Bulimia has recently emerged as an increasing threat to the health of young women in Western society. Though thought by some to be primarily prompted by psychological and physiological instabilities, this research attempts to explore the association between bulimic symptoms and the external pressures to conform to accepted standards of excessive thinness. It is noted that the bulimia trend primarily appears among the population which is overwhelmingly targeted by messages promoting the ideals of success through excessive beauty and thinness. Therefore, this study explores the relationships among several variables: the level of pressure felt by young, achievement-oriented women to control their weight in order to accomplish their goals; the level of difficulty experienced in achieving weight control; and the presence of bulimic symptoms. The sample for this study was taken from five undergraduate sociology courses at Virginia Polytechnic Institute and State University. The research found that among women who held career, social, and family relationships to be of high priority, the pressure to be thin in order to succeed in these areas, along with the difficulty experienced by the respondent in achieving weight loss, was positively associated with the appearance of bulimic attitudes and behaviors. Analysis of responses of males in the study did not produce significant findings with regard to the relationships between bulimic symptoms, the pressure to lose weight to achieve goals, and the difficulty in controlling one's weight. This study concludes that the unrealistic expectations imposed on young women in Western culture regarding their bodily appearance, and the difficulty in adhering to these expectations, have a direct impact on the appearance of bulimia in young achievement-oriented women. / Master of Science

Research efforts in the area of eating disorders have been numerous and varied. However, few studies have investigated the existence of specific predisposing factors that could render a young female adolescent more susceptible to developing an eating disorder. The present study was attempted in an effort to fill this knowledge gap. One hundred and fifty nine, 12 to 14 year old female students not known as having an eating disorder, were surveyed at a public school in Roanoke County, Virginia. The participants were asked to complete four different instruments which were: The Piers-Harris Children's Self-Concept Scale, the Children's Assertiveness Inventory, the Nutrition Questionnaire designed by the researchers and the Eating Disorder Inventory or EDl. Correlational statistics were used to identify any significant relationships between the first three instruments and the ED!. Significant relationships were identified, suggesting the existence of specific factors related to tendencies toward eating disorders as assessed by the EDI. Among these factors were: poor self-concept and body image, obesity and weight problems, active interest or involvement in dieting as well as certain familial behaviors. The results of this research effort will hopefully be used in designing educational programs for the prevention of eating disorders, as well as for enhancing the detection of these disorders. Further research needs will also be suggested. / Master of Science

Research suggests that the associations between femininity, body image and eating disorders are intricate. How these constructs are linked to each other still needs to be determined. The purpose of this study was to gain a deeper understanding of these links, examining the mediational relationship among these constructs. Also, the prediction that bulimia and binge eating disorder symptoms have a similar origin was tested and compared. Some researchers have suggested that the pathways leading to these disorders are equivalent and the main difference between the two is the dietary restriction, while others see them as distinct disorders with different etiology. A total of 355 female college students (ages 18 to 26) completed a set of questionnaires that assessed femininity, feminine gender role stress, body dissatisfaction, bulimia, and binge eating disorder. Results showed that body dissatisfaction mediates the relationship between femininity or feminine gender role stress with bulimia symptoms, as well as the relationship between feminine gender role stress and binge eating disorder symptoms. Results indicate that body dissatisfaction related to femininity or to feminine gender role stress may contribute to higher levels of bulimia symptoms. The findings also suggest that body dissatisfaction related to feminine gender role stress may contribute to higher levels of binge eating disorder symptoms. Results did not support the mediational role of body dissatisfaction between femininity and binge eating disorder. However, the mediational role of feminine gender role stress between femininity and body dissatisfaction was partially supported, suggesting that feminine gender role stress might only be one pathway by which femininity may have an impact on body dissatisfaction. / Master of Science

The research presented here is an exploratory investigation of the potential role of psychosexual factors in the development of the eating disorders anorexia and bulimia. The study sample involved 41 female eating disordered patients (16 anorexics and 25 bulimics), diagnosed using the DSM-III-R criteria. These patients were recruited from The Eating Disorders Program at St. Albans Psychiatric Hospital in Radford, Virginia. Five hypotheses were tested concerning the following psychosexual factors: sexual knowledge and attitudes; sexual experience and functioning; sex roles; gender identity (sexual orientation); and history of sexual abuse or incest. The hypotheses postulated that the psychosexual factors would exist or be perceived by eating disordered patients as significantly different than would be statistically expected according to available normative data. The instrumentation for measuring these factors included the Derogatis Sexual Functioning Inventory, the Bern Sex Role Inventory, and the Klein Sexual Orientation Grid. Compared to normative data, significant results were found in the total sample for all psychosexual factors except Sexual Knowledge and Gender Identity. However, no significant differences were found between the anorexic and bulimic subsamples. These results are discussed along with their implications for therapy and research. / Ph. D.

Ätstörningar är en sjukdom som drabbar många och resulterar i stort lidande samt en påverkan i vardagen. Behandlingen som ges är bara delvis effektiv då många aldrig blir friska, en stor risk för återfall och även dödsfall finns. Syftet med studien var att undersöka vilken effekt arbetsterapeutiska och icke-arbetsterapeutiska interventioner baserade på aktivitet hade på patienter med ätstörningar. En systematisk litteraturstudie användes för att besvara syftet och åtta artiklar inkluderades i studien. Resultatet visade på en bredd av interventioner där majoriteten kretsade kring att träna på aktiviteter kopplat till att äta och laga mat. Aktivitetsbaserade interventioner kan ha god effekt på person med ätstörningar och arbetsterapeutiska interventioner kan bland annat bidra med ökad motivation. Resultatet och tidigare forskning tyder på att en kombination av olika professioner och interventioner kan vara fördelaktig i ätstörningsvården.  Mer forskning behövs i ämnet och då framför allt kontrollerade studier med specifika arbetsterapeutiska interventioner.

Mental health risks within the adult male homosexual population have been researched; however no comprehensive synthesis of research findings was identified. The purpose of this research was to synthesize current research findings of mental health risks among the male homosexual population. This was limited to international studies conducted between 2003-2008 focusing on suicide, Eating Disorders, and Depression. These findings may serve as an educational resource for nurses and healthcare providers. Findings indicated that homosexual men are at an increased risk for suicide, Eating Disorders, and Depression. Several possible causes were identified, such as internalized homophobia, minority stress, social isolation, gender role orientation, community pressure, and comorbidity with mental health disorders. Limitations included small sample sizes, with limited age and ethnic diversity. Non probability sampling and lack of consistency in measurement of research variables limited the generalizability of the findings. Nursing education and practice should emphasize culturally-competent care and specific healthcare needs of this population. A focus on assessment and awareness of healthcare risks may be beneficial. Recommendations for future research include large, probability samples, and possibly population-based surveys. Research should focus on stressors and protective factors to formulate culturally sensitive interventions. Clinical trials of interventions are needed to form evidence-based practice guidelines.

The current study investigated the impact of Learned Helplessness (LH) training on normal (N), depressed (D), and bulimic (B) female college students (N=135). Participants were selected through a screening procedure using an eating behavior questionnaire and the Beck Depression Inventory (BDI; Beck, 1971) as the primary instruments. Bulimic subjects met the DSM-III criteria for that disorder, and depressed subjects met a criterion of 20 or above on the BDI. Normal subjects had BDI scores below 10 and endorsed 1 or less of the critical items regarding eating behavior which had been used to select bulimic subjects. A11 three groups were matched for weight, height, and age. Each category of subjects was divided into three groups which were exposed to Learned Helplessness (LH), Contingent Feedback (CF), or No Training Control (NTC) conditions. Dependent measures included performance on an anagram test (latency and errors), performance prediction and performance satisfaction questionnaires, and a Self-Statement Test. Results indicated no difference in anagram performance following LH training relative to CF and NTC conditions for normal and bulimic subjects, although depressed subjects demonstrated longer response latency and more errors as a function of training (LH>CF). NTC subjects did not differ significantly from the other conditions, however. Ratings of performance satisfaction differed as a function of training condition in the expected directions. Bulimic subjects demonstrated an interesting pattern of declining ratings of performance satisfaction across training trials within the CF condition. Also, bulimic subjects were found to make more errors on anagrams of nonfood words relative to food words, although this pattern was not reliably related to training condition. Self-Statement Test items did not produce the expected group x training condition effects. The present findings provide limited support for the experimental hypothesis that ineffective coping in stressful situations, mediated by cognitive self-statements, is a useful model for understanding bulimia. Methodological issues are discussed, particularly issues related to subject classification. The present study was likely confounded by the presence of depression (i.e., high BDI scores) among the bulimic subjects. Future research should systematically‘ address the relationship between bulimia and depression. / Ph. D.

A booklet was completed by 7 anorexia nervosa patients, 12 bulimia nervosa patients, and 19 non-clinical individuals. The research instrument was designed to measure transgenerational family processes, interpersonal relations orientations, coping strategies, and stressful behavioral response patterns of anorexics and bulimics. Separate multivariate analysis of variance procedures were performed on the aforementioned variables to determine significant differences among the groups. The findings indicated that significant differences existed among the groups in regards to transgenerational family processes (F = .000), interpersonal relations orientations (F = .014), and coping strategies (F = .003). / Ph. D.

