australia
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3
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Kenny TE, Lewis SP. More than an outcome: a person-centered, ecological framework for eating disorder recovery. J Eat Disord 2023; 11:45. [PMID: 36949489 PMCID: PMC10032254 DOI: 10.1186/s40337-023-00768-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 03/08/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Eating disorder recovery is a complex phenomenon. While historical understandings focused on weight and behaviours, the importance of psychological factors is now widely recognized. It is also generally accepted that recovery is a non-linear process and is impacted by external factors. Recent research suggests a significant impact of systems of oppression, though these have not yet been named in models of recovery. BODY: In this paper, we propose a research-informed, person-centered, and ecological framework of recovery. We suggest that there are two foundational tenets of recovery which apply broadly across experiences: recovery is non-linear and ongoing and there is no one way to do recovery. In the context of these tenets, our framework considers individual changes in recovery as determined by and dependent on external/personal factors and broader systems of privilege. Recovery cannot be determined by looking solely at an individual's level of functioning; one must also consider the broader context of their life in which changes are being made. To conclude, we describe the applicability of the proposed framework and offer practical considerations for incorporating this framework in research, clinical, and advocacy settings.
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Affiliation(s)
- Therese E Kenny
- Department of Psychology, University of Guelph, 50 Stone Road E., Guelph, ON, N1G 2W1, Canada.
| | - Stephen P Lewis
- Department of Psychology, University of Guelph, 50 Stone Road E., Guelph, ON, N1G 2W1, Canada
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Farářová A, Papežová H, Gricová J, Štěpánková T, Čapek V, Reedtz C, Lauritzen C, van Doesum K. ChildTalks+: a study protocol of a pre-post controlled, paired design study on the use of preventive intervention for children of parents with a mental illness with focus on eating disorders. BMC Psychiatry 2022; 22:715. [PMID: 36384579 PMCID: PMC9670502 DOI: 10.1186/s12888-022-04349-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 10/29/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Children of parents with a mental illness are at high risk of developing a mental disorder as a result of transgenerational transmission. Without effective intervention, they could form the next generation of psychiatric patients. ChildTalks+ is a preventive intervention involving four structured psychoeducational sessions designed for parents affected by a mental disorder and their children. Its aim is to reduce the risk of mental disorders in children of parents with mental illness. This study draws on our clinical practice and involves a group of patients with eating disorders. The aim of the project, which will run in the Czech Republic, is to evaluate the effectiveness of ChildTalks+ methodology. METHODS ChildTalks+ therapists (professionals from health, social, and educational facilities) will recruit 66 families where a parent is treated for a mental disorder and the family includes children aged 6-18. Paired allocation into an intervention group (N = 33) and a control group (N = 33) will be based on the number of risk factors identified in the family. Both groups will complete questionnaires at the baseline, post-test, and follow-up assessments after six and 12 months. The intervention group will receive the ChildTalks+ intervention within 2 months of the baseline assessment; the control group after the last assessment. Questionnaires will be completed by parents and children aged 12+ and, in two cases, 15+ years. Quantitative data will be supplemented with qualitative data from ChildTalks+ therapists working with patients with eating disorders. DISCUSSION The ChildTalks+ intervention is expected to strengthen parenting competencies and family protective factors, improve family communication, increase awareness of parental mental health issues, and improve the wellbeing of children of parents with mental illness with long-term sustainable outcomes. The study should contribute to the evidence base for the ChildTalks+ program and help identify key themes in the implementation of similar preventive interventions. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05554458. Registered 26 September 2022. Retrospectively registered.
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Affiliation(s)
- Adéla Farářová
- First Faculty of Medicine, Charles University, Prague, Czech Republic. .,Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
| | - Hana Papežová
- grid.4491.80000 0004 1937 116XFirst Faculty of Medicine, Charles University, Prague, Czech Republic ,grid.411798.20000 0000 9100 9940Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jana Gricová
- grid.4491.80000 0004 1937 116XFirst Faculty of Medicine, Charles University, Prague, Czech Republic ,grid.411798.20000 0000 9100 9940Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Tereza Štěpánková
- grid.4491.80000 0004 1937 116XFirst Faculty of Medicine, Charles University, Prague, Czech Republic ,grid.411798.20000 0000 9100 9940Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Václav Čapek
- grid.4491.80000 0004 1937 116XFirst Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Charlotte Reedtz
- grid.10919.300000000122595234RKBU North, Faculty of Health, UiT – Arctic University of Norway, Tromsø, Norway
| | - Camilla Lauritzen
- grid.10919.300000000122595234RKBU North, Faculty of Health, UiT – Arctic University of Norway, Tromsø, Norway
| | - Karin van Doesum
- grid.5590.90000000122931605Department of Clinical Psychology, Radboud University, Nijmegen, Netherlands
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Abstract
BACKGROUND Delayed diagnosis, gaps in services and subsequent delays in specialist care and treatment lead to poorer health outcomes for individuals with eating disorders (EDs) and drive significant government healthcare expenditure. Given the significant disease burden associated with EDs, it is imperative that current implementation research is summarised to identify gaps in care and enable refinement for optimal patient outcomes. This review aimed to provide an updated synthesis on models of care for EDs in developed healthcare systems. METHODS This paper was conducted as part of a series of Rapid Reviews (RRs) to be published in a special series in the Journal of Eating Disorders. To provide a current and rigorous review, peer-reviewed articles published in the English language between 2009 and 2021 across three databases (ScienceDirect, PubMed and Ovid/Medline) were searched, with priority given to higher level evidence (e.g., meta-analyses, large population studies, Randomised Control Trials (RCTs)). The current review synthesises data from included studies investigating models of care for people with EDs. RESULTS Sixty-three studies (4.5% of the original RR) were identified, which included several diagnostic populations, the most common being Anorexia Nervosa (AN) (30.51%). Across EDs, specialist care was found to improve patient outcomes, with many patients effectively being treated in outpatient or day programs with multi-disciplinary teams, without the need for lengthy inpatient hospitalisation. Few studies investigated the interaction of different ED services (e.g., inpatient, community services, primary care), however stepped care models emerged as a promising approach to integrate ED services in a targeted and cost-effective way. Issues surrounding low treatment uptake, underdiagnosis, long waiting lists and limited hospital beds were also evident across services. CONCLUSION Findings suggested further research into alternatives to traditional inpatient care is needed, with partial and shorter 'hospitalisations' emerging as promising avenues. Additionally, to tackle ongoing resource issues and ensure timely detection and treatment of EDs, further research into novel alternatives, such as active waiting lists or a greater role for primary care clinicians is needed. This paper is part of a larger Rapid Review series carried out to guide Australia's National Eating Disorders Research and Translation Strategy 2021-2031. Rapid reviews aim to thoroughly summarise an area of research over a short time period, typically to help with policymaking in this area. This Rapid Review summarises the evidence relating to how we care for people with eating disorders in Western healthcare systems. Topics covered include inpatient/hospital care, residential care, day programs, outpatient/community care, and referral pathways. Findings suggested specialist eating disorder services may enhance detection, referral, and patient care. Stepped care models presented as a cost-effective approach which may help with linkage between different eating disorder services. There was a trend towards shorter hospital stays and approaches which allow for greater connection with the community, such as day programs. Evidence was also found of treatment delays, due to system issues (long waiting lists, lack of accurate assessment and diagnosis) and patient-related barriers (stigma, recognition). Upskilling and involving primary care clinicians in diagnosis and referral as part of a stepped care model may help to address some of these concerns. Further efforts to improve mental health literacy and de-stigmatise help-seeking for eating disorders are needed.
