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Thesis (Ph.D.)--University of Adelaide, Dept. of Anthropology and Social Inquiry, 2002. / Includes bibliographical references (leaves [287]-309).

Thesis (Ph. D.)--Universität Hamburg, 1996. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (M.S.)--University of Wisconsin--Madison, 1985. / Typescript (photocopy). eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 58-60).

Thesis (Ph. D.)--Universität Hamburg, 1996. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Anorexia nervosa är en allvarlig psykologisk sjukdom med hög dödlighet. Studien vill belysa den psykodynamiska terapin som behandlingsmetod vid anorexia nervosa. Frågeställning: Vilka är de verksamma faktorerna i psykodynamisk psykoterapi vid behandling av anorexia nervosa? Semistrukturerade kvalitativa forskningsintervjuer har genomförts med fem kvinnliga psykodynamiskt inriktade psykoterapeuter. Intervjumaterialet har bearbetats och analyserats utifrån tematisk analys (TA). Resultatet visade att det mest verksamma vid behandlingen av anorexia nervosa var att lyckas bryta igenom patientens avvisande förhållningssätt, motstå attacker samt att nå en stark allians. Resultatet visade också att psykoterapeutens syn på patientens symtom och självbild ofta yttrade sig i motöverföringsreaktioner såsom ilska, frustration och känsla av maktlöshet. Tid och kontinuitet uppfattades som viktiga faktorer för det kliniska behandlingsarbetet, liksom att kunna erbjuda psykoterapi efter det att patienten nått viktmål enligt DSM-IV. Undersökningen visade att den psykoterapeutiska relationen i sig anses vara den mest verksamma faktorn vid behandling av anorexia nervosa. Den visade att interaktionen mellan patient och terapeut, den terapeutiska alliansen, uppfattades som den faktor som mest gynnar tillfrisknande för patienter med anorexia nervosa, en sjukdom med ett ofta långdraget förlopp.

Esta pesquisa parte da constatação clínica de que os sujeitos anoréxicos apresentam subjetividades uniformizadas e uma propensão à homogeneidade discursiva e atitudinal entre si. Tal identidade levanta a hipótese sobre a presença de um tipo de contágio psíquico entre as pacientes anoréxicas. Consideramos a epidemia anoréxica como um movimento coletivo definido por uma mesma narrativa de sofrimento, que possui uma frequência significativamente relevante, entre mulheres jovens, de aproximadamente 0,4% ao ano. Investigamos o conceito de identificação em Freud e em Lacan, e encontramos comentadores que tratam da identificação na anorexia, sugerindo a presença de um tipo especial de identificação necessário para explicar a noção de epidemia anoréxica. Tal hipótese nos levou simultaneamente a um modelo epidemiológico psicanalítico para certas formas de sofrimento que se propagam, historicamente, sob a forma de um contágio psíquico. Localizamos a epidemia anoréxica na identificação imaginária, do estádio do espelho, e a relacionamos ao discurso do capitalista e a uma comunidade de gozo. O fracasso da identificação narcísica nas anorexias severas mais especificamente as falhas na constituição da unidade da imagem é responsável por um excesso no plano da identificação imaginária entre as anoréxicas, que se identificam com o semblante do sintoma. Os sujeitos nas anorexias severas fazem epidemia para se livrarem do saber inconsciente, e se fixam num gozo autístico, que exclui o Outro. A psicanálise que se propõe a tratar o sofrimento, e não o sintoma aborda o que fica de fora da comunidade de gozo. Como resultado, postulamos que o conceito de identificação na epidemia anoréxica é importante para o tratamento institucional da anorexia, incluindo a fundamentação de projetos terapêuticos / This research is based on the clinical finding that anorexic subjects show, among them, standardized subjectivities and a tendency to homogeneity in discourse and attitude. That identity leads to the hypothesis of the presence of a type of psychic transmition among anorexic patients. We have considered anorexic epidemics as a groupal movement defined by the same suffering narrative, with significantly relevant frequency among young women, of approximately 0.4% per year. We have investigated the concept of identification in Freud and in Lacan theories and found commentators who treat anorexia identification suggesting the presence of a special type of identification necessary to explain the notion of anorexic epidemics. Simultaneously, such hypothesis has led us to a psychoanalytic epidemiologic model for certain forms of suffering historically spread as psychic transmition. We have found the anorexic epidemics in the imaginary identification of the mirror stage and established its relationship to the capitalist discourse and to a joy community. Failure of a narcissist identification in severe anorexics more specifically failures in the constitution of the image unit , is responsible for excess in the level of the imaginary identification among anorexics who identify themselves with the symptom semblance. The subjects in severe anorexia make epidemics to become free from the unconscious knowledge, and stick to an autistic joy which excludes the Other. The Psychoanalysis that proposes treating the suffering and not the symptom, addresses to what is outside the joy community. As a result of this research, we have postulated that the concept of identification in anorexic epidemics is important to the institutional treatment of anorexia and serves as basis for therapeutic projects

