D.Litt. et Phil. / This study explored the impact of psoriasis on the self-concept (a multifaceted, hierarchical construct of self with both cognitive and emotional components) (Hattie & Marsh, 1996), of men and women who live with this cutaneous disease. Psoriasis is a common (frequently occurring), chronic inflammatory dermatological disease that can severely affect the sufferer's quality of life. While the underlying cause is unknown, the immediate cause of psoriasis is the rate of growth and differentiation of the outer layer of the skin. In a process known as hyper-proliferation (renewal of skin every four days as opposed to every 28 days), psoriasis is anatomically disfiguring. Symptoms include: the thickening of psoriatic plaques, the sloughing of silvery scales, severe itching of the affected areas and a thickening and yellowing of the fingernails. The severity of psoriasis varies from small scattered patches to total skin coverage (Young, 2005). Chronic skin diseases, such as psoriasis, can affect one's self-concept at the level of the physical, emotional, social and spiritual dimensions of self (Kew, Nevin & Cruickshank, 2002). According to Gupta and Gupta (1995), sufferers of psoriasis experience external shame (fear of negative evaluations and stigmatisation) as well as internal body shame (negative self-evaluations and self-focussed feelings). According to Stake, Huff and Zand (1995), a disturbance in one dimension of self (e.g. the physical self-concept), invariably effects other self-dimensions (e.g. the private, social self-dimensions). A study by Gupta and Gupta (1995) revealed that psoriasis was a major contributing factor to the onset of psychopathology such as depression, anxiety, unfocussed anger and obsessional behaviours. A study by Choi and Koo (as cited in Young, 2005), found that the impact of psoriasis on the psychological and emotional dimensions of self-concept to be comparable to that experienced by sufferers of more chronic diseases such as cancer, heart disease and clinical depression. General healthcare providers who treat the medical components of psoriasis may be surprised to learn that the emotional and social burdens of psoriasis are often greater than the physical toll of psoriasis on patients. Further, psoriasis is observed to be persistent, unpredictable and stressful over longer periods of time than more serious illnesses (Young, 2005). Although many people with disfiguring skin disorders cope remarkably well psychologically and socially, many do not and may require professional help in describing their bodily being in relation to the world and to come to terms with the positive and negative aspects of self (Van Deurzen-Smith, 1997). Significantly, studies in psychoneuroendocrineimmunology have shown the interconnectedness of emotions and mental attitude to physical health and which underscores the importance of treating the whole person and not just the symptoms (Linsteadt, 2002). Consistently, studies have shown the importance of self-concept to psychological health (Francis, 2002; Hattie & Marsh, 1996; Newell, 2000; Young, 2005) and body satisfaction as being pivotal in one's overall concept of self (Tiggemann & Williamson, 2000). Problematic however is that the literature indicates a dearth of dermatological studies detailing the meaning-making experiences of individuals who have undergone changes to their physical appearance as a result of this and the impact of cutaneous disease on the self-concept (Hill, 2004; Papadopoulos, Bor & Legg, 1999; Thompson & Kent, 2001). Our experiences and how we make sense of what we experience is primarily dependent upon the kinds of bodies we have and also on the ways we interact with the various environments we inhabit. It is through our embodied interactions that we inhabit a world, and it is through our bodies that we are able to understand and act within this world with varying degrees of success (Johnson, 1999). The importance of skin for an individual's psychosocial equilibrium can easily be appreciated. First, the skin represents the outward packaging of our being. Second, the cutaneous surface is what society initially perceives and with dermatological disease being the basis for social stigma. Arguably, having a healthy, unblemished skin can enhance one's self-esteem, self-identity and not infrequently, one's social standing (Koo & Yeung, 2002). Studies investigating the impact of disfiguring cutaneous disease on the self-concept appear to be lacking in the literature. In 2004, at a meeting of the Editorial Board for the Journal of Dermatology Nursing, the need for studies presenting the patient's experience of cutaneous disease was discussed. It was thought that qualitative exploration of the patient's experience of cutaneous disease would provide medical and mental healthcare professionals with valuable insights and important information to help improve dermatology patient care (Hill, 2004). Dermatology and self-concept phenomena tend to be investigated interdependently of each other. Furthermore, the majority of research in this area focuses on quantitative research design. Consequently, much of the depth of information regarding the experiential world of sufferers of cutaneous disease is invariably lost (Hill, 2004; Thompson & Kent, 2001). In light of that stated above, this study explored the meaning-making experience of men and women who suffer from psoriasis and the impact of this on the various dimensions of the self-concept. Due to the sparsity of South African studies investigating