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Theodoropoulou O, Holyoak L, Caswell N, Gardner KJ. The continuation of non-physical abuse from childhood to adulthood in eating disorder patients: An interpretative phenomenological analysis. CHILD ABUSE & NEGLECT 2024; 149:106661. [PMID: 38295605 DOI: 10.1016/j.chiabu.2024.106661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 01/12/2024] [Accepted: 01/19/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND The ED literature has focused on the physical forms of childhood abuse with respect to eating disorders, overlooking non-physical abuse even though eating disorder patients report the latter either as primary experiences or as a revival of their childhood experiences. Additionally, there is no literature exploring whether adult eating disorder patients who have experienced childhood non-physical abuse continue to experience abuse as adults, and if they do, how well-being is impacted or linked with eating pathology. OBJECTIVE This study explored the lived experiences of eating disorders patients who have experienced non-physical childhood abuse in childhood and adulthood. PARTICIPANTS AND SETTINGS Six adult female eating disorder outpatients each took part in a semi-structured interview. METHODS This study used the Interpretative Phenomenological Analysis framework. RESULTS Three master themes and eleven superordinate themes were drawn from the analysis, addressing the research question: continuation of non-physical abuse across a lifetime, developmental factors and non-physical abuse, and non-physical abuse and eating pathology. CONCLUSIONS The participants' accounts indicate that childhood non-physical abuse is related to eating disorder onset, and abuse continuation in adulthood contributes to the disorder's maintenance. Moreover, the lifelong consequences of non-physical childhood abuse impact psychological factors, such as self-esteem, attachment and emotion regulation, affecting the individuals' adult lives and keeping participants inside a vicious cycle of trauma re-enactment. Low self-esteem is considered by the participants as the key factor for their disturbed relationship with food.
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Affiliation(s)
- Olga Theodoropoulou
- School of Psychology and Computer Science, University of Central Lancashire, Preston, Lancashire PR1 2HE, UK.
| | - Lynda Holyoak
- School of Psychology and Computer Science, University of Central Lancashire, Preston, Lancashire PR1 2HE, UK.
| | - Noreen Caswell
- School of Psychology and Computer Science, University of Central Lancashire, Preston, Lancashire PR1 2HE, UK.
| | - Kathryn Jane Gardner
- School of Psychology and Computer Science, University of Central Lancashire, Preston, Lancashire PR1 2HE, UK
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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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Budia JM, Alcover CM, Fernández-Muñoz JJ, Blanco-Fernández A, Félix-Alcántara MP. Attachment, motivational systems and anorexia nervosa: A systematic review and proposed framework for eating disorders. Clin Psychol Psychother 2023; 30:913-930. [PMID: 36861498 DOI: 10.1002/cpp.2845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/22/2023] [Accepted: 02/26/2023] [Indexed: 03/03/2023]
Abstract
INTRODUCTION There is a direct association between patients with insecure attachment style (IAS), behavioural inhibition (BIS) and behavioural activation (BAS) motivational systems, and anorexia nervosa (AN). However, the possible direct relationships between these three variables have not been studied. OBJECTIVE The main objective of this study is to analyse the relationship between these variables and propose a framework for analysing and understanding these relationships. METHODOLOGY A systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, searching the following terms: 'anorexia', 'attachment' and those related to motivational systems. The final search was limited to publications in English dated between 2014-2022 for 'anorexia and attachment' and 2010-2022 for 'anorexia and BIS/BAS'. RESULTS Of the 587 articles retrieved, 30 were included in this study for the textual data analysis of the relationship between anorexia and attachment (17), anorexia and motivational systems (10) and anorexia, attachment and motivational systems (3). An association between avoidant IAS, AN and hypersensitivity to punishment of the BIS was observed in the analysis. A relationship was also observed with hyperreinforcement sensitivity of the BAS. After reviewing the articles, a possible relationship between the three factors, along with other mediating factors, was found. DISCUSSION AN is directly related to the avoidant IAS and to BIS. Similarly, bulimia nervosa (BN) was directly related with anxious IAS and BAS. However, contradictions were found in the BN-BAS relationship. This study proposes a framework for analysing and understanding these relationships.