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Hower H, LaMarre A, Bachner-Melman R, Harrop EN, McGilley B, Kenny TE. Conceptualizing eating disorder recovery research: Current perspectives and future research directions. J Eat Disord 2022; 10:165. [PMID: 36380392 PMCID: PMC9664434 DOI: 10.1186/s40337-022-00678-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/25/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND How we research eating disorder (ED) recovery impacts what we know (perceive as fact) about it. Traditionally, research has focused more on the "what" of recovery (e.g., establishing criteria for recovery, reaching consensus definitions) than the "how" of recovery research (e.g., type of methodologies, triangulation of perspectives). In this paper we aim to provide an overview of the ED field's current perspectives on recovery, discuss how our methodologies shape what is known about recovery, and suggest a broadening of our methodological "toolkits" in order to form a more complete picture of recovery. BODY: This paper examines commonly used methodologies in research, and explores how incorporating different perspectives can add to our understanding of the recovery process. To do this, we (1) provide an overview of commonly used methodologies (quantitative, qualitative), (2) consider their benefits and limitations, (3) explore newer approaches, including mixed-methods, creative methods (e.g., Photovoice, digital storytelling), and multi-methods (e.g., quantitative, qualitative, creative methods, psycho/physiological, behavioral, laboratory, online observations), and (4) suggest that broadening our methodological "toolkits" could spur more nuanced and specific insights about ED recoveries. We propose a potential future research model that would ideally have a multi-methods design, incorporate different perspectives (e.g., expanding recruitment of diverse participants, including supportive others, in study co-creation), and a longitudinal course (e.g., capturing cognitive and emotional recovery, which often comes after physical). In this way, we hope to move the field towards different, more comprehensive, perspectives on ED recovery. CONCLUSION Our current perspectives on studying ED recovery leave critical gaps in our knowledge about the process. The traditional research methodologies impact our conceptualization of recovery definitions, and in turn limit our understanding of the phenomenon. We suggest that we expand our range of methodologies, perspectives, and timeframes in research, in order to form a more complete picture of what is possible in recovery; the multiple aspects of an individual's life that can improve, the greater number of people who can recover than previously believed, and the reaffirmation of hope that, even after decades, individuals can begin, and successfully continue, their ED recovery process.
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Affiliation(s)
- Heather Hower
- Department of Psychiatry, Eating Disorders Center for Treatment and Research, University of California at San Diego School of Medicine, 4510 Executive Drive, San Diego, CA, 92121, USA. .,Department of Health Services, Policy, and Practice, Hassenfeld Child Innovation Institute, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA.
| | - Andrea LaMarre
- School of Psychology, Massey University, North Shore, Private Bag 102-904, Auckland, 0632, New Zealand
| | - Rachel Bachner-Melman
- Clinical Psychology Graduate Program, Ruppin Academic Center, 4025000, Emek-Hefer, Israel.,School of Social Work, Hebrew University of Jerusalem, Mt. Scopus, 9190501, Jerusalem, Israel
| | - Erin N Harrop
- Graduate School of Social Work, University of Denver, 2148 S High Street, Denver, CO, 80208, USA
| | - Beth McGilley
- University of Kansas School of Medicine, 1010 N Kansas St, Wichita, KS, 67214, USA
| | - Therese E Kenny
- Department of Psychology, Clinical Child and Adolescent Psychology, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada
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7
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Sedgewick F, Leppanen J, Austin A, Tchanturia K. Different pathways, same goals: A large-scale qualitative study of autistic and non-autistic patient-generated definitions of recovery from an eating disorder. EUROPEAN EATING DISORDERS REVIEW 2022; 30:580-591. [PMID: 34820930 DOI: 10.1002/erv.2873] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/05/2021] [Accepted: 11/07/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Definitions of recovery from an eating disorder (ED) have generally been formulated around clinical conceptualisations, rather than based on the views of patients. This paper therefore asked those with lived experience of ED for their own definitions of recovery. METHOD Data were collected as part of an online study looking at EDs, autism and relationships. About 173 participants identified as recovered from ED and gave free-response definitions of recovery. Responses were subject to thematic analysis. RESULTS Seven major themes were identified: Weight restoration, lack of ED behaviours, thoughts and behaviours, cognitions, emotional responses, getting on with life, and ongoing challenges. CONCLUSIONS Many definitions of recovery given by those who have lived experience of ED echoed those used by clinicians and researchers. There were also points of divergence around the ongoing challenges of recovery. Our findings highlight the need for continuing support post-weight restoration to facilitate the successful long-term recovery for those with ED.
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Affiliation(s)
- Felicity Sedgewick
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- School of Education, University of Bristol, Bristol, UK
| | - Jenni Leppanen
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Amelia Austin
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Kate Tchanturia
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Trust, London, UK
- Department of Psychology, Illia State University, Tbilisi, Georgia
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Erwin SR, Liu PJ, Datta N, Nicholas J, Rivera-Cancel A, Leary M, Chartrand TL, Zucker NL. Experiences of mimicry in eating disorders. J Eat Disord 2022; 10:103. [PMID: 35841035 PMCID: PMC9288029 DOI: 10.1186/s40337-022-00607-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 06/13/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND People unknowingly mimic the behaviors of others, a process that results in feelings of affiliation. However, some individuals with eating disorders describe feeling "triggered" when mimicked. This study explores the effects of implicit non-verbal mimicry on individuals with a history of an eating disorder (ED-His) compared to healthy controls (HCs). METHOD Women (N = 118, nED-His = 31; Mage = 21 years) participated in a laboratory task with a confederate trained to either discreetly mimic (Mimicry condition) or not mimic (No-Mimicry condition) the mannerisms of the participant. Participants rated the likability of the confederate and the smoothness of the interaction. RESULTS Participants in the No-Mimicry condition rated the confederate as significantly more likable than in the Mimicry condition, and ED-His rated the confederate as more likable than HCs. ED-His in the Mimicry condition rated the interaction as less smooth than HCs, whereas this pattern was not found in the No-Mimicry condition. Among ED-His, longer disorder duration (≥ 3.87 years) was associated with less liking of a confederate who mimicked and more liking of a confederate who did not mimic. CONCLUSIONS We discuss the implications of these findings for interpersonal therapeutic processes and group treatment settings for eating disorders. Our study on subtle, nonverbal mimicry revealed differences in social behavior for women with a history of an eating disorder compared to healthy women. For participants with an eating disorder history, a longer duration of illness was associated with a worse pattern of affiliation, reflected in lower liking of a mimicker. Further research on how diverging processes of affiliation may function to perpetuate the chronicity of eating disorders and implications for treatment is needed.
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Affiliation(s)
- Savannah R Erwin
- Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA.
| | - Peggy J Liu
- Fuqua School of Business, Duke University, Durham, NC, USA.,Katz Graduate School of Business, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nandini Datta
- Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA.,Department of Psychiatry and Behavioral Sciences, Stanford Medicine, Stanford, CA, USA
| | - Julia Nicholas
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.,Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, USA
| | - Alannah Rivera-Cancel
- Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Mark Leary
- Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA
| | | | - Nancy L Zucker
- Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
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Ng QX, Lim YL, Loke W, Chee KT, Lim DY. Females with Eating Disorders and Urinary Incontinence: A Psychoanalytic Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4874. [PMID: 35457741 PMCID: PMC9028028 DOI: 10.3390/ijerph19084874] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 04/13/2022] [Accepted: 04/15/2022] [Indexed: 02/01/2023]
Abstract
Eating disorders (EDs) are complicated mental illnesses with significant treatment resistance and dropout rates. For successful treatment, it is important for clinicians to better understand the patients' narrative and their lived experiences. A thorough psychodynamic understanding of patients' childhood attachment and primary relationships, personality traits and mental processes is, therefore, crucial for managing patients with ED. Interestingly, several studies have observed an association between functional urinary symptoms and individuals with ED. EDs such as anorexia nervosa are associated with an increased risk of all urinary symptoms, and functional incontinence was also more common in extreme female athletes with low energy availability and with disordered eating. There is, however, a dearth of literature describing this relationship, and the underlying mechanisms remain remote. In this paper, we present a psychoanalytic approach to the presence of urinary symptoms in females with EDs. We hypothesize that these symptoms are tied to specific traits or characteristics of ED patients, namely the overarching need for control, a pathological strive for perfection and the self-denial of basic bodily urges. This is discussed in relation to psychopathological processes, development and personality factors commonly seen in patients with ED.