Os transtornos alimentares se caracterizam por comportamentos inadequados no consumo e padrão alimentar, além de crenças equivocadas sobre alimentação, que ocasionam uma piora da qualidade nutricional. Os Transtornos alimentares são determinados por uma etiologia multifatorial, onde os fatores socioculturais, as diferenças étnicas e psicossociais, associados à vulnerabilidade biológica, tem grande importância no desencadeamento, manutenção e perpetuação dos sintomas alimentares. Na Anorexia Nervosa o medo intenso ou mórbido de engordar representa o aspecto psicopatológico central desta doença. Estes pacientes caracterizam-se por uma excessiva perturbação da imagem corporal e pela busca incessante da magreza. Em função do medo de engordar, são incapazes de manter o peso em medidas ideais, além de apresentarem comportamentos alimentares inadequados na intenção de perpetuar o baixo peso. Para a compreensão dinâmica da personalidade destes pacientes é de extrema importância o conhecimento da personalidade na patogênese e patoplastia deste transtorno. Neste sentido, o Inventário de Temperamento e Caráter avalia fatores de temperamento e caráter aplicados à percepção dos traços de personalidade de pacientes com o transtorno alimentar, no caso, Anorexia Nervosa. Este trabalho teve como o objetivo avaliar os traços de personalidade, segundo o Inventário de Temperamento e Caráter (ITC), em pacientes com anorexia nervosa e compara-los a um grupo controle. Os RESUMO resultados indicaram que estes pacientes apresentam características sóciodemográficas de uma população jovem, com início do transtorno na adolescência, composta por mulheres, de etnia branca e solteiras. Os pacientes com Anorexia Nervosa diferenciam-se do grupo controle devido à presença de sintomatologia depressiva moderada pelo BDI. Além disso, na avaliação de personalidade confirmou-se a presença de elevados traços em esquiva ao dano e diminuídos em autodirecionamento nos pacientes com AN comparados aos controles normais. Houve diferenciação entre o grupo restritivo e purgativo na dimensão busca de novidades. A exclusão de pacientes com sintomatologia depressiva grave não interferiu na análise dos resultados dos traços de personalidade. / The eating disorders are characterized by behavior not good in consumption and dietary patterns, and wrong beliefs about diet that cause a worser nutritional quality. The Eating disorders are determined by a multifactorial etiology, where the sociocultural factors, psychosocial and ethnic differences associated to the biological vulnerability, have been great importance in triggering, maintenance and perpetuation of food´s symptoms. In anorexia nervosa the intense fear or morbid to be fat is the psychopathological central aspect of this disease. These patients are characterized by an excessive disturbance of theirs body image and the incessant quest for thinness. Depending on the fear of fat, are unable to keep the weight on measures ideals, and doing inadequate eat in order to perpetuate the low weight. To understand the dynamics of personality of these patients is very important knowledge of the personality and patoplasty in the pathogenesis of this disorder. In this case the Inventory of Temperament and Character value factors of temperament and character applied to the perception of the personality traits of patients with the eating disorder, in the case, anorexia nervosa. This study have been evaluate how the traits of personality, according to the inventory of Temperament and Character (ITC) in patients to anorexia nervosa and compares them to a control group. The results indicated that these patients present social-demographic characteristics of a young population, beginning the disorder in adolescence, composed of women, which ethnic white and single. Patients with anorexia nervosa are differentiated from the ABSTRACT control group because of the presence of moderate depressive symptoms by BDI. Also, the personality avaliation is confirmed the presence of high traits damage and reduced in selfdirection in patients with AN compared with normal controls. There was differentiation between the restrictive group and purgative in a dimension a search of news. The exclusion of patients with severe depressive symptoms had not been interfered in the analysis of the results in a personality traits.