qualitatively, the experiences of persons suffering from a common, chronic dermatological condition, this study followed an existential phenomenological approach in describing the impact of psoriasis on the self-concept as told from the perspective of the men and women who live with this. Existential phenomenology seeks to explicate the essence, structure and form of both human experiences and behaviour as revealed through essentially descriptive techniques that includes disciplined reflection (Sokolowski, 2000). Given the apparent lack of awareness and knowledge of psychological processes, meaning-making and coping strategies utilised by psoriasis sufferers in their experience of this, this methodology was thought most appropriate (Hill, 2004; Newell, 2000; Papadopoulos, et al., 1999; Thompson & Kent, 2001). In terms of the areas of participation, three male and four female sufferers of psoriasis participated in the study. For all participants, psoriasis was in the active phase and covered most parts of their body. Data was collected using a questionnaire set consisting of semi-structured questions and the research question, which was open-ended. The method of data analysis was based on an integration of the works by various phenomenologists and involved six phases, namely: bracketing, intuitive grasp, eidetic reduction, textural and structural descriptions, composite textural and structural descriptions, and the final synthesis. The participants confirmed that the statements generated were accurately reflected. The results evidenced several prominent themes shared by the group, namely: (a) that the severity of the physical manifestations and the painful symptoms of psoriasis can result in negative self-concept evaluations; (b) a lack of empathy and a failure to provide knowledge on psoriasis and a priori caution of the side-effects of psoriatic medications by the medical doctors consulted was experienced by the participants as disempowering and adversely affected their emotional well-being; (c) the doctor/patient relationship was observed as pivotal in influencing the participants general concept of self; (d) the participants acceded that medical aids need to place psoriasis on the list of chronic medical conditions; (e) social stigma adversely affects self-concept evaluations; (f) public education on psoriasis is required; (g) drawing on various methods of coping was deemed crucial to the enhancement of the self-concept in the participants journey towards psychological health; (h) positive meaning-making from the psoriatic/self-concept experience enhanced quality of life issues; and finally, (i) trait self-esteem and healthy self-concept development may be important determinant factors in the psychological recovery of patients suffering from psoriasis. More specifically, in terms of self-evaluation, the participants experienced psoriasis as an assault on the physical self that was painful, embarrassing and humiliating. In redefining psoriasis in this way, the participants redefined their body image (mental construct of the body), and with the pervasiveness of negative self-evaluations an offshoot of continuous negative cognitive and emotional schemas of the body. Regarding the doctor/patient relationship, the results of the study show a need for medical doctors to expand their focus of treating the symptoms of psoriasis to incorporate a more holistic treatment approach that places emphasis on psychological, social and nutritional processes. The willingness of medical professionals to network with psychologists and other healthcare professionals and also being prepared to integrate the concept of holism into their treatment programmes was thought one method of attaining a holistic approach to the treatment and management of dermatology patients. Significantly, the doctor/patient relationship was also experienced as being an important factor in the patients drive to want to heal (healing is not here equated with cure but rather being able to approach living with psoriasis more positively). The participants in this study experienced doctors to be largely unsympathetic and not well versed in the physiology of psoriasis. Additionally, the degree of psychological trauma experienced by the participants in their suffering with psoriasis seemed to go unnoticed by the treating doctors. To this end, helplessness and feelings of disempowerment were heightened. In terms of treatment implications, the participants claimed that their treating doctors failed to inform them of the severity of the side-effects, the dangers of various treatments, and the possible inefficacy of many treatments utilised. The participants experience of this resulted in the following: a) diminished trust in the doctor/patient relationship and the medical profession generally; b) heightened body shame and repulsion of self (as opposed to feeling repulsed by the psoriasis alone); c) intense anger and with some participants describing emotional anarchy; and finally, d) in feeling left out of the treatment decision-making process, participants felt as though they had lost control over their own body. In terms of medical aid support, the participants pointed out that psoriasis is not on the government approved list of chronic conditions and as such, given their experiences, acceded that this is something that needed to be challenged. Regarding social stigma, the participants’ experience of this appeared to result in re-enforcing a sense of their feeling socially shunned and physically alienated from their familiar body. Furthermore, it