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Affiliation(s)
- Qin Xiang Ng
- MOH Holdings Pte Ltd., 1 Maritime Square, Singapore 099253, Singapore; (Y.L.L.); (W.L.)
| | - Yu Liang Lim
- MOH Holdings Pte Ltd., 1 Maritime Square, Singapore 099253, Singapore; (Y.L.L.); (W.L.)
| | - Wayren Loke
- MOH Holdings Pte Ltd., 1 Maritime Square, Singapore 099253, Singapore; (Y.L.L.); (W.L.)
| | - Kuan Tsee Chee
- Institute of Mental Health, 10 Buangkok View, Buangkok Green, Medical Park, Singapore 539747, Singapore; (K.T.C.); (D.Y.L.)
| | - Donovan Yutong Lim
- Institute of Mental Health, 10 Buangkok View, Buangkok Green, Medical Park, Singapore 539747, Singapore; (K.T.C.); (D.Y.L.)
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Safi F, Aniserowicz AM, Colquhoun H, Stier J, Nowrouzi-Kia B. Impact of eating disorders on paid or unpaid work participation and performance: a systematic review and meta-analysis protocol. J Eat Disord 2022; 10:7. [PMID: 35033207 PMCID: PMC8760832 DOI: 10.1186/s40337-021-00525-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 12/21/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Eating disorders (ED) can reduce quality of life by limiting participation and performance in social and occupational roles, including paid or unpaid work. The association between ED pathologies and work participation and performance must be well understood to strengthen vocational rehabilitation programmes and prevent occupational disruptions in the ED population. The aims of this study are: (1) to examine the degree of association between ED pathologies and work participation and performance in 15-year-olds and older; (2) to highlight the specific ED symptoms that are most correlated with changes in work performance and participation; (3) to compile the most common metrics and assessments used to measure work participation and performance with ED. METHODS Medline, Embase, CINAHL, Web of Science, PsycINFO, and Cochrane Library will be searched for observational and experimental studies that meet the following criteria: (1) a clinical sample of typical or atypical ED; (2) paid or unpaid employment or training; (3) an association between ED pathologies and work participation or performance. Unpublished data will also be examined. Title and abstract, and full-text screening will be conducted in duplicate. Risk of bias and quality of evidence assessments will be completed. A random-effect meta-analysis will be performed. DISCUSSION This synthesis can clarify knowledge and gaps around the impact of ED on work functioning, thereby allowing better evaluation, improvements and development of current workplace assessments, interventions, and policies. TRIAL REGISTRATION The registration number for this systematic review on PROSPERO is CRD42021255055.
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Affiliation(s)
- Fatima Safi
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 160-500 University Avenue, Toronto, ON, M5G 1V7, Canada
| | - Anna M Aniserowicz
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 160-500 University Avenue, Toronto, ON, M5G 1V7, Canada
| | - Heather Colquhoun
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 160-500 University Avenue, Toronto, ON, M5G 1V7, Canada
| | - Jill Stier
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 160-500 University Avenue, Toronto, ON, M5G 1V7, Canada
| | - Behdin Nowrouzi-Kia
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 160-500 University Avenue, Toronto, ON, M5G 1V7, Canada.
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11
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Murayama Y, Ohya A. A cross-sectional examination of the simultaneous association of four emotion regulation strategies with abnormal eating behaviours among women in Japan. J Eat Disord 2021; 9:122. [PMID: 34583776 PMCID: PMC8480045 DOI: 10.1186/s40337-021-00477-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 09/15/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Research has suggested an association between emotion regulation strategies (ERSs) and abnormal eating behaviours/attitudes (AEB), and many studies have examined the association of one particular ERS with AEB. Additionally, different ERSs are reported to be strongly correlated with each other. Therefore, the associations between an individual ERS and AEB, reported previously, may be spurious. The present cross-sectional study aims to examine the simultaneous associations of four ERSs (brooding, reflection, expressive suppression, cognitive reappraisal) with AEB in a sample of women in Japan. METHODS The participants comprised 1528 Japanese women (Mage = 40.65 years, SDage = 10.22 years, range 21-59). They self-reported the frequency at which they use these ERSs, their levels of AEB (i.e. drive for thinness, bulimic symptoms), and the confounding variables (e.g. psychological distress and BMI) online. AEB was measured using the Japanese version of the 91-item Eating Disorder Inventory; brooding and reflection were measured using the Japanese version of the Rumination Response Scale; individual differences in the use of reappraisal and expression suppression was measured using the Japanese version of the Emotion Regulation Questionnaire (J-ERQ); and participants' psychological distress was assessed using the Kessler 6 Japanese version (K6-J). RESULTS Correlation analyses revealed that all ERSs were positively correlated with AEB. However, regression analyses revealed inconsistent findings. In the regression model, after controlling for the confounding variables, only brooding indicated a positive association with the drive for thinness. Regarding bulimic symptoms, all ERSs showed a positive association, except reappraisal, which had a weak, negative association. CONCLUSION These results suggest that brooding is related to the symptom levels of both eating disorders among women, whereas, the other ERSs are related to those of bulimic symptoms only. However, further research is required to clarify the causal relations between AEB and ERSs.
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Affiliation(s)
- Yasuo Murayama
- Institute of Human and Social Sciences, Kanazawa University, Kakuma-machi, Kanazawa, Ishikawa, 921-1192, Japan.
| | - Aiko Ohya
- Faculty of Psychology, Doshisha University, 1-3 Tatara, Miyakodani, Kyotanabe-shi, Kyoto, 610-0394, Japan
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Karlsson S, Friberg W, Rask M, Tuvesson H. Patients' Experiences and Perceptions of Recovering from Anorexia Nervosa While Having Contact with Psychiatric Care: A Literature Review and Narrative Synthesis of Qualitative Studies. Issues Ment Health Nurs 2021; 42:709-719. [PMID: 33290125 DOI: 10.1080/01612840.2020.1847222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Anorexia nervosa (AN) is a serious disease which is difficult to treat. Little is known about the recovery from AN, and therefore, this review's aim was to review and synthesise patients' experiences and perceptions of what is meaningful for recovery from anorexia nervosa while having contact with psychiatric care. Cinahl, PubMed, and PsycINFO were systematically searched, and 24 studies met the inclusion criteria and were included in the review. Three themes were identified: Being in a trustful and secure care relationship, Finding oneself again, and Being in an engaging and personal treatment. Efforts supporting staff learning and person-centred care should be emphasised and researched further.