The purpose of the study is to articulate the phenomenology of the anorexic body. In order to describe the complex meaning of the anorexic body, the present research adopts the qualitative and exploratory approach of Seidman's (1991) in-depth phenomenologically based interviewing method. This involves a series of three separate interviews, with three research participants who have had personal experience of anorexia. The method of data analysis used is essentially on editing style of analysis (Miller and Crabtree, 1992) and is based on a hybrid of the grounded theory approach of Glaser and Strauss (1967) and Heidegger's (1927) ontological hermeneutics to form what Addison (1992) calls grounded interpretive research. Anorexic embodiment is conceptualised as precipitating a fundamental disturbance between the interactions of embodied consciousness and the world. The body is no longer taken-for-granted, and becomes an object for scrutiny. As an object, the body is experienced as a thing exterior to the self, and this awareness contributes to the sense of qisorder which permeates anorexic embodiment. Bodily intentionality is frustrated when the sphere of bodily actions and habitual acts become circumscribed. The character of lived temporality and lived spatiality are also effected with the anorexic's focus on the now, ushering in a spatiality of the here. These findings indicate that anorexic embodiment is experienced primarily as a disruption of the 'lived body' rather than that of the biological body. The prevailing discourses of anorexic embodiment are shown to be split between the naturalized discourses that provide a model of the body that is biologically determined and ahistorical, and the denaturalized discourses that provide a model of the body that is culturally constructed and lacks embodied givenness. It is argued that Merleau-Ponty's phenomenology of the body offers a renaturalization of the body that overcomes the nature/culture dichotomy of the naturalized and denaturalized discourses, thereby providing a solid foundation that more directly addresses the phenomenology of the anorexic body. The theoretical and treatment implications of Merleau-Ponty's renaturalization of the anorexic body are highlighted, and suggestions for further research are presented.

Aspects of the social networks of anorexic (N=34) and non-anorexic (N=35) women were examined according to hypotheses derived from social network theory and research and from the literature pertaining to anorexia nervosa. The nature of the social network was discussed from the perspective of Pattison's (1977a) psychodynamic psychosocial systems theory. Subjects were compared on selected social network variables using the Pattison Psychosocial Inventory (PPI). The California Psychological Inventory (CPI) and the Family Environment Scale (FES) were used to investigate the contribution of certain personality and environmental variables to social network variation. Statistical analyses of the difference between means were tested using the Hotelling's T² procedure followed by univariate t-tests. Analyses of proportions were performed using z-tests. The Bonferroni inequality was employed in order to reduce the probability of Type I error when determining the statistical significance of the univariate t-tests and z-tests. The null hypothesis was accepted for the majority of the results. Only one social network variable, total network size, significantly differentiated anorexic and control subjects, although several other variables were approaching statistical significance. Various contrasting explanations of the results were discussed. For example, it is possible that anorexia nervosa is not a homogeneous or singular nosological entity and does not inevitably result in predictable and largely invariant social impairment. It was proposed that recent typologies of anorexia nervosa may yield significant between-group variation in social network variables. Furthermore, social networks may vary with the degree of severity and/or chronicity of the anorexic condition. The correlational analyses produced several statistically significant results. Regarding environmental (FES) variables, both cohesion and independence were positively correlated with support from family network members. Contrary to hypotheses, however, interpersonal effectiveness (CPI) achieved only weak and non-significant correlations with social network size and support. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate