As an exploratory study, a sample of five anorexia nervosa subjects, diagnosed on standardized criteria, were tested while hospitalized for treatment, on elicited and assigned construct repertory grids, where the latter grid's construction reflected aspects of central interest to the syndrome. The two repertory grids for each subject were processed using Slater's (1972) "INGRID 72 PROGRAM : the principal components analysis for the repertory grid", and comprehensive data is tabulated and discussed with reference to each subject's psychological grid space. A comparison of the efficacy of the two repertory grid measures is discussed and nomothetic data is descriptively presented and viewed in terms of the literature. Suggestions for more refined repertory grid investigation in this area are forwarded.

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Chow Yuet-ming. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (leaves 254-262). / Abstracts in English and Chinese, appendix in Chinese. / Abstract --- p.i / Acknowledgement --- p.iv / Chapter Chapter 1: --- Introduction --- p.1 / Chapter 1.1 --- Rationale for Selecting this Research Topic --- p.1 / Chapter 1.2 --- Research Objectives --- p.4 / Chapter 1.3 --- Research Questions --- p.5 / Chapter 1.4 --- Overview of the Present Thesis --- p.5 / Chapter Chapter 2: --- Literature review --- p.7 / Chapter 2.1 --- Anorexia Nervosa in Western Countries --- p.7 / Chapter 2.1.1 --- Historical Perspective --- p.8 / Chapter 2.1.2 --- Biomedical Perspective --- p.10 / Chapter 2.1.2.1 --- Physiological manifestation of anorexia nervosa patients --- p.10 / Chapter 2.1.2.2 --- Behavioral manifestation of anorexia nervosa patients --- p.12 / Chapter 2.1.3 --- Psychological Models --- p.14 / Chapter 2.1.3.1 --- Bruch ´ةs view --- p.14 / Chapter 2.1.3.2 --- Minuchin´ةs view --- p.16 / Chapter 2.1.3.3 --- Palazzoli 's view --- p.17 / Chapter 2.1.4 --- Sociological Perspective --- p.24 / Chapter 2.1.5 --- Summary of Part I (2.1) --- p.30 / Chapter 2.2 --- Psychology of Self-development --- p.33 / Chapter 2.2.1 --- "Erikson ,s identity formation" --- p.33 / Chapter 2.2.2 --- Women self-development --- p.38 / Chapter 2.2.3 --- Bowen's differentiation of self --- p.42 / Chapter 2.2.4 --- Summary of Part II (2.2) --- p.46 / Chapter 2.3 --- Anorexia Nervosa in Hong Kong Context --- p.48 / Chapter 2.3.1 --- The notion of self in traditional Chinese family --- p.49 / Chapter 2.3.2 --- Women position in Hong Kong --- p.55 / Chapter 2.3.3 --- Related research in Hong Kong --- p.62 / Chapter 2.3.4 --- Summary of Part III (2.3) --- p.69 / Chapter Chapter 3: --- Theoretical framework --- p.71 / Chapter 3.1 --- Theoretical Framework as Summarized from the Literature Review --- p.71 / Chapter 3.2 --- Definition of Terms --- p.77 / Chapter 3.2.1 --- Anorexia nervosa --- p.77 / Chapter 3.2.2 --- Family --- p.78 / Chapter 3.2.3 --- Family interaction --- p.79 / Chapter 3.2.4 --- Family rule --- p.79 / Chapter 3.2.5 --- Family myths --- p.80 / Chapter 3.2.6 --- Family myths as quest for meaning --- p.80 / Chapter 3.2.7 --- Meaning --- p.80 / Chapter 3.2.8 --- Power --- p.81 / Chapter 3.2.9 --- Power struggle --- p.81 / Chapter 3.2.10 --- Differentiation of self --- p.81 / Chapter Chapter 4: --- Research Methodology --- p.83 / Chapter 4.1 --- General Overview --- p.83 / Chapter 4.2 --- Research Methodology of this Study --- p.88 / Chapter 4.2.1 --- Rationale in Selecting Qualitative Method --- p.88 / Chapter 4.2.2 --- Research Design --- p.89 / Chapter 4.2.3 --- Unit of Analysis --- p.90 / Chapter 4.2.4 --- Sampling --- p.90 / Chapter 4.2.5 --- Methods of Data Collection --- p.92 / Chapter 4.2.5.1 --- Direct Observation of the Family Interviews of AN families --- p.92 / Chapter 4.2.5.2 --- Participant Observation in an AN Mutual Support Group --- p.94 / Chapter 4.2.5.3 --- Summary of the Case Study Protocol of this Study --- p.96 / Chapter 4.2.6 --- Time Frame for Data Collection --- p.96 / Chapter 4.2.7 --- Method of Analysis --- p.97 / Chapter 4.2.8 --- Validity and Reliability of this Study --- p.97 / Chapter 4.2.9 --- Summary of Chapter --- p.98 / Chapter Chapter 5: --- Results of the Study :Data Gathered from Family Interview Sessions --- p.100 / Chapter 5.1 --- Case History --- p.100 / Chapter 5.2 --- Results Gathered from Family Interview Sessions --- p.104 / Chapter 5.2.1 --- Having difficulties in differentiating from the family and self- starvation as a means of asserting the personal boundariesin the families --- p.104 / Chapter 5.2.2 --- Being triangulated in the parents' marital discords and self- starvation as a means of diluting their conflicts --- p.122 / Chapter 5.2.3 --- Self-sacrificing for the family interest --- p.131 / Chapter 5.2.4 --- "Being helpless and powerless in the families, self-starvation as a means of empowering the mothers in the families " --- p.134 / Chapter Chapter 6: --- Results of the Study:Data Gathered from Mutual Support Group Sessions --- p.138 / Chapter 6.1 --- Case History --- p.138 / Chapter 6.2 --- Results Gathered from Mutual Support Group sessions --- p.140 / Chapter 6.2.1 --- Having difficulties in handling peer relationship --- p.140 / Chapter 6.2.2 --- Having difficulties in resisting their mothers intrusiveness to their personal boundaries and self-starvation as a means of exerting their personal boundaries --- p.143 / Chapter 6.2.3 --- Being triangulated in their parents marital discords and self- starvation as a means of diluting the marital conflicts --- p.149 / Chapter 6.2.4 --- Acting for their mothers in the families --- p.149 / Chapter 6.3 --- Cross-checking of findings with group members and worker --- p.161 / Chapter Chapter 7: --- Discussions and Conclusion --- p.163 / Chapter 7.1 --- Research Findings of this Study --- p.163 / Chapter 7.2 --- Contributions of this Study --- p.173 / Chapter 7.3 --- Limitations of this Study --- p.174 / Chapter 7.4 --- Recommendation --- p.175 / Chapter 7.4.1 --- Future Research --- p.175 / Chapter 7.4.1.1 --- Proposed Theoretical Framework for Future Study --- p.175 / Chapter 7.4.1.2 --- Proposed Methodology --- p.179 / Chapter 7.4.2 --- Management of AN patients --- p.179 / Chapter 7.4.3 --- Prevention of AN --- p.181 / Appendix I: The Chinese verbatim of family interview sessions --- p.183 / Appendix II: The Chinese verbatim of mutual support group sessions --- p.234 / List of Figures: / Figure 1: Summary of the framework from western literature --- p.75 / "Figure 2: Interplay among individual, family and society " --- p.76 / Figure 3: Socio-demographic characteristics of the AN patients and their families of the family interview sessions --- p.91 / Figure 4: Socio-demographic characteristics of the AN patients and their families of the mutual support group --- p.92 / Figure 5: Summary of the proposed theoretical framework of Understanding self-starvation in Hong Kong --- p.178 / Bibliography --- p.254

徐文艷. / Thesis (doctoral)--Chinese University of Hong Kong, 2007. / Includes bibliographical references (p. 259-278). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in Chinese and English. / Xu Wenyan.

Bakgrund: Anorexia nervosa är en allvarlig psykisk störning. Sjukdomen förekommer främst bland flickor och kvinnor. God kunskap och terapeutisk kompetens hos vårdpersonal krävs för att kunna bemöta en patient med diagnosen anorexia nervosa som en enskild individ med unika behov. Syfte: Syftet med denna litteraturstudie var att belysa anorexiadrabbade flickors och kvinnors upplevelser i samband med vård. Metod: Åtta kvalitativa studier har granskats och analyserats. Resultat: Genom analys av studierna framkom att anorexiadrabbade patienters upplevelser i samband med vård har betydelse för deras återhämtning. Utifrån analysen framkom två teman och fem subteman. Det första temat belyser positiva upplevelser i samband med vård understött av två subteman: att bli bemött som en individ och vårdpersonalens engagemang. Det andra temat belyser negativa upplevelser i samband med vård understött av tre subteman: att bli bemött som en anorektiker, behandling fokuserar på viktuppgång i stället för psykiska problem och känslor av skam och osäkerhet. Slutsats: För patienternas återhämtning är det viktigt att vårdpersonal bemöter patienterna som unika individer och ser till deras olika behov. Vårdpersonalens engagemang samt god terapeutisk kompetens är en förutsättning för att patienten ska uppleva behandlingen som givande och som stöd för tillfrisknandet.