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Affiliation(s)
| | | | - Mikael Rask
- Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Hanna Tuvesson
- Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
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13
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Froreich FV, Ratcliffe SE, Vartanian LR. Blind versus open weighing from an eating disorder patient perspective. J Eat Disord 2020; 8:39. [PMID: 32821384 PMCID: PMC7429892 DOI: 10.1186/s40337-020-00316-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 07/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Weighing is a key component in the treatment of eating disorders. Most treatment protocols advocate for open weighing, however, many clinicians choose to use blind weighing, especially during the early phase of treatment. Despite considerable debate about this issue in the literature, there is no empirical evidence supporting the superiority of one weighing approach over the other. In addition, little is known about patients' perspectives of open and blind weighing and which weighing practice they view as more acceptable and/or beneficial for their treatment. METHODS Semi-structured qualitative interviews were conducted with 41 women with a current or past diagnosis of Anorexia or Bulimia Nervosa: 26 were undergoing specialist inpatient treatment (n = 13 being blind weighed; n = 13 being open weighed) and 15 were community members who have recovered from an eating disorder. Interviews were audiotaped, transcribed verbatim and analysed thematically using framework methods. Participant demographics, clinical characteristics, weighing anxiety and weight concerns were also assessed. RESULTS Qualitative analyses yielded five themes: (1) therapy engagement and progress; (2) Control and tolerance of weight uncertainty; (3) treatment team relationships and autonomy; (4) life outside of treatment; and (5) weighing practice preferences and rationale. Participants stated that blind weighing decreased anxiety and eating disorder psychopathology (e.g., weight preoccupation) and increased treatment responsivity. For many, relinquishing control over their weight facilitated body trust and was a necessary step towards recovery. Participants found that not knowing their exact weight helped challenge their overconcern with weight. Lack of support post-discharge was identified as a major difficulty of blind weighing. Overall, the majority of participants preferred blind weighing, particularly at the early, acute stage of treatment, whereas open weighing was viewed as more suitable at later stages of recovery. Quantitative analyses found current blind-weighed patients felt significantly less anxiety around being weighed and had greater tolerance of weight uncertainty than current open-weighed patients. CONCLUSIONS This study provided in-depth patient insights into open versus blind weighing practices. The next step for future research will be to supplement these insights with treatment outcomes gained from randomised controlled trials comparing the two weighing practices.
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Bartholdy S, O'Daly OG, Campbell IC, Banaschewski T, Barker G, Bokde ALW, Bromberg U, Büchel C, Quinlan EB, Desrivières S, Flor H, Frouin V, Garavan H, Gowland P, Heinz A, Ittermann B, Martinot JL, Paillère Martinot ML, Nees F, Orfanos DP, Poustka L, Hohmann S, Fröhner JH, Smolka MN, Walter H, Whelan R, Schumann G, Schmidt U, Artiges E, Schneider S, Bach C, Paus T, Barbot A, Gareth Barker, Bokde A, Vetter N, Büchel C, Cattrell A, Constant P, Gowland P, Crombag H, Czech K, Dalley J, Decideur B, Spranger T, Ripley T, Heym N, Flor H, Sommer W, Fuchs B, Gallinat J, Spanagel R, Kaviani M, Heinrichs B, Andreas Heinz, Subramaniam N, Jia T, Ihlenfeld A, Ireland J, Ittermann B, Conrod P, Banaschewski T, Jones J, Klaassen A, Lalanne C, Lanzerath D, Lawrence C, Lemaitre H, Desrivieres S, Mallik C, Karl Mann, Mar A, Martinez-Medina L, Jean-Luc Martinot, Mennigen E, Mesquita de Carvahlo F, Schwartz Y, Bruehl R, Müller K, Nees F, Nymberg C, Lathrop M, Trevor Robbins, Pausova Z, Jani Pentilla, Biondo F, Jean-Baptiste Poline, Hohmann S, Poustka L, Millenet S, Michael Smolka, Fröhner J, Struve M, Steve Williams, Hübner T, Bromberg U, Aydin S, Rogers J, Romanowski A, Schmäl C, Schmidt D, Ripke S, Arroyo M, Schubert F, Pena-Oliver Y, Fauth-Bühler M, Mignon X, Whelan R, Speiser C, Fadai T, Dai Stephens, Ströhle A, Paillere ML, Strache N, Theobald D, Jurk S, Vulser H, Miranda R, Yacubian J, Frouin V, Genauck A, Parchetka C, Gemmeke I, Kruschwitz J, Weiß K, Walter H, Feng J, Papadopoulos D, Filippi I, Ing A, Ruggeri B, Xu B, Macare C, Chu C, Hanratty E, Burke Quinlan E, Robert G, Schumann G, Yu T, Ziesch V, Stedman A. Neural Correlates of Failed Inhibitory Control as an Early Marker of Disordered Eating in Adolescents. Biol Psychiatry 2019; 85:956-965. [PMID: 31122340 DOI: 10.1016/j.biopsych.2019.01.027] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 01/23/2019] [Accepted: 01/24/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND Binge eating and other forms of disordered eating behavior (DEB) are associated with failed inhibitory control. This study investigated the neural correlates of failed inhibitory control as a potential biomarker for DEB. METHODS The study used prospective longitudinal data from the European IMAGEN study adolescent cohort. Participants completed baseline assessments (questionnaires and a brain scan [functional magnetic resonance imaging]) at 14 years of age and a follow-up assessment (questionnaires) at 16 years of age. Self-reported binge eating and/or purging were used to indicate presence of DEB. Neural correlates of failed inhibition were assessed using the stop signal task. Participants were categorized as healthy control subjects (reported no DEB at both time points), maintainers (reported DEB at both time points), recoverers (reported DEB at baseline only), and developers (reported DEB at follow-up only). Forty-three individuals per group with complete scanning data were matched on gender, age, puberty, and intelligence (N = 172). RESULTS At baseline, despite similar task performance, incorrectly responding to stop signals (failed inhibitory control) was associated with greater recruitment of the medial prefrontal cortex and anterior cingulate cortex in the developers compared with healthy control subjects and recoverers. CONCLUSIONS Greater recruitment of the medial prefrontal and anterior cingulate regions during failed inhibition accords with abnormal evaluation of errors contributing to DEB development. As this precedes symptom onset and is evident despite normal task performance, neural responses during failed inhibition may be a useful biomarker of vulnerability for DEB. This study highlights the potential value of prospective neuroimaging studies for identifying markers of illness before the emergence of behavior changes.
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Affiliation(s)
- Savani Bartholdy
- Section of Eating Disorders, Department of Psychological Medicine, London, United Kingdom.
| | - Owen G O'Daly
- Centre for Neuroimaging Sciences, London, United Kingdom
| | - Iain C Campbell
- Section of Eating Disorders, Department of Psychological Medicine, London, United Kingdom
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Gareth Barker
- Centre for Neuroimaging Sciences, London, United Kingdom
| | - Arun L W Bokde
- Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Dublin, Ireland
| | - Uli Bromberg
- University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | | | - Erin Burke Quinlan
- Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Sylvane Desrivières
- Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Herta Flor
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Vincent Frouin
- Neurospin, Commissariat à l'énergie atomique et aux énergies alternatives, Université Paris-Saclay, Gif-sur-Yvette, Paris, France
| | - Hugh Garavan
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, Vermont
| | - Penny Gowland
- Sir Peter Mansfield Imaging Centre School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Bernd Ittermann
- Physikalisch-Technische Bundesanstalt, Braunschweig, Germany
| | - Jean-Luc Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM Unit 1000 "Neuroimaging & Psychiatry," University Paris Sud - Paris Saclay, University Paris Descartes, Paris, France
| | - Marie-Laure Paillère Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM Unit 1000 "Neuroimaging & Psychiatry," University Paris Sud - Paris Saclay, University Paris Descartes, Paris, France; Department of Adolescent Psychopathology and Medicine, Maison de Solenn, Cochin Hospital, Public Assistance Hospitals of Paris, Paris, France
| | - Frauke Nees
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Dimitri Papadopoulos Orfanos
- Neurospin, Commissariat à l'énergie atomique et aux énergies alternatives, Université Paris-Saclay, Gif-sur-Yvette, Paris, France
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, Göttingen, Germany; Clinic for Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Juliane H Fröhner
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Robert Whelan
- School of Psychology and Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Gunter Schumann
- Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Ulrike Schmidt
- Section of Eating Disorders, Department of Psychological Medicine, London, United Kingdom; South London & Maudsley National Health Service Foundation Trust, London, United Kingdom
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Sun KS, Lam TP, Kwok KW, Chong KY, Poon MK, Wu D. Treatment of Chinese adolescents with anorexia nervosa in Hong Kong: The gap between treatment expectations and outcomes. PLoS One 2019; 14:e0216582. [PMID: 31071136 PMCID: PMC6508709 DOI: 10.1371/journal.pone.0216582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 04/25/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Anorexia nervosa (AN) is one of the most difficult-to-treat psychiatric disorders. AN is associated with individual vulnerability, societal and family factors. There has been limited research in Asia regarding the patients or their families' perceptions on its treatment. This study explored the perceived treatment outcomes among Chinese families having adolescents with AN. METHODS Qualitative interviews were conducted on parents of adolescents with AN recruited through an eating disorder association in Hong Kong to understand their views and experiences regarding the help-seeking and treatment process. RESULTS The parents expressed dissatisfaction towards help-seeking and treatment outcomes, including relationships with health professionals, hospitalization, health professionals' knowledge of AN, understanding of the treatment model and parents' role, amount of psychological support, and coordination among health professionals. The parents were unclear about the treatment plan as they received little explanation from the health professionals. The parents perceived that the AN treatment only focused on weight restoration with limited psychological support. Home diet monitoring was seen as a harsh task which worsened the relationship with their children. The parents often needed to take up the coordinator role and search around for different health professionals and integrate their advices by themselves. CONCLUSIONS The study shows that limited psychoeducation, communication and coordination in the treatment for AN are major problems in a Chinese context. Open communication between the health professionals and the parents about the expected treatment outcomes and limitations is needed to enhance their mutual trust. Besides, treatment should emphasize not only family involvement but also empower them to fight against AN.
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Affiliation(s)
- Kai Sing Sun
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Tai Pong Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
- * E-mail:
| | - Kit Wing Kwok
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - King Yee Chong
- Department of Psychiatry, The University of Hong Kong, Hong Kong, China
| | - Man Kay Poon
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Dan Wu
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Bachner-Melman R, Lev-Ari L, Zohar AH, Lev SL. Can Recovery From an Eating Disorder Be Measured? Toward a Standardized Questionnaire. Front Psychol 2018; 9:2456. [PMID: 30618916 PMCID: PMC6297874 DOI: 10.3389/fpsyg.2018.02456] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 11/20/2018] [Indexed: 01/12/2023] Open
Abstract
Background: There is a clear need for a standardized definition of recovery from eating disorders (EDs) and for self-report instruments to assess where individuals with an ED are situated at a given point of time along their process of illness and recovery. It has been acknowledged that psychological and cognitive symptoms are important to recovery in addition to physical and behavioral indices. This study proposes a 28-item multidimensional questionnaire encompassing the main features of recovery from ED, derived from the endorsement of different criteria by people with a lifetime ED diagnosis, family members and ED clinicians. Methods: Participants were 213 volunteers over the age of 18 (118 people with a lifetime ED diagnosis, 58 healthy family members of people with EDs and 37 ED clinicians), who completed the ED-15 and indicated online how important they thought each of 56 criteria were for recovery from an ED. Results: Four factors were identified in an exploratory factor analysis: Lack of Symptomatic Behavior (LSB), Acceptance of Self and Body (ASB), Social and Emotional Connection (SEC), and Physical Health (PH). Confirmatory factor analysis using the seven highest loading items from each subscale confirmed the structure validity of a shortened version of this questionnaire, the Eating Disorders Recovery Endorsement Questionnaire (EDREQ), which had excellent goodness-of-fit indices. Despite a few between-group differences, there was general agreement that LSB was most salient to recovery, followed by ASB, SEC, and PH in that order. Conclusion: Despite the absence of a standardized definition of recovery from ED, there is a general consensus about its components. The EDREQ is a psychometrically sound questionnaire containing items that people with an ED history, their family members and therapists all define as important components of recovery. The inclusion of emotional and psychosocial aspects of recovery in addition to symptomatic and medical aspects is important to expand treatment goals and the concept of recovery from EDs beyond symptom relief and the absence of disease markers. As a clinical tool, the EDREQ stands to assist in setting and refining therapeutic goals throughout therapy, and in establishing standardized, comparable norms for recovery levels in research.
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Affiliation(s)
- Rachel Bachner-Melman
- Clinical Psychology Graduate Program, Ruppin Academic Center, Hadera, Israel
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Lilac Lev-Ari
- Clinical Psychology Graduate Program, Ruppin Academic Center, Hadera, Israel
| | - Ada H. Zohar
- Clinical Psychology Graduate Program, Ruppin Academic Center, Hadera, Israel
| | - Shay Lee Lev
- Clinical Psychology Graduate Program, Ruppin Academic Center, Hadera, Israel
- Student Counselling Service, University of Haifa, Haifa, Israel
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Wehrens R, Walters BH. Understanding each other in the medical encounter: Exploring therapists' and patients' understanding of each other's experiential knowledge through the Imitation Game. Health (London) 2018; 22:558-579. [PMID: 28770633 PMCID: PMC6168741 DOI: 10.1177/1363459317721100] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The ability of health-care professionals to understand the lived experiences of their patients has become increasingly important but has been a difficult topic to investigate empirically because it involves two distinctive research strands: interpretative phenomenological analysis and patient-provider communication. While interpretative phenomenological analysis focuses on experiences and illness narratives of patients, but not on therapist's understanding of those, patient-provider communication surveys focus primarily on effective forms of communication without addressing the actual illness experiences of patients. There is a need for empirical research that combines both strands to investigate not only the experiences of patients but also whether professionals are able to understand these. This study combined both strands by means of a novel research method called the Imitation Game (combined with other qualitative methods). This sociological method was developed to investigate what different social groups know of each other's lifeworld. It focused on the important domain of eating disorder treatment to investigate whether therapists were able to understand the experiences of their patients and vice versa. This study provides insights into the domains in which therapists and patients were able to develop insights into each other's experiential knowledge (and where they had difficulties in doing so). The findings also implicate the high potential of the Imitation Game as an interdisciplinary research method. We propose that the Imitation Game may be particularly valuable as a 'can opener' that enables the development of in-depth, qualitative insights into the substantive themes that matter in the lifeworlds of patients and therapists.
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Affiliation(s)
- Rik Wehrens
- Erasmus University Rotterdam, The Netherlands
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18
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de Vos JA, LaMarre A, Radstaak M, Bijkerk CA, Bohlmeijer ET, Westerhof GJ. Identifying fundamental criteria for eating disorder recovery: a systematic review and qualitative meta-analysis. J Eat Disord 2017; 5:34. [PMID: 29118983 PMCID: PMC5664841 DOI: 10.1186/s40337-017-0164-0] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 06/29/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Outcome studies for eating disorders regularly measure pathology change or remission as the only outcome. Researchers, patients and recovered individuals highlight the importance of using additional criteria for measuring eating disorder recovery. There is no clear consensus on which additional criteria are most fundamental. Studies focusing on the perspectives of recovered patients show criteria which are closely related to dimensions of positive functioning as conceptualized in the complete mental health model. The aim of this study was to identify fundamental criteria for eating disorder recovery according to recovered individuals. METHODS A systematic review and a qualitative meta-analytic approach were used. Eighteen studies with recovered individuals and meeting various quality criteria were included. The result sections of the included papers were searched for themes that were stated as criteria for recovery or 'being recovered'. All themes were analyzed using a meta-summary technique. Themes were labeled into criteria for recovery and the frequency of the found criteria was examined. RESULTS In addition to the remission of eating disorder pathology, dimensions of psychological well-being and self-adaptability/resilience were found to be fundamental criteria for eating disorder recovery. The most frequently mentioned criteria were: self-acceptance, positive relationships, personal growth, decrease in eating disorder behavior/cognitions, self-adaptability/resilience and autonomy. CONCLUSIONS People who have recovered rate psychological well-being as a central criterion for ED recovery in addition to the remission of eating disorder symptoms. Supplementary criteria, besides symptom remission, are needed to measure recovery. We recommend including measurements of psychological well-being and self-adaptability/resilience in future research, such as outcome studies and in routine outcome measurement.
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Affiliation(s)
- Jan Alexander de Vos
- Centre for eHealth and Well-being Research, University of Twente, Psychology, Health, & Technology, Enschede, The Netherlands
- Human Concern Foundation, center for Eating Disorders, Amsterdam, The Netherlands
| | - Andrea LaMarre
- University of Guelph, Department of Family Relations and Applied Nutrition, Ontario, Canada
| | - Mirjam Radstaak
- Centre for eHealth and Well-being Research, University of Twente, Psychology, Health, & Technology, Enschede, The Netherlands
| | | | - Ernst T. Bohlmeijer
- Centre for eHealth and Well-being Research, University of Twente, Psychology, Health, & Technology, Enschede, The Netherlands
- Optentia Research Focus Area, North-West University (VTC), Vanderbijlpark, South Africa
| | - Gerben J. Westerhof
- Centre for eHealth and Well-being Research, University of Twente, Psychology, Health, & Technology, Enschede, The Netherlands
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19
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Young adults' use of emotional food memories to build resilience. Appetite 2017; 112:210-218. [DOI: 10.1016/j.appet.2017.01.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 01/20/2017] [Accepted: 01/30/2017] [Indexed: 11/22/2022]
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20
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Froreich FV, Vartanian LR, Zawadzki MJ, Grisham JR, Touyz SW. Psychological need satisfaction, control, and disordered eating. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2016; 56:53-68. [PMID: 27885691 DOI: 10.1111/bjc.12120] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 10/20/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Unfulfilled basic psychological needs have been associated with disordered eating behaviours, but the mechanisms underlying that associations are not well understood. This study examined a two-stage path model linking basic psychological need satisfaction to disordered eating behaviours via issues of control. METHODS Female university students (N = 323; Mage = 19.61), community participants (N = 371; Mage = 29.75), and women who self-reported having been diagnosed with an eating disorder (ED; N = 41; Mage = 23.88) completed measures of psychological need satisfaction (i.e., autonomy and competence), issues of control (i.e., feelings of ineffectiveness and fear of losing self-control [FLC]), and ED pathology. RESULTS Path analysis revealed that unsatisfied needs of autonomy and competence were indirectly related to disordered eating behaviours through feelings of ineffectiveness and FLC. CONCLUSIONS The results indicate that issues of control might be one of the mechanisms through which lack of psychological need satisfaction is associated with disordered eating. Although the model was constructed using cross-sectional data, these findings suggest potential targets for prevention and treatment efforts aimed at reducing disordered eating in young females. PRACTITIONER POINTS Our results indicate that young women with chronically unfulfilled basic psychological needs might be vulnerable to developing disordered eating behaviours. The observed patterns suggest that persistent experience of need frustration may engender an internal sense of ineffectiveness and lack of control, which then compels individuals to engage in disordered eating behaviours in an attempt to regain autonomy and competence. Interventions for eating disorders may be most effective when emphasizing the promotion of people's needs for autonomy and competence. Limitations The model was constructed using cross-sectional data. Future experimental and longitudinal studies are needed to confirm the temporal sequence from basic psychological needs to issues of control. The sample only consisted of young women. Further research should explore how thwarting of psychological need satisfaction functions in men. Our clinical sample was small and diagnosis was not confirmed through clinical interview; therefore, those data should be interpreted with caution.
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Affiliation(s)
| | - Lenny R Vartanian
- School of Psychology, UNSW Australia, Sydney, New South Wales, Australia
| | - Matthew J Zawadzki
- Psychological Sciences, University of California, Merced, California, USA
| | - Jessica R Grisham
- School of Psychology, UNSW Australia, Sydney, New South Wales, Australia
| | - Stephen W Touyz
- School of Psychology, University of Sydney, New South Wales, Australia
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Quality of life as a vulnerability and recovery factor in eating disorders: a community-based study. BMC Psychiatry 2016; 16:328. [PMID: 27724943 PMCID: PMC5057465 DOI: 10.1186/s12888-016-1033-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 09/07/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Emerging evidence suggests that changes in quality of life (QoL) predicts later changes in eating disorder (ED) symptoms. The objective of this study was to explore individual sufferers' perspectives on the influence of QoL on the onset, maintenance, and/or remission of ED symptoms. METHOD 19 women from the community with a history of eating disorders (n = 13 currently symptomatic; n = 6 recovered) were interviewed about their observations on the relationship between QoL and ED symptoms over time in their own lives. Interviews were audio-taped and transcribed, and then thematically analysed. RESULTS Thematic analysis uncovered two major themes: 1. QoL as a Vulnerability Factor, and 2. QoL as a Recovery Factor. In relation to the first theme, onset of ED symptoms was discussed by women in this study as having been triggered by impairment in QoL, including a general sense of lacking control in life, stress, abusive intimate relationships, poor role modelling from family, physical impairment related to obesity, peer pressure, and weight-related teasing. On the other hand, and in relation to the second theme, subsequent improvement in QoL was nominated as central to symptom improvement and recovery. QoL improvement was described by participants differently, but included increased general satisfaction in life, emotional maturation, prioritising and improving physical health, the development of a supportive intimate relationship and social relationships, and having children. CONCLUSIONS Impairment in QoL may act as a trigger for the onset and maintenance of ED symptoms, whereas improvement in QoL may be central to eating disorder improvement and eventual recovery. Treatment should involve consideration of a core focus on QoL improvement as a potential 'backdoor' approach to improving ED symptoms.
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Zohar AH, Lev Ari L, Bachner-Melman R. My Sister Myself: A Controlled Study of the Relationship Between Women with a Lifetime Diagnosis of Anorexia Nervosa and Their Sisters. EUROPEAN EATING DISORDERS REVIEW 2016; 24:466-473. [DOI: 10.1002/erv.2465] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 06/18/2016] [Accepted: 06/26/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Ada H. Zohar
- Clinical Psychology Program; Ruppin Academic Center; Emek Hefer Israel
| | - Lilac Lev Ari
- Clinical Psychology Program; Ruppin Academic Center; Emek Hefer Israel
| | - Rachel Bachner-Melman
- Clinical Psychology Program; Ruppin Academic Center; Emek Hefer Israel
- Clinical Psychology Program; Hebrew University of Jerusalem; Jerusalem Israel
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Smethurst L, Kuss D. ‘Learning to live your life again’: An interpretative phenomenological analysis of weblogs documenting the inside experience of recovering from anorexia nervosa. J Health Psychol 2016; 23:1287-1298. [DOI: 10.1177/1359105316651710] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study aimed to explore the construct of recovery from anorexia nervosa through the medium of weblogs, focusing on the benefits and barriers to the recovery process. Data were extracted from female ( n = 7) and male ( n = 1) participants’ textual pro-recovery weblogs, all of which were posted between 2013 and 2015 in the public domain. Data were analysed using interpretative phenomenological analysis. Three superordinate themes were identified: (1) barriers to recovery, (2) factors increasing the likelihood of recovery and (3) support. Results suggest supportive relationships, regaining control and recognising the consequences of the eating disorder benefit recovery, whereas public perceptions, the anorexia nervosa voice and time act as barriers to recovery. Out of eight participants, four described seeking professional help as part of their recovery, of which three believed their professional therapy experience helped aid recovery. Implications for anorexia nervosa treatment are discussed in detail.