1 online resource (vii, 138 leaves : ill.) / Following an awareness of an increased turn over of staff in the eating disorder unit as compared with other specialised units, in a psychiatric hospital in Johannesburg, South Africa, Tara Hospital, the researcher was motivated to investigate the issue. An exploratory, descriptive based research was chosen to explore and gain information about the topic and its implications. A qualitative research approach was used to gain insight into the perceptions and needs of the team working on the unit. The case study method was used. A pilot study was undertaken to test the validity of the interview schedules. The sampling category was a non- probability one. Individuals were selected from the population of staff working on the unit. Participants were selected from two groups, those who were presently working on the unit and those who had previously worked on the unit and now working in other units. Interview procedure involved personal semi-structured interviews conducted by the researcher and analysed qualitatively and a structured interview questionnaire analysed quantitatively. The researchers assumption that many staff members move from working in an eating disorders unit was confirmed and is due to the following: Staff turnover is due to constant exposure to occupational stress and burnout. Feelings of helplessness, a sense of being unappreciated and excessive exposure to conflict from the patients. In addition, staff experience minimum rewards leading to lowered job satisfaction due to the patients slow recovery rates and a poor prognosis of the illness. Staff also experience a change in their eating patterns and an increased awareness around food and food issues. Recommendations to the staff include: * Psycho-education on eating disorders. * Implementation of strategies to provide supportive care for all staff members. * Education on stress management and strategies to prevent staff burnout and lowered job satisfaction. * A multidisciplinary teamwork approach by the staff, when working in the unit. / Social Work / M. A. (Social Science in Mental Health)

Introdução - Pacientes portadores de diabetes tipo 1 que manifestam comportamentos de risco para transtornos alimentares (TA) possuem grandes chances de complicações microvasculares e macrovasculares e maiores taxas de mortalidade. Objetivo Avaliar a freqüência de comportamento de risco para TA em adolescentes e adultos portadores de diabetes tipo 1 bem como sua relação com variáveis socioeconômicas, nutricionais, relacionadas ao diabetes e satisfação corporal. Metodologia: Foram aplicados: Teste de Investigação Bulímica de Edinburgh (BITE), Teste de Atitudes Alimentares (EAT), Escala de Compulsão Alimentar Periódica (ECAP) e Escala de Silhuetas de Stunkard, além da mensuração de peso, estatura e cálculo do IMC. Foram verificadas associações ou diferenças estatísticas por meio dos testes de Qui-Quadrado e T-Student e Regressão Logística para identificar fatores que influenciaram o risco da doença. Resultados: Um total de 58,7% dos pacientes apresentaram escore positivo em algum dos testes utilizados para risco de TA. Houve diferença significante entre os grupos com e sem risco para TA com relação ao IMC (p=0,009), gênero (p=0,001), omissão de insulina (p=0,003), uso de insulina NPH (p=0,006), ausência do uso da insulina Glargina (p=0,021), ausência do uso da técnica de contagem de carboidratos (p=0,019), controle da glicemia (p=0,049) e insatisfação corporal (p=0,001). Conclusão: Portadores de diabetes tipo 1 apresentaram grande freqüência de comportamentos de risco para o TA, o que requer atenção e cautela dos profissionais de saúde. / Introduction - Patients suffers of type 1 diabetes that reveal risk behavior for eating disorders (ED) have more chances of micro and macro vascular complications and a high mortality level. Objective Evaluate the frequency of risk behavior for ED in teenagers and adults suffers of type 1 diabetes as well as its relation to the socially economical variable, nutritional variable, related to diabetes and body satisfaction. Methodology: There was applied: The Bulimic Inventory Test of Edinburgh (BITE), Eating Attitudes Test (EAT), Binge Eating Scale (BES) and The Stunkard´s Figure Rating Scale, besides weight measure, height and BMI calculation of the patients. There were verified associations or statistical differences through tests of Chi-Square and T-student and Logistical Regression to identify the factors that influenced the risk of the disease. Results: A total of 58,7% patients presented positive score in tests used for ED risk. There was a significant difference among the groups with and without risk for ED in relation to the BMI (p=0,009), gender (p=0,001), omission of insulin (p=0,003), usage of NPH insulin (p=0,006), lack of usage of Glargine insulin (p=0,021), lack of usage of the technique of carbohydrate counting (p=0,019), blood glucose control (p=0,049) and body dissatisfaction (p=0,001). Conclusion: The suffers of type 1 diabetes presented high frequency of risk behavior for ED, which require more attention when caring for patients for the prevention of the disease.