This qualitative study explores client experiences to further understand psychotherapy for the treatment of eating disorders in community practice settings. Eight participants shared their experiences of individual psychotherapy, where eating disorders were the primary focus, during minimally-structured and open-ended interviews. Data were analyzed using interpretive phenomenological analysis. Analysis resulted in 20 themes representing what participants described as meaningful in their experience of therapy. These themes are organized in five broader thematic categories: Goals and Expectations of Therapy, Therapist Way of Being, Session Process, Eating Disorder Specific Interventions, and Non-Eating Disorder Specific Interventions. Each thematic category and theme is described in detail, including verbatim quotes from participant accounts, and depicting points of agreement or divergence among participant experiences. The constructivist orientation, principles of hermeneutic phenomenology, and helpful factors design forefront participant perspectives and allow for elucidation of nuances in which therapy and therapeutic interventions unfold. The findings reinforce and expand upon scholarly literature, including ways that participants find it helpful when therapists consider the client’s context, but also value direction provided by therapists who have eating disorder expertise. Implications of the study for research, practice, and training are discussed.

This study examined the psychosocial variables of assertiveness, intimate relationships, interpersonal distrust, and social self-esteem in eating disordered and non-eating disordered women. Assertiveness was examined between three eating disordered subgroups, namely, restricting anorexics, previously anorexic bulimics, and never anorexic bulimics, in an attempt to answer the question: Are there differences in assertiveness between these subgroups? Intimate relationships, interpersonal distrust, and social self-esteem were examined between the overall eating disordered group and the non-eating disordered group. It was expected that eating disordered women, as compared to non-eating disordered women would report more difficulty in establishing and maintaining intimate relationships, higher interpersonal distrust, and lower social self-esteem. The subjects were 82 females (41 eating disordered and 41 non-eating disordered), aged 19 to 40 years. Eating disordered subjects were recruited from a local support group for women with eating disorders. None of the eating disordered subjects were hospitalized at the time of testing. Eating disordered subjects were classified using the DSM-III (1980) criteria for anorexia nervosa and Russell's (1979) criteria for bulimia nervosa. Non-eating disordered subjects were nursing students at a local community college. Non-eating disordered subjects were screened using the Eating Attitudes Test in order to prevent the inclusion of women with mild eating disorders into the comparison group. All subjects completed a battery of tests including: The Eating Attitudes Test; The Assertion Inventory; The Adult Self-Perception Profile; The Eating Disorder Inventory; The Social Self-Esteem Inventory; arid a demographic information sheet. All subjects were weighed and their height measured. A one-way multivariate analysis of variance was computed for the assertiveness measures of discomfort and response probability, examining differences between the three eating disordered subgroups. No significant differences were found. Post hoc analysis between the overall eating disordered group and the non-eating disordered group revealed highly significant differences between the two groups on both assertiveness measures (ϱ<.001). An examination of the means revealed that the eating disordered group experiences more discomfort in situations requiring assertiveness, and are less likely to respond assertively in those situations. Intimate relationships, interpersonal distrust, and social self-esteem were tested using a one-way multivariate analysis of variance. Differences were tested between the eating disordered and non-eating disordered groups. Highly significant differences were found between the groups on all three measures (ϱ<.001). An examination of the means revealed that the eating disordered group have more difficulty in forming and maintaining intimate relationships, a greater degree of interpersonal distrust, and less social self-esteem. Implications of these results and suggestions for future research are discussed. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

This study is an investigation into entomophagy (insect eating by humans) as a practice that could enrich a culinary experience and thereby create a sense of ‘place’ in the urban context of Pretoria. Entomophagy is as old as man itself, but has suffered under globalised trends in food production and consumption. Humans are furthest removed from the origins and growth medium of the food they consume as food has become merely a commodity. The investigation entails exploring how architecture can be a cognitive tool and mediating device between food production processes and the public consumer. By bringing awareness and value to insects as food, the study hopes to redirect prejudices and open up new thoughts and behaviours in the food industry. / Dissertation MArch(Prof)--University of Pretoria, 2012. / Architecture / MArch(Prof) / Unrestricted

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Personality traits, such as neuroticism, perfectionism, and a narrow self-concept have been identified as risk factors for eating disorders or have been found at higher rates in those with eating disorders (e.g., Brannan & Petrie, 2008; Cash & Deagle, 1997; Cervera et al., 2003). Musicians exhibit many of these personality traits associated with eating disorders (e.g., Kemp, 1981), however eating disorder prevalence has not been studied in musicians. The present study examined the prevalence of eating disorders and pathogenic weight control behaviors among college music majors. This study also compared personality traits (i.e., neuroticism, perfectionism, musician identity) between music majors and nonmajors and examined which personality traits best predicted bulimic symptomatology. Participants were 93 female and 126 male undergraduate students majoring in music and a nonmusician comparison group of 310 women 140 men from the same university. Music majors and nonmajors did not differ from each other with regards to eating disorder prevalence rates. Exercising and fasting/strict dieting were the primary means of weight control amongst all participants. With regards to personality traits, female and male music majors reported higher levels of perfectionism than their nonmajor counterparts and male music majors reported higher levels of neuroticism than male nonmajors. After controlling for BMI, neuroticism and doubts about actions predicted bulimic symptoms in female music majors, whereas concern over mistakes predicted bulimic symptomatology among men majoring in music. Findings suggest that any additional appearance-based pressures from the music environment do not translate into increased levels of eating pathology. Music majors higher levels of perfectionism and neuroticism may help them to succeed within the music and perform at a high level. Lastly, personality dimensions of neuroticism and concern over making mistakes predict disordered eating in all students.