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Collin P, Karatzias T, Power K, Howard R, Grierson D, Yellowlees A. Multi-dimensional self-esteem and magnitude of change in the treatment of anorexia nervosa. Psychiatry Res 2016; 237:175-81. [PMID: 26837476 DOI: 10.1016/j.psychres.2016.01.046] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 12/02/2015] [Accepted: 01/21/2016] [Indexed: 11/16/2022]
Abstract
Self-esteem improvement is one of the main targets of inpatient eating disorder programmes. The present study sought to examine multi-dimensional self-esteem and magnitude of change in eating psychopathology among adults participating in a specialist inpatient treatment programme for anorexia nervosa. A standardised assessment battery, including multi-dimensional measures of eating psychopathology and self-esteem, was completed pre- and post-treatment for 60 participants (all white Scottish female, mean age=25.63 years). Statistical analyses indicated that self-esteem improved with eating psychopathology and weight over the course of treatment, but that improvements were domain-specific and small in size. Global self-esteem was not predictive of treatment outcome. Dimensions of self-esteem at baseline (Lovability and Moral Self-approval), however, were predictive of magnitude of change in dimensions of eating psychopathology (Shape and Weight Concern). Magnitude of change in Self-Control and Lovability dimensions were predictive of magnitude of change in eating psychopathology (Global, Dietary Restraint, and Shape Concern). The results of this study demonstrate that the relationship between self-esteem and eating disorder is far from straightforward, and suggest that future research and interventions should focus less exclusively on self-esteem as a uni-dimensional psychological construct.
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Affiliation(s)
- Paula Collin
- NHS Tayside Eating Disorders Service/Psychological Therapies Service, Dundee, UK
| | - Thanos Karatzias
- Edinburgh Napier University, Faculty of Health, Life & Social Sciences, Edinburgh, UK; NHS Lothian, Rivers Centre for Traumatic Stress, Edinburgh, UK.
| | - Kevin Power
- NHS Tayside Eating Disorders Service/Psychological Therapies Service, Dundee, UK; Stirling University, School of Natural Sciences, Stirling, UK
| | - Ruth Howard
- Edinburgh Napier University, Faculty of Health, Life & Social Sciences, Edinburgh, UK
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Froreich FV, Vartanian LR, Grisham JR, Touyz SW. Dimensions of control and their relation to disordered eating behaviours and obsessive-compulsive symptoms. J Eat Disord 2016; 4:14. [PMID: 27144009 PMCID: PMC4853853 DOI: 10.1186/s40337-016-0104-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 04/17/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Issues of personal control have been proposed to play a central role in the aetiology and maintenance of eating disorders. Empirical evidence supporting this relationship is inconsistent, partly due to the multiplicity of constructs used to define "control". This study compares six commonly used measures of control with the aim of determining which operationalisation of control is most centrally relevant to eating pathology. Given the high level of comorbidity between eating disorders and obsessive-compulsive disorder and the potentially common risk/maintenance factors for the two disorders, we also examine the relationship between control and obsessive-compulsive symptomatology. METHODS Female community participants (N = 175) completed self-report measures of control, eating disorder pathology and obsessive-compulsive symptoms. RESULTS Multivariate analyses of variance indicated significant differences between individuals with high vs. low levels of psychopathology on most of the measures of control. Using regression analyses, we found that a sense of ineffectiveness and fear of losing self-control were the only significant independent predictors of eating pathology, and fear of losing self-control was the most significant predictor of obsessive-compulsive symptoms. CONCLUSIONS This study highlights the importance of issues of control, particularly feelings of ineffectiveness and fear of losing self-control, in eating disorder symptoms. Furthermore, our findings suggest that there may be a similar underlying fear of losing self-control among individuals who engage in disordered eating and obsessive-compulsive behaviours. Thus, ineffectiveness and fear of losing self-control are two dimensions that are important to consider in maintenance and treatment models of disordered eating behaviours.
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Affiliation(s)
| | - Lenny R Vartanian
- School of Psychology, UNSW Australia, Sydney, New South Wales 2052 Australia
| | - Jessica R Grisham
- School of Psychology, UNSW Australia, Sydney, New South Wales 2052 Australia
| | - Stephen W Touyz
- School of Psychology, University of Sydney, Sydney, 2006 New South Wales Australia
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26
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Abstract
This article explores how women understand and experience the relationship between physical, sexual, and emotional abuse and the emergence of an eating disorder in their lives. The past three decades have seen increased attention to the links between abuse and eating disorders; however, the social contexts of abuse, the specific emotions involved, and how these might link to an eating disorder have not been explored. Through an in-depth interview study with 14 women, narrative-discursive analysis reveals how socially situated, abuse-related emotions, such as shame and self-contempt, can play out in an eating disorder and are located within social power relations framed primarily by gender but also by race and class.
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27
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O’Hara CB, Campbell IC, Schmidt U. A reward-centred model of anorexia nervosa: A focussed narrative review of the neurological and psychophysiological literature. Neurosci Biobehav Rev 2015; 52:131-52. [DOI: 10.1016/j.neubiorev.2015.02.012] [Citation(s) in RCA: 168] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 02/09/2015] [Accepted: 02/22/2015] [Indexed: 12/13/2022]
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Affiliation(s)
- Dallong Han
- Department of Nursing, College of Health Sciences, Cheongju University, Cheongju, Korea
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29
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Blodgett Salafia EH, Jones ME, Haugen EC, Schaefer MK. Perceptions of the causes of eating disorders: a comparison of individuals with and without eating disorders. J Eat Disord 2015; 3:32. [PMID: 26380085 PMCID: PMC4570226 DOI: 10.1186/s40337-015-0069-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 09/04/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In this study, we examined perceptions regarding the causes of eating disorders, both among those with eating disorders as well as those without. By understanding the differences in perceived causes between the two groups, better educational programs for lay people and those suffering from eating disorders can be developed. METHOD This study used open-ended questions to assess the beliefs of 57 individuals with self-reported eating disorders and 220 without. Participants responded to the questions, "What do you think was (were) the cause(s) of your eating disorder?" and "What do you think is (are) the cause(s) of eating disorders?". RESULTS A list of possible codes for the causes of eating disorders was created based on a thorough review of the literature. A manually-generated set of eight codes was then created from individuals' actual responses. Frequencies and chi square analyses demonstrated differences in rates of endorsement between those with eating disorders and those without. Participants with eating disorders most frequently endorsed psychological/emotional and social problems, with genetics/biology and media/culture ideals least endorsed. Participants without eating disorders most frequently endorsed psychological/emotional problems and media/culture ideals, with traumatic life events and sports/health least endorsed. There was a difference between groups in the endorsement of the media as a cause of eating disorders, suggesting that those without eating disorders may overly attribute the media as the main cause while those with eating disorders may not be fully aware of the media's impact. Additionally, while both groups highly endorsed psychological/emotional problems, there was a noticeable stigma about eating disorders among those without eating disorders. CONCLUSIONS There were noteworthy differences between samples; such differences suggest that there is a need for more education on the topic of eating disorders. Furthermore, despite empirical support for the effects of genetics, sports, and family factors, these were infrequently endorsed as causes of eating disorders by both groups. Our results suggest that there is a need for more education regarding the factors associated with eating disorders, in order to reduce the stigma surrounding these disorders and to potentially aid the treatment process.