Background: Anorexia nervosa is a common and very serious mental illness that most people know about. The fear of losing control and the low motivation for change makes it difficult for the patient to realize how serious the condition is. It is important that health professionals pay attention to these patients to reduce pain and to shorten the period of illness. Objective: The aim of this descriptive literature review was to describe how patients with anorexia nervosa experience being treated by nurses and how nurses experience treating and caring for patients with anorexia nervosa. Method: A systematic literature review was completed and 14 studies were used in the result. Results: Analyzed data shows that there are many different thoughts and experiences about the care of anorexia nervosa. An important part of the care and also important for the patients recovery, was that the patient and the nurse were communicating with each other and that they developed a relationship. Anorexia nervosa is characterized by a large need for the patient to take control that could lead to a struggle between the patient and the nurse. A lack of knowledge among the nurses in care of these patients was also noted. Conclusion: Through good communication and by building up a relationship, the understanding of the disease is increased. This has shown to be an important part of the patients’ recovery and therefore it is important that the nurses consider the needs of each patient and threat them with respect and empathy. / Bakgrund: Anorexia nervosa är idag ett vanligt och mycket allvarligt psykosocialt tillstånd som de flesta känner till. Rädslan för att tappa kontrollen och den låga motivationen till förändring gör det dock svårt för den sjuka att inse sitt eget bästa. Det är viktigt att sjukvårdspersonal uppmärksammar dessa patienter för att kunna minska lidande och förkorta sjukdomstiden. Syfte: Syftet var att utifrån relevanta vetenskapliga studier beskriva hur patienter med anorexia nervosa upplever att de blir bemötta av sjuksköterskor, samt hur sjuksköterskor upplever att vårda patienter med anorexia nervosa. Metod: En systematisk litteraturstudie genomfördes och 14 studier användes i resultatet. Resultat: Analyserad data visar att det föreligger olika tankar och upplevelser kring omvårdnaden av anorexia nervosa. Kommunikation var en central del i omvårdnaden och blev en viktig del i patientens återhämtning. Att en relation mellan patient och sjuksköterska byggdes upp visade sig vara betydelsefullt. Sjukdomen anorexia nervosa karaktäriseras av ett stort kontrollbehov vilket kunde leda till en kamp om kontroll mellan patient och sjuksköterska. Utifrån resultatet märktes även en bristande kunskap hos sjuksköterskor i vårdandet av patienter med anorexia nervosa. Slutsats: God kommunikation förbättrar chanserna att utveckla en relation och det har visat sig ge ökad förståelse för sjukdomen hos båda parterna. Ökad förståelse för sjukdomen har visat sig underlätta då patienter upplever en trygghet och tillit till sjuksköterskan. En förståelse för sjukdomen har också stor betydelse för patienters tillfrisknande och det är därmed viktigt att sjuksköterskan ser till varje enskild individs behov och bemöter dem med respekt och empati.

<p><strong>Bakgrund: </strong>Anorexia nervosa karaktäriseras av en beslutsam strävan efter viktnedgång. Fler kvinnor än män drabbas och sjukdomen debuterar oftast i samband med puberteten.</p><p><strong>Syfte: </strong>Syftet var att belysa anorektikers upplevelser av att leva med anorexia nervosa. <strong></strong></p><p><strong>Metod: </strong>En kvalitativ ansats som baserades på fyra självbiografier. För att få fram biografiernas essens genomfördes en analys som baserades på Graneheim och Lundmans (2004) innehållsanalys. <strong>Resultat: </strong>Kvinnorna i biografierna uttryckte olika former av lidande. Sjukdomen är ett sätt att uttrycka sin olycka och sitt inre kaos. Den dagliga kampen mellan den friska och den sjuka sidan leder till att kvinnorna känner maktlöshet inför det inre kaos de drabbats av. Den drabbades vardag präglas av tvång, av en inre röst som bestämmer hur personen ska agera samtidigt som självförtroendet sakta men säkert bryts ner. Sjukdomen får dem att tvivla på sig själva och den bidrar till den skeva kroppsbild som är central för sjukdomen. <strong>Slutsats:</strong> Studien visar att sjukdomen anorexia nervosa är psykisk, fysisk och socialt påfrestande, vilket kräver att vi som vårdpersonal bör ha en bra förståelse och tillräckligt med kunskap som kan underlätta att hjälpa patienterna i deras lidande.</p>

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Eating disorders are difficult to treat: there is still no NICE-approved first-line treatment for anorexia nervosa. In part this could be due to a lack of a compelling theoretical model to account for the development and dogged persistence of the illness. Sociocultural factors implicating western preoccupation with thinness and attractiveness are likely to play a contributory role, but cannot be by themselves causal in societies where such ideals are dominant. Recent theoretical models in neuroscience predict that predisposing neurobiological factors in early brain development may render some young people more vulnerable than others to universal psychosocial pressures, especially during adolescence. This dissertation reviews the existing evidence for abnormal neurobiological functioning in eating disorders, acknowledging that it is difficult to distinguish between the acute effects of starvation on the brain and possibly pre-existing underlying factors. Nevertheless, such empirical studies do support the development of a novel hypothesis implicating abnormal functioning of a neural network centred on the insula cortex in anorexia nervosa. The insula hypothesis is tested in a series of functional imaging studies using Single Positron Emission Computed Tomography (SPECT) indicating focal abnormalities in the temporal region that persist following weight restoration treatment and correlate with neuropsychological deficits. A subsequent study using higher resolution functional Magnetic Resonance Imaging (fMRI) lends further partial support to the insula hypothesis (in three out of four tasks) and also implicates additional brain structures in the basal ganglia. These findings, if replicated, could contribute to the development of novel therapeutic approaches to the treatment of anorexia nervosa, including realtime fMRI and mindfulness-based approaches, both of which have been shown to modulate insula activation. The studies presented here could hopefully also help to reduce the stigma and shame so often associated with eating disorders, for the benefit of sufferers and their families.