Objective: Students from 5 public schools in east Tennessee in grades 6 through 10 were assessed for their risk of eating disorder. Method: The Eating Attitudes Test (EAT40), a self-administered questionnaire, was given anonymously to 1,302 male and female adolescents. Results: The results showed that 19.8% of females and 3.7% of males scored above 29, indicating high risk for development of an eating disorder. There was also a trend toward increased prevalence of risk in areas that are more rural. Conclusions: These findings suggest that the risk for eating disorders may be greater in rural areas than has previously been believed. This has implications for understanding the etiology of these diseases as well as demonstrating the need for more research in these often underserved areas.

Bibliography: pages 313-322. / This study addresses eating and body problems among women. It has three central aims. Firstly, it is a prevalence study of the attitudes and behaviours associated with the eating disorders of anorexia nervosa and bulimia, among a sample of female undergraduate students. Secondly, it serves as a study of the nature of problems associated with eating and body affect among this community of women, with a particular focus on those women who consider themselves to have an eating problem. Thirdly, it has a theoretical aim to address the issue of the role of culture, in particular socially constructed femininity, within the understanding of eating/body problems, ranging from "normal" women's relationships to their body and eating to the severe disorders of anorexia nervosa and bulimia. The theoretical project within this study involves a critical review of theories which are pertinent to an understanding of the role of culture and femininity, both from within and outside of eating disorder literature. This review, together with empirical evidence from prevalence studies, highlights the importance of "normal" women's experiences with their body and eating and the ideological prescriptions in which these occur, within the understanding of eating/body problems. The mainstream view of eating disorders as abnormalities, apart from the "normal", is challenged in this way. The need for a theory which can articulate the complex psychical acquisition of cultural femininity, which does not reduce this process to either social or asocial determinants alone, is argued.

Ph.D., Faculty of Health Sciences, University of the Witwatersrand, 2008 / The ‘two-world hypothesis’ argues that women may employ self-starvation as a means of coping with the demands of ‘straddling two worlds’ which occurs during periods of transition such as adolescence, industrialization, emancipation of women and culture clash, where women are required to ‘juggle’ the demands of conflicting socio-cultural expectations (Katzman & Lee, 1997). This resonates with the construct of acculturative stress proposed by Rodriguez, Myers, Mira et al., (2002) as the simultaneous ‘push and pull’ of opposing pressures to acculturate to a new culture and pressures against this acculturation from the culture of origin; and suggests that acculturative stress may mediate the development of eating disorders during periods of sociocultural transition. This study aimed to identify relationships between acculturative stress and eating disorder by exploring associations between the Multidimensional Acculturative Stress Scale (MASI: Rodriguez et al., 2002), the Eating Attitudes Test-26 (EAT26; Garner, Olmsted, Bohr & Garfinkel, 1982) and the Eating Disorders Diagnostic Scale (EDDS: Stice, Telch & Rizvi, 2000) as a substitute for follow-up clinical interview, in a sample of black adolescent schoolgirls in the rapidly changing socio-cultural context of South Africa. Focus Groups were conducted to evaluate the validity of these instruments within the South African context. Groups suggested that the EAT26 needed to be qualified and the MASI needed to be modified and revised. The 34-item MASI-Revised contained three subscales, Pressure to Acculturate, Pressure against Acculturation, and a new subscale, Conflict, which appeared to reflect the sum of opposing acculturative pressures as cultural-identity confusion. The General Health Questionnaire-12 was used as a ‘gold standard’ measure of stress. The study selected a sample of 5 urban state high schools from which 187 black female learners were sampled from grades 9-12. Response rate was low and random sampling was not possible. Results indicated that 24.5% of the sample scored positively on the EAT26 and 13.9% qualified for a diagnosis of eating disorder as measured by the EDDS; while a further 24% engaged in regular dysfunctional eating patterns worthy of clinical attention. Subjects scoring positively on both the EAT26 and the MASI-R were significantly more likely (Odds Ratio=29.408; p<0.001) to have an eating disorder on EDDS than those who were negative on both scales. Eating disorders were also significantly and independently predicted by the MASI-R and the EAT26, where subjects scoring positively on either of these scales were significantly (Odds Ratio=4.917; p<0.001) more likely to have an eating disorder than those scoring negatively on both scales. Results suggested that acculturative stress may be a significant risk factor in the development of eating disorders in black South African females and that adolescents experiencing cultural identity confusion may be most at risk.

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