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Affiliation(s)
- Elizabeth H Blodgett Salafia
- Department of Human Development and Family Science, North Dakota State University, 283-H EML Hall, #2615, P.O. Box 6050, Fargo, North Dakota 58108 USA
| | - Maegan E Jones
- Department of Human Development and Family Science, North Dakota State University, 283-H EML Hall, #2615, P.O. Box 6050, Fargo, North Dakota 58108 USA
| | - Emily C Haugen
- Department of Human Development and Family Science, North Dakota State University, 283-H EML Hall, #2615, P.O. Box 6050, Fargo, North Dakota 58108 USA
| | - Mallary K Schaefer
- Department of Human Development and Family Science, North Dakota State University, 283-H EML Hall, #2615, P.O. Box 6050, Fargo, North Dakota 58108 USA
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Duncan TK, Sebar B, Lee J. Reclamation of power and self: a meta-synthesis exploring the process of recovery from anorexia nervosa. ACTA ACUST UNITED AC 2014. [DOI: 10.1080/21662630.2014.978804] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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31
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Lindgren BM, Enmark A, Bohman A, Lundström M. A qualitative study of young women's experiences of recovery from Bulimia Nervosa. J Adv Nurs 2014; 71:860-9. [DOI: 10.1111/jan.12554] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2014] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Anna Bohman
- Department of Nursing; Umeå University; Sweden
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Dawson L, Rhodes P, Touyz S. "Doing the impossible": the process of recovery from chronic anorexia nervosa. QUALITATIVE HEALTH RESEARCH 2014; 24:494-505. [PMID: 24594747 DOI: 10.1177/1049732314524029] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In this study, we aimed to explore the process of recovery over time from the perspective of those who had fully recovered from chronic anorexia nervosa (AN), using stringent recovery criteria. Eight women, assessed as fully recovered from chronic AN, told their story of the process of recovery. Data were analyzed using the qualitative method, narrative inquiry. Recovery was identified as a long and complex process that spanned four phases: from being unable or unready to change, to experiencing a tipping point where motivation increased and changed in quality, allowing the women to take action against the AN and finally allowing them to reflect and rehabilitate. Results provide a framework for understanding this complex process. Findings suggest that full recovery from chronic AN is possible and emphasize the importance of hope, motivation, self-efficacy, and support from others in the recovery process.
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Affiliation(s)
- Lisa Dawson
- 1The University of Sydney, Sydney, New South Wales, Australia
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Arthur-Cameselle JN, Quatromoni PA. Eating disorders in collegiate female athletes: factors that assist recovery. Eat Disord 2014; 22:50-61. [PMID: 24365527 DOI: 10.1080/10640266.2014.857518] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The purpose of this study was to identify factors that assist female athletes' recovery from eating disorders. Forty-seven female collegiate athletes who experienced eating disorders responded to an open-ended question regarding factors that most helped their recovery. The most common factors were the desire to be healthy enough to perform in sport, support from others, and shifts in values/beliefs. A unique finding was that the desire to be healthy enough to perform in sport most frequently facilitated recovery. This knowledge can help treatment providers to foster athletes' motivation to recover and distinguishes athletes as a unique treatment population from non-athletes.
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Ulian MD, Unsain RF, Sato PDM, Pereira PDR, Stelmo IDC, Sabatini F, Scagliusi FB. Current and previous eating practices among women recovered from anorexia nervosa: a qualitative approach. JORNAL BRASILEIRO DE PSIQUIATRIA 2013. [DOI: 10.1590/s0047-20852013000400005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE: The aim of this study was to analyze qualitatively how women, who have recovered from anorexia nervosa, perceive and describe their current eating practices, as well as the ones developed during the eating disorder period. METHODS: Seven women were interviewed individually with the objective of investigating their eating practices, transition phases and all relevant aspects that somewhat contributed to the habit-forming; experiences, feelings and perceptions related to mealtime and the influence that food has had over the present subjects' life. The interviews were analyzed by the discourse of the collective subject method. RESULTS: The results brought up the following topics: a) control; b) concerns and feelings; c) deprivation d) beauty dictatorship; e) eating competence; f) importance of food; g) food cacophony. CONCLUSIONS: What stands out is a multiplicity of eating practices, which during the eating disorder were similar to and characterized by restriction; however, after recovery, part of the subjects seem to have developed a higher eating competence, whereas others show a practice similar to the one acquired during the anorexia nervosa, such as the difficulty in realizing when they are satisfied and a feeling of discomfort when facing social interactions.
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35
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Matusitz J, Martin J. The Application of Self-Determination Theory to Eating Disorders. JOURNAL OF CREATIVITY IN MENTAL HEALTH 2013. [DOI: 10.1080/15401383.2013.850392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Salzmann-Erikson M. An integrative review of what contributes to personal recovery in psychiatric disabilities. Issues Ment Health Nurs 2013; 34:185-91. [PMID: 23477439 DOI: 10.3109/01612840.2012.737892] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of this integrated literature review is to identify what people with psychiatric disabilities experience as contributing to their personal recovery. The study design is based on Whittemore and Knafl's integrative review and includes 14 qualitative peer-reviewed articles. The analysis reveals three main themes: recovery as an inner process; recovery as a contribution from others; and recovery as participating in social and meaningful activities. If mental health nurses adhere to the personal recovery perspective, nursing practice will focus on the patients' needs, conveying hope and supporting the patient in the recovery process.
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Affiliation(s)
- Martin Salzmann-Erikson
- Oslo University Hospital, Ullevål, Division of Mental Health and Addiction, Department of Acute Psychiatry, Oslo, Norway.
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37
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Robinson KJ, Mountford VA, Sperlinger DJ. Being men with eating disorders: Perspectives of male eating disorder service-users. J Health Psychol 2012; 18:176-86. [DOI: 10.1177/1359105312440298] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aimed to explore experiences of men currently using eating disorder services. Eight men from two eating disorder services were interviewed about their experiences of seeking and receiving treatment. Two superordinate themes emerged from Interpretative Phenomenological Analysis: (1) difficulty seeing self as having an eating disorder; and (2) experiences of treatment: how important is gender? The underlying themes varied in their specificity to men, with some echoing findings from the female eating disorder literature. Difficulty admitting the eating disorder may link with eating disorder psychopathology as well as gender-specific issues. Implications for clinical practice and future research are discussed.
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Elliot ML. Figured World of Eating Disorders: Occupations of Illness. The Canadian Journal of Occupational Therapy 2012; 79:15-22. [DOI: 10.2182/cjot.2012.79.1.3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Background. The biomedical diagnosis of eating disorders signifies a mental illness with complex physical symptomology. The socio-cultural determinants and impact of eating disorders on daily occupations are not adequately addressed in this classification. Purpose. This paper introduces the concept of a figured world as a framework for how eating disorders exist in daily activity and social discourse. How occupations become ascribed with meaning generated by an eating disorder will be proposed through the voice of a composite character in the figured world. Key Issues. Central elements to contextualizing figured worlds include positional identity, self-authoring, and semiotic mediation. The generation of meaning in illness arises from the integration of these elements into this specific figured world. Implications. The competing agendas of the biomedical model and figured world permit a new understanding of the challenges associated with recovery. For occupational therapists, these challenges require the reattribution of meaning of daily occupations.
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Abstract
A limited series of community studies including non-treatment-seekers has shown that a considerable number of eating disorder patients do not enter the health care system but can be considered "clinically recovered" (remission of major symptoms) if followed up long enough. The possibility of "spontaneous recovery" (overcoming an eating disorder without professional treatment or formal help) often faces scepticism on the part of professionals. Clearly, self-change is an underestimated pathway to recovery from an eating disorder, but open-minded clinicians can learn a lot from it. Active coping and making use of one's "recovery capital" are key features of self-change even if maintenance of change is associated with social support and positive life changes.
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Bardone-Cone AM, Schaefer LM, Maldonado CR, Fitzsimmons EE, Harney MB, Lawson MA, Robinson DP, Tosh A, Smith R. Aspects of Self-Concept and Eating Disorder Recovery: What Does the Sense of Self Look Like When an Individual Recovers from an Eating Disorder? JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2010. [DOI: 10.1521/jscp.2010.29.7.821] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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