would appear that social stigma might play a participatory role in increasing the severity of the psoriatic condition due to the stress evoked in the experience of feeling socially stigmatised and also the heightening of psychological difficulties experienced as participants moved from pride to shame. All participants felt public education and awareness of the onset, cause and course of psoriasis was required. Methods of coping utilised by the participants included: the seeking out of empathetic medical practitioners, psychotherapy, hypnotherapy, assertiveness skills training, implementing spirituality in their lives, and drawing upon the support of family and friends. Finally, in the midst of much adversity, the participants found an inner strength from which to reclaim their sense of self and which they attribute to having had a positive demeanour prior to suffering from psoriasis. In the deconstruction (fracturing) of self, the participants seemed to have felt compelled into a process of change that could be characterised as a reconstruction of self - an evolving of the old and new dimensions of self that would evolve further into a stronger and more resilient sense of self that characterises the participants today. The participants to this study embarked upon a journey of self-empowerment and which was a defining factor in their making meaning from their suffering. Not alluded to in the literature is that, for the participants, psoriasis became a tool that they utilised to reclaim their lives and to re-build the self anew. The results of this study reveal many important areas for future research with persons suffering from psoriasis and dermatological conditions generally, such as: i) the focussing on levels of trait self-esteem in effecting how positive change in one's self-concept may or may not occur; ii) the exploration of disfiguring skin conditions as an impetus for self-concept enhancement and creating meaning in one’s life; iii) exploring the efficacy of combining psychotherapy with medical treatments in the management of dermatology patients; iv) exploring the role of the doctor/patient relationship in the patient’s drive towards psychological health and treatment compliance; and finally, v) exploring the impact of dermatological disease on the family of the sufferer, especially given the significance of the familial system in the sufferers coping. Importantly, the results of this study suggest that having a healthy self-concept prior to the development of illness or disease is pivotal in accounting for why some people recover remarkably well psychologically and others do not. The findings of this study are valuable and will have important implications for all within the healing profession in helping to effect positive change in their future endeavours with persons who suffer from dermatological disease.

M.A. (Psychology) / Body dysmorphic disorder is a somatoform disorder characterised by a preoccupation with an imagined defect in appearance, causing clinically significant distress or impairment in functioning. An electronic search of articles and dissertations yielded no results on the prevalence of body dysmorphic disorder in South Africa. This study aimed to determine the prevalence of body dysmorphic disorder among 395 undergraduate students at an inner-city university. Proportionate stratified random cluster sampling was used to select the sample. The students completed a demographics survey and the Body Image Disturbance Questionnaire. Results indicated an overall prevalence of 5.1%, which is similar to prevalence rates reported in existing literature among student populations. No clinically significant differences were found on the ,demographic variables of gender, race or sexual orientation. However, students differed significantly in their experience of the severity of the disorder in terms of age, such that students over the age of 21 reported higher severity levels than did students under the age of 21.

Background: Ostomy surgery refers to surgical procedures that reroute the elimination process of the bowel and alters the usual form of elimination. There are different reasons why a person gets a ostomy, depending on the reason for the surgery. The number of persons living with ostomys in Sweden is unknown. However, the reaction to intestinal diversion surgery can be a devastating experience. Living with a ostomy for a longer period may affect the individual. Nurses are important members of the health care team and have a significant role in caring for patients with ostomy. Aim: The aim was to describe experiences living with a permanent ostomy. Method: A qualitative litterature-based design was used in the study. CINAHL and PubMed databases were used to search qualitative articles. Articles were analyzed and reviewed by the five-step method in Friberg. Results: The result is based on ten qualitative articles. After making the analysis three main themes and nine sub-themes were identified. The three main themes were: the altered body appearance, the changing of daily life and interference with anticipated return to normal. The sub- themes were: fear, anxiety, disgrace and irritated skin, body image, acceptance, independence, daily activities, diet, impact on relationships, supporting, loneliness and isolation. Conclusion: Having a ostomy is a major event and it affects personal self-concept and restricts their lives in various ways. Nurses need to provide education, support advice and referral for specialist help if required to promote health and reduce suffering.

Body image (BI) reflects how a person views his or her own body, and how one thinks, feels and acts toward it. This study examined the relationship of activity (sport vs. leisure) and gender to body image among adults aged 50 years and older. The sample included 182 Senior Olympians (79 men; 103 women) with a mean age of 65.5 years. Three scales measured the components of BI: the Social Physique Anxiety Scale (SPAS) measured affective BI, the Contour Rating Drawing Scale (CRDS) measured cognitive BI, and the Body Image Avoidance Questionnaire (BIAQ) measured behavioral BI. The Body Satisfaction Scale (BSS) measured satisfaction with appearance and functionality, and grip strength was used as a measure of body function. Women scored higher than men on the SPAS and the CRDS, indicating greater dissatisfaction with their affective and cognitive BI. Women also scored higher than men on the clothing and grooming behaviors of the BIAQ, while men scored higher on social avoidance. Sport participants scored higher than leisure participants on the grip strength test. Results suggest that gender differences in BI appear to persist into older adulthood. The results also suggest that the effects of sport on BI among older adults may depend in part on gender.

The negative health consequences of dieting for individuals are well established. Yet little is known about the interpersonal consequences of dieting for romantic couples. This study utilized self-report questionnaire data from undergraduate students (N = 221) and their romantic partners (N = 74) to examine whether dieting is associated with romantic relationship processes. I hypothesized that dieting engagement would indirectly predict worse relationship outcomes. Body dissatisfaction is a core dimension of self-esteem, and people with low self-esteem often project their self-doubts onto their partner. Because dieting is strongly associated with body dissatisfaction, I hypothesized that people who engaged in more extreme dieting may project their negative self-evaluations of their bodies onto their partners, resulting in negative evaluations of their romantic partner’s attractiveness. Moreover, I expected that negative partner evaluations would predict worse relationship outcomes for both partners. As hypothesized, participants who engaged in more dieting (e.g., restricting food intake, feeling guilty after eating, compensatory behaviors) experienced higher body dissatisfaction, which predicted more negative evaluations of their romantic partner’s physical attractiveness. In turn, finding their partner less attractive predicted more negative evaluations of their partner’s worth, increased conflict, and lower commitment to their relationship. Moreover, romantic partners who were rated as less attractive perceived participants’ negative evaluations of their attractiveness, and experienced lower self-esteem. However, participant dieting did not predict relationship outcomes for their romantic partners. Overall, results indicate that dieting is negatively associated with both individual and interpersonal well-being. Findings must be replicated in longitudinal research, but highlight the potential for the negative consequences of dieting to extend beyond the individual to influence close relationship processes. This research also contradicts dominant models of dieting and close relationships that frame dieting in a positive light. / Graduate / 2020-08-15

Thesis (M.A.)--University of the Witwatersrand, Faculty of Humanities, 2012 / The primary aim of this study was to investigate the relationship between binge eating disorder and personality traits. Studying personality characteristics may eventually enable us to identify individuals at heightened risk for developing binge eating, and to use this information to design more effective prevention and early intervention strategies. 138 females and 42 males participated in this study. Questionnaires using the EDI, EAT-26 and 16PF as well as an interview schedule were adopted for the study. Results revealed that there appeared to be a significant positive relationship between the EAT-26 and factor O (apprehension-self assured) and factor Q 4(tension-relaxed). There appears to be a significant positive relationship between the EDI and factor I (sensitive versus tough minded), factor L (suspicious versus accepting), factor O (insecure versus complacent) and factor Q4 (tense versus relaxed and easy going). Factor O (apprehension-self assured) appears to predict the scores obtained on the EAT-26 and the propensity to develop binge eating disorder. Factor O (insecure versus complacent) and Q4 (tense versus relaxed) were able to predict the scores on the EDI and the propensity to develop binge eating disorder. Secondary aims of the study revealed that there appears to be a relationship between body image disturbance and the total EAT-26 and EDI scores respectively. This means that participants scoring high on the body dissatisfaction subscale of the EDI will also score higher on the EAT-26 total. There appeared to be a positive relationship between gender of the participants and the total scores of the EAT-26 and EDI respectively. There were 2 interviews carried and the results of the interviews reinforced the quantitative data and previous research on binge eating disorder (Belangee et al, 2003) that personality traits are link to the development of binge eating disorder.

Conti MA. Imagem corporal e estado nutricional de estudantes de uma escola particular. São Paulo; 2002. [Dissertação de Mestrado – Faculdade de Saúde Pública da USP]. A imagem corporal, entendida como imagem do corpo formada pela mente, desenvolve-se desde o nascimento pela maturação do mundo psíquico. O objetivo do presente trabalho foi verificar a percepção da imagem corporal de adolescentes, utilizando avaliação do estado nutricional (IMC) e aplicação de uma escala adaptada de satisfação corporal. A amostra constituiu-se por 147 adolescentes, sendo 52 meninos e 95 meninas, com idade média 12 anos, que após mensuração antropométrica (peso e altura) responderam questionário sobre satisfação por áreas corporais. Dos meninos estudados, 1,92% apresentaram estado nutricional de “magreza", 53,84% de “normalidade" e 44,23% de “sobrepeso/obesidade", e para as meninas, 3,15%, 77,89% e 18,92% respectivamente. Os meninos identificaram insatisfação com peso corporal (34,6%) e estômago (25,0%) e as meninas, insatisfação com peso corporal (30,5%), tórax/seio (20,0%) e estômago (17,9%). Detectou-se associação significantemente estatística entre estado nutricional e grau de satisfação corporal, com meninos classificados com “sobrepeso e obesidade" inferindo maior insatisfação para as áreas do estômago, cintura e peso corporal e para meninas, todas as áreas, exceto rosto, cintura, tórax/seio, braço e altura. Associando-se fase de adolescência (maturação sexual) e grau de satisfação por áreas corporais, os meninos pré-púberes revelaram maior insatisfação para a área ombro/costas, e as meninas pós-púberes maior insatisfação para a área do rosto, cabelo, quadril, estômago, cintura, tórax/seio, tônus muscular, altura e aspectos gerais. Associando-se gênero e satisfação corporal, os meninos evidenciaram maior insatisfação para as áreas do estômago e nádegas e meninas para tórax/seio. Concluí-se, para a população estudada, que o estado nutricional, maturação sexual e sexo interferem na satisfação e imagem corporal. Os possíveis motivos geradores da insatisfação corporal na adolescência em nível de saúde pública, definem-se pela pressão da mídia, influências sociais e influências negativas parentais e de amigos. / Conti MA. Body image and nutritional status among students of a private school. São Paulo; 2002. [Dissertação de Mestrado – Faculdade de Saúde Pública da USP].The body image, understood as the body image formed by mind, has been developing since the birth. The present study aimed to verify the body image perception of adolescents, through nutritional status evaluation and an adapted body satisfaction scale application. The sample was 147 teenagers (52 boys and 95 girls) with 12 years old on average who had their weight and stature measured and answered a body satisfaction questionnaire. In relation to the nutritional status, it was registered for the boys, 1.92% of leanness, 53.84% of normality and 44.23% of overweight/obesity, and for the girls, 3.15%, 77.89% and 18.92% respectively. The boys had identified complete body dissatisfaction with weight (34.6%) and stomach area (25.0%) and girls with their weight (30.5%), thorax/breast (20.0%) and stomach area (17.9%). It was detected significant association between nutritional status and body satisfaction. The boys classified as ‘overweight/obesity’ had greater dissatisfaction with the stomach area, waist and weight comparing to the boys classified as ‘normal’. The girls had greater dissatisfaction with their hair, buttocks, hip, thighs, legs, stomach, shoulder/back, muscle strenght, weight and general aspects. It was registered significant differences between the phase of adolescence (sexual maturation) and degree of body satisfaction. The pre-pubescent boys had greater dissatisfaction with the shoulder/back area than the pubescent ones. For the pos-pubescent girls, greater dissatisfaction was related to the face area, hair, hip, stomach area, waist, thorax/breast, muscle strength, height and general aspects, comparing to the pubescent ones. When gender and body satisfaction was associated, the boys had shown greater dissatisfaction with the stomach area and buttocks and girls with the thorax/breast area. In conclusion the nutritional status, sexual maturation and gender were associated with body satisfaction and body image. In the public health area, the possible body dissatisfaction causes among teenagers are midia, social, familiar and peer’s influences.

As transformações sociais com a excessiva valorizção da imagem corporal idealizada esteticamente, em especial das mamas como símbolo da feminilidade, submete as mulheres a procurar recursos cirúrgicos para adequar sua aparência aos padrões vigentes. A maior facilidade de acesso às cirurgias estéticas repercute na prática assistencial e observamos um número crescente de mulheres com mamoplastia. O objetivo deste estudo foi de compreender a experiência de amamentação de um grupo de mulheres com mamoplastia redutora e de aumento. A pesquisa qualitativa foi desenvolvida utilizando o modelo teórico representativo da experiência de amamentar, \"Pesando Riscos e Benefícios\", elaborado por Silva (1997), e o Discurso do Sujeito Coletivo (DSC) para organização dos dados. Participaram do estudo 14 mulheres, sendo oito com mamoplastia redutora e seis com implante mamário, as quais expressaram o desejo de amamentar e apresentavam boas condições clínicas e, mãe e recém-nascido tinham qualquer distúrbio impeditivo à amamentação. Na ocasião das entrevistas, cerca de um mês após o nascimento, no grupo de mulheres com mamoplastia redutora, a amamentação exclusiva foi observada em caráter de exceção, duas mulheres desmamaram e seis estavam em aleitamento materno. As mulheres com prótese mamária, metade estavam amamentando exclusivmente e as restantes, em aleitamento materno. Na análise dos dados foram extraídos 16 DSC, distribuídos em quatro temas: \"Opção pela cirurgia plástica e o projeto de amamentação\", \"Vivenciando a prática da amamentação\", Reflexão sobre a interface da cirurgia com o processo de amamentação\" e \"Conciliar o papel de mãe, nutriz e mulher - não é fácil\". Os DSC revelaram o movimento de mulheres em buscar a mamoplastia para obtenção de maior satisfação com a imagem corporal e as ansiedades decorrentes da opção cirúrgica que afloram na gestação ou no pós-parto ao se depararem com a prática da amamentação. Ao vivenciarem a amamentação, as mulheres avaliaram a capacidade de produzir leite em quantidade adequada às necessidades do filho. O complemento lácteo apareceu como benefício à mulher, sendo uma estratégia para prolongar o período de amamentação e postergar o desmame e, por vezes, como auxílio para recuperação dos traumas mamilares. As mulheres em sua maioria acreditam que a mamoplastia interferiu na amamentação, observando dificuldade de ejeção e produção láctea reduzida. As mulheres que não foram capazes de manter a amamentação exclusiva expressam sentimento de culpa pela opção cirúrgica e procuraram garantir o vínculo com o filho e transmitir o amor materno construindo outras estratégias. As dificuldades em amamentar foram pautadas em questões biológicas e estruturais da glândula mamária e não em questões culturais de valorização do corpo feminino. A crença social e dos profissionais da área da saúde que a mulher com mamoplastia não deseja amamentar, para não comprometer o resultado estético de suas mamas obtido pela cirurgia não se evidenciou. Percebe-se que permanece a intenção da mulher em manter sua imagem em corcordância com os padrões idealizados, projetando a possibilidade de repetir a cirurgia no futuro / The social transformations with excessive valuation of the aesthetically idealized body image and, specially the breasts as femininity, submit the women to search surgical resources in order to adequate their appearance to the present patterns. The bigger easiness of access to the aesthetical surgeries reverberates on the first-aid practice and we observe an increasing number of women with mammoplasty. The object of present study was to understand the breastfeeding experience of a group of women with reducing and enlarging mammoplasty. The qualitative research was developed utilizing the representative theoretical model of the breastfeeding experience \"Pesando Riscos e Benefícios\" [Weighing Risks and Benefits] elaborated by Silva (1997) and for the data organization the Discurso do Sujeito Coletivo (DSC) [Collective Subject Speech]. It has participated in the study 14 women being 8 with reducing mammoplasty and 6 with mammary implant, that expressed the desire for breastfeeding and that presented good clinical conditions and both, mother and newborn, did not have any impeditive disturbance to the breastfeeding. By the occasion of the interviews, about one month after the birth, in the group of women with reducing mammoplasty, the exclusive breastfeeding was observed in exception character, two women have weaned and six were in maternal feeding. On the women with mammary prosthesis, half of them was exclusively breastfeeding and the remaining, on maternal feeding. In the data analysis there were drawn 16 DSCs, distributed in four themes: \"Options for the plastic surgery and the breastfeeding project\", \"Experiencing the breastfeeding practice\", \"Reflection about the surgery interface with the breastfeeding process\" and \"Conciliating the mother, nourisher and woman role - it is not easy\". The DSCs have disclosed the women motion searching the mammoplasty for achieving greater satisfaction with the body image and the anxieties elapsing from the surgical option that arise on the gravidity or on the post-partum when facing with the breastfeeding practice. When experiencing the breastfeeding, the women have assessed the capacity for producing milk in a quantity adequte to the child necessities. The lactic complement has shown up as a benefit for the woman, being a strategy for extending the beastfeeding period and postponing the weaning and, many times, as a help for recovering from the mammilary traumas. Most of the women believe that the mammoplasty has interfered in the breastfeeding, observing ejection difficulty and reduced lactic production. The women that were not capable of sustaining the exclusive breastfeeding expressed guilty sense for the surgical option and tried to ensure the entailment with the child and to transmit the maternal love building new strategies. The difficulties for breastfeeding were guided by biological and structural questions of the mammary gland and not by cultural questions of female body valuation. The social belief and among the professionals of the area that the woman with mammoplasty do not desire to breastfeed in order to not compromise the static results of her breasts achieved through surgery has not been shown clearly, although being perceived that it remains the intention for keeping her image according to the idealized patterns, projecting the possibility for repeating the surgery in the future

Fundamentando-se nas perspectivas teóricas da análise do discurso de linha francesa e da psicanálise lacaniana, busca-se investigar o significante corpo em uma paciente anoréxica. Considerando-se que o caráter primordial do significante se exerce em relação ao sujeito, buscamos compreender o sujeito anoréxico através da investigação do significante corpo. O material analisado foi constituído por uma entrevista semi-estruturada, realizada com uma paciente diagnosticada como anoréxica, em tratamento no Hospital das Clínicas de Ribeirão Preto da Faculdade de Medicina da Universidade de São Paulo. De acordo com os referenciais teóricos, a análise dos dados foi qualitativa e obedeceu ao paradigma indiciário. A análise da entrevista permitiu-nos observar que o significante \"corpo\" atrelou-se aos significantes \"peso\" e \"alimentação\" em uma mesma cadeia: como \"a única coisa que eu consigo controlar na minha vida\". O significante corpo constituiu, para o sujeito, a via encontrada na busca por sua alteridade. Desse modo, essa cadeia significante veio compor a ordem da identidade e da alteridade, sob a égide do (sem)controle. Concluímos que a queixa muda da anoréxica, enunciada sob o comportamento da recusa alimentar, era dirigida ao Outro como uma tentativa de alcançar sua alteridade. / Basing theoretical perspectives of analysis on the discourse of the Lacanian and the French line of psychoanalysis, the body signifier of an anorexic patient was investigated. Remembering that the primordial character of the signifier exerts an influence on the subject, we attempted to understand the anorexic individual through an investigation of body signifiers. The analyzed material was formed from a semi-structured interview of a patient diagnosed as anorexic, who was being treated in the Teaching Hospital das Clínicas, University of São Paulo, Ribeirão Preto. According to theoretical references, data analysis was qualitative and followed the indicated paradigm. Analysis of the interview allowed us to observe that the body signifier was linked to the ?weight? and ?feeding? signifiers in a single chain, as ?the only thing that I can control in my life?. The body signifier constituted, for the individual, the way the patient found to identify her alterity. Thus, this signifier chain established the order of the identity and alterity, by the support of (lack of)control. In conclusion, the silent complaint of anorexia, confirmed by the behavior of refusing to eat, is directed at the ?Big Other? in an attempt to attain alterity.