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Wu YY, Chou WH. Smartphone addiction, gender and interpersonal attachment: A cross-sectional analytical survey in Taiwan. Digit Health 2023; 9:20552076231177134. [PMID: 37256009 PMCID: PMC10226168 DOI: 10.1177/20552076231177134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 05/04/2023] [Indexed: 06/01/2023] Open
Abstract
Overview Smartphone use has dramatically increased worldwide, contributing to a profound change in interpersonal interactions. They have become the primary medium of human interaction, and smartphone addiction, consequently, has become a modern-day reality. Recent research on smartphone addiction has provided diverse explanations regarding the correlation between gender and addiction. Therefore, this study aims to analyse the correlation and variance among smartphone addiction, gender and interpersonal attachment. Methods The participants included Taiwanese citizens and the questionnaires were randomly distributed; 1190 valid questionnaires (534 males, 656 females) were collected. Descriptive statistics were computed to observe the average value and standard deviation between interpersonal attachment and gender. Next, Spearman's ρ was conducted to interpret the correlation among smartphone addiction, gender and interpersonal attachment. Finally, the participants were divided into three groups based on their pre-determined level of smartphone addiction: high, moderate and low addictions. The Analysis of variance (ANOVA) was performed based on interpersonal attachment as the independent variable to determine any statistically significant difference among the three levels. Results There are four patterns of interpersonal attachment: secure, avoidant, dismissing and anxious attachments. The correlation analysis revealed a significant positive correlation between interpersonal attachment and smartphone addiction (p > 0.000), while revealing no relationship between gender and smartphone addiction or gender and interpersonal attachment. Additionally, the ANOVA indicated the difference was statistically significant in the groups of high and moderate addictions; no statistical significance was identified in the group of low addiction (p < 0.204). Conclusion This study revealed that there was no correlation between gender and smartphone addiction, but rather, a positive correlation between smartphone addiction and interpersonal attachment. This positive correlation suggests both high and moderate addiction groups display insecurity in their interpersonal attachment. Therefore, to lower the prevalence of unhealthy smartphone addiction, maintaining healthy interpersonal relationships is suggested.
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Affiliation(s)
- Yi-Ying Wu
- Graduate School of Design, National Yunlin University of Science and
Technology, Douliou
| | - Wen-Huei Chou
- Department of Digital Media Design, National Yunlin University of Science and
Technology, Douliou
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Ling NCY, Serpell L, Burnett-Stuart S, Pugh M. Interviewing anorexia: How do individuals given a diagnosis of anorexia nervosa experience Voice Dialogue with their eating disorder voice? A qualitative analysis. Clin Psychol Psychother 2021; 29:600-610. [PMID: 34269497 DOI: 10.1002/cpp.2652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 07/08/2021] [Accepted: 07/13/2021] [Indexed: 11/11/2022]
Abstract
A proportion of individuals given an eating disorder diagnosis describe the experience of an eating disorder 'voice' (EDV). However, methods for working with this experience are currently lacking. Voice Dialogue (Stone & Stone, 1989) involves direct communication between a facilitator and parts of the self to increase awareness, understanding, and separation from inner voices. Adapted forms of this method have shown promise in working with voices in psychosis. This study aimed to explore the experience and acceptability of Voice Dialogue amongst individuals with anorexia nervosa who experience an EDV. Nine women participated in a semistructured interview following a single Voice Dialogue session. Interview transcripts were analysed using interpretative phenomenological analysis (IPA). Three overarching themes were identified as follows: (i) "separating from the EDV"; (ii) "better understanding of the EDV"; and (iii) "hopeful, motivated, and afraid of recovery". The majority of participants found Voice Dialogue acceptable and helpful for exploring their EDV. Whilst preliminary, the results suggest that Voice Dialogue has potential in terms of helping individuals establish a more constructive relationship with their EDV and motivating change. Further research is needed to build upon these findings. Implications for addressing the EDV using voice-focused interventions are explored.
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Affiliation(s)
- Natalie Chua Yi Ling
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Lucy Serpell
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Sarah Burnett-Stuart
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Matthew Pugh
- Central and North West London NHS Foundation Trust, London, UK
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Bucharová M, Malá A, Kantor J, Svobodová Z. Arts Therapies Interventions and Their Outcomes in the Treatment of Eating Disorders: Scoping Review Protocol. Behav Sci (Basel) 2020; 10:E188. [PMID: 33316926 PMCID: PMC7763866 DOI: 10.3390/bs10120188] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/02/2020] [Accepted: 12/03/2020] [Indexed: 11/29/2022] Open
Abstract
Arts therapies (AsTs) are considered a valuable intervention for people with eating disorders, however the range of research studies and the comparison between the types of arts therapies are unknown. The goal of the future scoping review is to explore the therapeutic outcomes addressed by arts therapists in research studies on people with eating disorders and compare the different types of arts-based interventions. This scoping review will be conducted in accordance with the Joanna Briggs Institute methodology. Included will be research studies and sources oriented towards people with eating disorders of all ages and AsTs of any type (art therapy, drama therapy, music therapy, dance/movement therapy, and expressive therapies). There is no language/publication period limitation. The following databases will be searched: CINAHL Plus, EMBASE, MEDLINE (OvidSP), ProQuest Central, PsycINFO, PubMed, Scopus, and Web of Science. Sources of unpublished studies and grey literature will include Google Scholar, MedNar, clinical trials, and current controlled trials. Titles/abstracts and full texts of studies will be assessed against the inclusion criteria, and the data extracted by two independent reviewers. Based on the results, we will compare the types of AsTs according to the research designs, country/settings, intervention methods/materials, adverse effects reported, and therapeutic outcomes related to AsTs.
