Anorexia nervosa är en allvarlig ätstörning som ofta har en psykiatrisk samsjuklighet. Maudsleys familjeterapi är en evidensbaserad metod som har empiriskt stöd att vara effektiv och bör erbjudas alla ungdomar och familjer med anorexia nervosa. Det har dock konstaterats att de inte alltid räcker med Maudsley-modellen, utan i dessa fall rekommenderas tilläggsbehandling för att fler ska bli friska. Den behandling som erbjuds patienter med anorexia nervosa för ungdomar under 18 år delas in i tre faser enligt Maudsley-modellen och studien undersöker Dialektisk beteendeterapi (DBT), färdighetsträning som en tilläggsbehandling till familjeterapin under slutfasen i behandlingen. Via en enkät undersöktes ungdomarnas upplevda nöjdhet och nytta med behandlingen samt deras upplevelse av gruppledarnas insats. Utvärderingen som baseras på 25 ungdomars svar vid sista grupptillfället och visar att ungdomarna upplevt sig nöjda med den tilläggsbehandling de fått samt gruppledarnas insats. Ett moment om självkänsla/självförtroende, som även innehöll områden som perfektion, var särskilt uppskattat av flertalet som också tyckte att det avsnittet borde få större plats. Slutsatsen är att DBT färdighetsträning kan vara en värdefull tilläggsbehandling vid svår och långdragen anorexia nervosa för ungdomar.

Bakgrund: Anorexia är en ätstörning som främst drabbar unga kvinnor och som yttrar sig både fysiskt och psykiskt. Sjukdomen drabbar inte enbart den enskilda individen utan hela dess omgivning. Mötet med vården är viktigt för att underlätta tillfrisknandet för kvinnorna. Syfte: Syftet var att belysa unga kvinnors upplevelser av att leva med anorexia. Metod: En kvalitativ litteraturstudie baserad på fem självbiografier som analyserades med Lundman och Hällgren-Graneheims (2012) manifesta innehållsanalys. Resultat: Det framkom att anorexia medförde stora förändringar i kvinnornas liv. De upplevde anorexian som en inre röst som styrde över livet. Sociala relationer blev lidande som följd av att mat och vikt blev livets medelpunkt. I tillfrisknandet var vårdrelationerna och anhörigas stöd av stor vikt för att främja hälsan.  Slutsats: Anorexia är en komplex sjukdom där många faktorer påverkar behandlingsresultatet, inte minst patientens egen vilja att bli frisk. Alla möten och personer, exempelvis ett välfungerande teamarbete mellan professioner i vården har betydelse för att uppnå ett gott behandlingsresultat. Sjuksköterskan kan, genom att ge trygghet och vara en fast punkt, bli en viktig tillgång i behandlingen av unga kvinnor med anorexia. Även anhöriga har en avgörande roll för kvinnornas tillfrisknande då de både kan vara ett stöd och skapa motivation.

<p>Emotions guide the way individuals interact with the world, influencing nearly every psychological process from attention, to learning, to metacognition. Constructionist models of emotion posit that emotions arise out of combinations of more general psychological ingredients. These psychological ingredients, however, also form the building blocks of other affective responses such as subjective reactions to rewarding and social stimuli. Here, I propose a domain-general account of affective functioning; I contend that subjective responses to emotional, rewarding, and social stimuli all depend on common psychological and neural mechanisms. I support this hypothesis with three independent studies using both a basic science approach and a clinical approach. In the first study (Chapter 2) I demonstrate that the ventromedial prefrontal cortex (vmPFC), which has been implicated in encoding the value of primary, monetary, and social rewards, also encodes the hedonic value of emotional stimuli. In addition to showing that the mechanisms responsible for processing affective information are shared across reward and emotional processing, I also discuss the relevance of a domain-general constructionist account of affect for clinical disorders. In particular, I hypothesize that in anorexia nervosa (AN), affective disturbances should be manifest across responses to emotional, rewarding, and social stimuli (Chapter 3). In Chapter 4, I provide empirical evidence for this conclusion by demonstrating that when viewing social stimuli, women with a history of AN show disturbances in the insula, a brain region that is responsible for interoceptive and affective processing. This suggests that the interpersonal difficulties frequently observed in patients with AN may be due to biases in domain-general affective responses. In Chapter 5, I support this conclusion by showing that individual differences in harm avoidance in healthy women, women with a current diagnosis of AN, and women who have recovered from AN explain the relationship between disordered eating and social dysfunction. Collectively, these results indicate that subjective affective responses to rewarding, emotional, and social information all rely on common mechanisms as would be suggested by a domain-general theory of affect. Furthermore, the application of a constructionist domain-general account of affect can help to explain the fundamental nature of affective disturbances in psychiatric disorders such as AN.</p> / Dissertation

<p><strong>Bakgrund:</strong> Anorexia nervosa drabbar ca 1 procent av alla kvinnor och 0,1 procent av alla män innan 18 års ålder i Sverige. Patientgruppen återfinns i både allmänsjukvård och psykiatriska vårdavdelningar. Sjuksköterskan behöver redskap för att utveckla en vårdrelation till dessa patienter, då vårdrelationen är essentiell för att uppnå hälsa. <strong>Syfte:</strong> Att belysa de olika faktorer som påverkar vårdrelationen mellan sjuksköterska och patient med diagnosen anorexia nervosa. <strong>Metod:</strong> Studien är en systematisk litteraturstudie. Totalt åtta artiklar analyserades för att få fram ett resultat. <strong>Resultat:</strong> Vi kom fram till fyra kategorier som påverkade vårdrelationen. Dessa är bemötande, kunskap, föreställningar och kontroll. <strong>Slutsats:</strong> Vi kom fram till att en medvetenhet och kunskap om dessa faktorer hos sjuksköterskan bör leda till en förbättrad vårdrelation.</p>

In opposition to theories of power which focus on the domination of one group by another, Michel Foucault coined the term "biopower" to refer to the ways in which power manifests itself in the form of daily practices and routines through which individuals engage in self-surveillance and self-discipline, and thereby subjugate themselves. Biopower is a useful concept for medical anthropology because it focuses on the body as the site of subjugation, and because it highlights how individuals are implicated in their own oppression as they participate in habitual daily practices such as the self-regulation of hygiene, health, and sexuality. Yet few medical anthropologists have taken advantage of Foucault's framework to illuminate how both the individual and society are involved in perpetuating such practices. This paper brings together Foucault's theory and three concrete examples of bodily practice in Western culture, demonstrating how behaviors associated with physical fitness, femininity, and obstetrical practices all contribute to the creation of "docile bodies". The article ends by considering why some scholars have found Foucault's conception of power to be problematic.

This study hypothesized body weight and eating patterns to be important discriminators of psychological characteristics among eating disordered groups. A total of 146 bulimic and non-bulimic women from underweight (anorexic), normal weight, and overweight (obese) categories were examined. Based upon the theoretical and research literature reviewed, this study hypothesized locus of control, personal potency, self-esteem, and psychopathology to be central psychological characteristics in anorexia nervosa, bulimia, and obesity. These variables were measured by Rotter's Internal-External Locus of Control Scale, the Semantic Differential Potency Scale, Rosenberg's Self-Esteem Scale, and the Minnesota Multiphasic Personality Inventory, respectively. The relative importance of these variables in the disorders was also addressed. Results showed women in the eating disordered groups examined to demonstrate the following psychological characteristics: (1) Non-bulimic anorexics--an external locus of control, low self-esteem, and hysteria; (2) Bulimic anorexics--the greatest external locus of control, the lowest self-esteem, psychopathic deviance, hysteria, thought disorder, depression, a preoccupation with somatic concerns, and hypofemininity; (3) Normal weight bulimics--an external locus of control, low self-esteem, psychopathic deviance, hysteria, thought disorder, and depression; (4) Non-bulimic obese--low self-esteem; and (5) Bulimic obese--low self-esteem, an external locus of control, thought disorder and depression. The primary conclusion drawn from this study is that bulimia is a better predictor of the psychological characteristics than body weight. Bulimia, across all weight categories, was associated with an external locus of control, low self-esteem, psychopathic deviance, hysteria, thought disorder, and depression. That there was little variability in personality characteristics associated with bulimia across weight categories emphasized the stability of the symptom constellation associated with this disorder. This study supported the view of the normal weight bulimic as psychologically similar to the bulimic anorexic. This study also supported the stance that simple obesity does not represent a unitary psychological disorder.

No description available.

This study considers and explores the relationship between eating disorders and the cognitive processes of attentional bias and cognitive avoidance. These processes are also considered in terms of their contribution to the current theoretical conceptualisations of eating disorders and how this may potentially inform treatment. Previous research in the field is limited yet indicates that attentional biases exist in eating disorders, at least for disorder-specific stimuli using well recognised experimental paradigms. The research into cognitive avoidance is scarce yet has indicated that those with bulimic tendencies may use this cognitive strategy. A modified emotional Stroop task and an anagram solution task were used to evaluate experimental hypotheses postulating that attentional bias to and cognitive avoidance of disorder relevant and self-esteem threat stimuli would be present in a group of patients with an eating disorder (N=23) in comparison with a control group (N=34). Using the emotional Stroop, the results showed limited support for the presence of attentional biases in eating disorders. For the anagram solution task, some limited evidence was found for the presence of cognitive avoidance in the clinical eating disorder sample. The limitations of the study were considered and discussed, with an emphasis on improvements for future research using these experimental paradigms. The findings of the study were also discussed in relation to the implications for eating disorder theory and treatment.

Background: Response to treatment in anorexia nervosa entails various challenges, including an increased risk of relapse and re-admission in those treated as inpatients. A better understanding of patients’ experiences is paramount to improve treatment acceptability and outcome. This qualitative study aimed to explore the lived experiences of adult female inpatients undergoing a specialist inpatient treatment programme for anorexia nervosa. Methods: Semi-structured interviews were carried out with 21 female participants (aged 18-41 years) with a diagnosis of anorexia nervosa, undergoing treatment in a specialist inpatient eating disorder unit. Data were analysed using interpretative phenomenological analysis (IPA). Results: Qualitative analysis highlighted 5 master themes which underpinned treatment experiences: (1) Shifts in control, (2) Experience of transition, (3) The importance of supportive staff relationships, (4) Sharing with peers and (5) Process of recovery and self-discovery. Conclusions: Overall, findings suggest patients experience a process of change and adjustment during inpatient treatment in relation to their levels of perceived control, attachment to the treatment environment and a sense of self-identity. Treatment experiences appear to be influenced by the development of supportive relationships and the provision of individualised care.

No description available.