A obesidade infantil é influenciada por aspectos ligados à família, orientações alimentares e nutricionais, prática de exercícios físicos, mídia entre outros. Diante deste contexto, o presente estudo teve por objetivo avaliar o estresse, as preferências alimentares e a imagem corporal de adolescentes na faixa etária de 10 a 13 anos e de seus cuidadores. Foram selecionados, por nutricionista, trinta adolescentes em acompanhamento médico e nutricional no Ambulatório de Obesidade Infantil e Adolescente (AOIA) do Departamento de Pediatria da Faculdade de Medicina de Ribeirão Preto (FMRP-USP). O critério para inclusão dos adolescentes obesos foi baseado no índice de massa corporal (IMC) com percentil do IMC maior que 95 calculado após pesagem e medida destes. Foram pareados com outros adolescentes eutróficos, de acordo com sexo e faixa etária e seus cuidadores, recrutados na Unidade de Atenção Primária à Saúde (PAM) da Vila Lobato, Ribeirão Preto (SP). Para avaliar os sintomas de estresse dos cuidadores foi utilizado o Inventário de Sintomas de Estresse para Adultos e para os adolescentes, o Inventário de Estresse Infantil. A percepção da imagem corporal foi investigada por meio da Escala de Silhuetas e a preferência alimentar pelo Teste de Preferências Alimentares. Para a análise dos dados foram utilizados os seguintes testes: Teste Exato de Fisher, Coeficiente de Correlação de Pearson , Modelo de Regressão Linear Múltiplo e Teste de Wilcoxon. Os resultados mostraram diferenças entre os grupos na percepção de imagem corporal e nas preferências alimentares, mas não em relação ao diagnóstico de estresse. As diferenças na percepção da imagem corporal entre eutróficos e obesos foram observadas tanto nos adolescentes quanto em seus cuidadores. Tanto os adolescentes quanto seus cuidadores apresentaram inacurácia na percepção da imagem corporal, que foi ainda maior no grupo de obesos, assim como em seus cuidadores. Ambos os grupos, de adolescentes e seus cuidadores, apresentaram insatisfação com a imagem corporal. Não houve diferenças entre os grupos na avaliação do estresse. Comparando-se os grupos, foram observadas diferenças significativas em relação à preferência por alimentar, pelos adolescentes e seus cuidadores. Os resultados obtidos sugerem que os cuidadores têm hábitos alimentares semelhantes aos de seus filhos. O julgamento da imagem corporal dos cuidadores também foi diferente comparando os grupos e semelhante ao dos adolescentes de cada grupo. / Rezende, C.A.A. Study of body image, stress and food preferences in adolescents and their caregivers. Thesis (Doctorade). 125 f. Faculdade de Filosofia Ciências e Letras, Universidade de São Paulo. Ribeirão Preto, 2012. The environmental influence on childhood obesity includes aspects related to family, food and nutrition guidelines, physical exercises, and media among others. Given this context, the present study aimed to assess the stress level, food preferences and body image in obese adolescents aged 10-13 years and their caregivers. Sixty adolescents were recruited by a dietitian under medical and nutrition supervision at the Clinic of Child and Adolescent Obesity (AOIA) Department of Pediatrics, Faculty of Medicine of Ribeirão Preto (FMRP-USP). Inclusion criteria was based on body mass index (IMC) calculated after weighing and measuring of adolescents. They were paired with eutrophic adolescents according to gender and age and also their caregivers, which were recruited from the Unit of Primary Health Care (PAM) of Vila Lobato, Ribeirão Preto (SP). The Stress Symptoms Inventory for Adults was used to evaluate the caregiver stress symptoms and, to assess the teenager´s, the Child Stress Inventory. The body image perception was investigated by Silhouettes Scale and the food preference through Preferences Food Test. For data analysis, the following tests were used: Fisher\'s exact test, Pearson correlation coefficient, Multiple linear regression model and Wilcoxon´s test. The results showed differences between groups related to the body image perception and food preferences, but not to stress diagnosis. The differences in body image perception between obese and eutrophic were observed, in adolescents and even in their caregivers. Both, adolescents and their caregivers, showed inaccuracy in body image perception, which was even higher in the obese group, as well as in their caregivers. The two groups, adolescents and their caregivers, showed dissatisfaction with body image, which was higher in females. There were no differences between groups in the stress evaluation. Comparing the groups, significant differences were observed regarding preference for low-calorie foods by eutrophic adolescents and their caregivers. These results suggest that caregivers can exert influence in the eating habits of their children regarding food preferences and in the judgment about their body image. Key-words: 1.Obesity; 2.Eating Habits; 3 Body image.