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Affiliation(s)
- Monika Bucharová
- Palacky University Evidence-Based Education Working Team: Mentee Centre, and Institute of Special Education Studies, Faculty of Education, Palacky University, 779 00 Olomouc, Czech Republic; (A.M.); (J.K.)
| | - Andrea Malá
- Palacky University Evidence-Based Education Working Team: Mentee Centre, and Institute of Special Education Studies, Faculty of Education, Palacky University, 779 00 Olomouc, Czech Republic; (A.M.); (J.K.)
| | - Jiří Kantor
- Palacky University Evidence-Based Education Working Team: Mentee Centre, and Institute of Special Education Studies, Faculty of Education, Palacky University, 779 00 Olomouc, Czech Republic; (A.M.); (J.K.)
| | - Zuzana Svobodová
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech Evidence-Based Healthcare Centre: Joanna Briggs Institute Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 3, 625 00 Brno, Czech Republic;
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Hampshire K, Tierney S, Varese F, Haddock G, Saeidi S, Fox JRE. The development and assessment of a scale to measure the experience of an anorexic voice in anorexia nervosa. Clin Psychol Psychother 2020; 27:940-954. [PMID: 32455482 DOI: 10.1002/cpp.2481] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/22/2020] [Accepted: 05/23/2020] [Indexed: 11/09/2022]
Abstract
The anorexic voice (AV) is defined as a critical internal dialogue, which has been implicated in the development and maintenance of anorexia nervosa (AN). Systematic research to explore this further requires a valid and reliable measurement tool. This study aimed to develop and assess the validity of the Experience of an Anorexic VoicE Questionnaire (EAVE-Q). EAVE-Q items were developed and checked for face and content validity through cognitive interviews with seven individuals diagnosed with AN. Participants with a diagnosis of AN (N = 148) completed the EAVE-Q, sociodemographic questions and measures of mood and quality of life to assess internal consistency and construct validity. Forty-nine participants completed the EAVE-Q twice more to assess test-retest reliability. The EAVE-Q had good face and content validity and good acceptability. Principal axis factoring resulted in an 18-item scale organized into five domains with high internal consistency (α = 0.70 to α = 0.85). Domains correlated significantly with eating disorder symptoms, psychological distress, and quality of life. The EAVE-Q did not discriminate between participants on the basis of body mass index. Test-retest reliability was moderate. Although the factor structure of the EAVE-Q requires replication in other AN samples, the EAVE-Q is the first measure of a critical internal dialogue in AN. It is hoped that it will aid future research to increase understanding of AN and the continued development of person-centred treatments.
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Affiliation(s)
- Kay Hampshire
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Stephanie Tierney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Filippo Varese
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Gillian Haddock
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Saeideh Saeidi
- Clinical Audit and Service Evaluation, Leeds and York Partnership NHS Foundation Trust, Leeds
| | - John R E Fox
- Department of Psychology, Cardiff University, Prifysgol Caerdydd and Cardiff and Vale NHS board, Cardiff, UK
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Olofsson ME, Oddli HW, Vrabel KAR, Hoffart A. «In solitude is safeness»: a patient perspective on eating disorders in the context of multiple childhood trauma. NORDIC PSYCHOLOGY 2020. [DOI: 10.1080/19012276.2020.1762714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | | | | | - Asle Hoffart
- Department of Psychology, Oslo University, Oslo, Norway
- Modum Bad Research Institute, Vikersund, Norway
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Murphy K, Simonds LM, Spokes N. Disclosure in therapy by clients with eating difficulties: a Q-Methodology study. Eat Disord 2020; 28:32-46. [PMID: 30676885 DOI: 10.1080/10640266.2018.1560239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Disclosure by those with eating difficulties is of considerable importance to clinicians and researchers. The aim of the present study was to explore variability in factors considered likely to influence the decision to disclose during psychological therapy by people who experience such difficulties. Thirty-seven participants recruited through a UK-based eating disorder charity completed a Q-sort task. This invited them to sort 47 statements onto a grid reflecting what would make them more or less likely to disclose in therapy. The thirty-seven Q-sorts were analysed using PQ method software. This resulted in the extraction of three factors explaining 41 percent of the variance. Participants loading on the first factor considered maintaining an eating disorder identity as most influential whilst participants loading on the second factor considered the therapeutic relationship as most influential. Those loading on the third factor considered personal readiness and feelings of security as most influential. This study suggests that clinicians need to assess influences on the decision to disclose for individual clients and to modify the early stages of intervention accordingly. Future research could assess the utility of using the Q-sort process and materials in this study as a way to elicit influences on disclosure decisions.
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Affiliation(s)
- Karen Murphy
- School of Psychology, University of Surrey, Guildford UK.,Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - Naomi Spokes
- Tavistock and Portman NHS Foundation Trust, City and Hackney Primary Care Psychotherapy Consultation Service (PCPCS), London, UK
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