In recent research body dissatisfaction has been identified as an important risk and maintenance factor in the development of eating disorders, and studies in adolescent girls have shown a relationship between body dissatisfaction and disordered eating. Sociocultural theories have highlighted the maternal influence on body dissatisfaction and weight concerns, however, contemporary research reveals contradictory results regarding a mother’s influence on the body dissatisfaction and eating concerns of her adolescent daughter. This study investigated whether a significant relationship existed between body dissatisfaction of mothers and body dissatisfaction of their adolescent daughters in a private Johannesburg high school. A convenience sample of 97 mother-daughter pairs completed a demographic questionnaire and the Body Dissatisfaction scale of the Eating Disorder Inventory-3 (EDI-3). The daughters also completed the three scales of the EDI-3 which measure disturbed eating directly in order to screen for the presence of disturbed eating attitudes and behaviours among the adolescent girls in the sample. No significant relationship was demonstrated between the body dissatisfaction of mothers and their adolescent daughters. Among both the mothers and daughters positive relationships were shown between body dissatisfaction and body mass index (BMI). Based on the results, a mother’s own body dissatisfaction does not influence her daughter’s body dissatisfaction and disturbed eating attitudes and behaviours. Based on the screening for the presence of disturbed eating attitudes and behaviours (measured by the Body Dissatisfaction, Drive for Thinness and Bulimia scales of the EDI-3), there were girls in the sample who demonstrated disordered eating attitudes and behaviours. Higher levels of disordered eating were associated with having a higher BMI. Girls with a higher BMI tended to perceive themselves as overweight and showed more disturbed eating. The findings of the study conform to the findings of other South African studies on high school girls regarding the presence of disturbed eating attitudes and behaviours. / Dissertation (MA (Counselling Psychology))--University of Pretoria, 2008. / Psychology / unrestricted

Although many factors have been Implicated in the etiology and maintenance of anorexia nervosa and bulimia, anxiety, particularly in the context of eating, may be critical. Applying the tri-partite model of anxiety, this study was designed to assess anxiety before, during, and after eating in eating disorder and normal control subjects. The experimental eating procedure was preceded by a neutral task. Four groups of ten female subjects each participated: normal-weight females, restricting-anorexics, bulimic-anorexics, and bulimics. Anxiety was assessed by self-report (ratings of pleasure, arousal, and anxiety), psychophysiological (heart rate and skin conductance) and behavioural (food consumption) measures. Controls reported themselves to be non-anxious throughout the study arid ate almost all of the small test meal. Somewhat surprisingly, physiological arousal (especially heart rate) was high during eating. During the neutral task, heart rate declined slightly in all groups. The eating disorder groups indicated a high level of anxiety throughout the study which showed a trend to increase further during eating. In addition, anorexics and bulimics described dysfunctional beliefs regarding the effects of eating on body shape and weight. Similar to controls, physiological arousal was high during eating. Overall, heart rate proved to be a more useful measure of arousal than skin conductance because many anorexics were hyporesponsive. Restricting-anorexics ate the least amount, bulimic-anorexics ate slightly more, and bulimics ate similar amounts to controls. Thus, food consumption was probably associated with weight status. Several conclusions were drawn. Women with eating disorders have a high level of general anxiety probably because of a conflict between biological pressures to eat and fears of weight gain. The high physiological arousal during eating appears to reinforce perceptions of anxiety. The eating disorder groups showed different degrees of concordance among measures of anxiety. Borrowing from the research on phobias, therapeutic procedures such as cognitive therapy, progressive relaxation, and exposure treatments can address the different components of anxiety anorexics and bulimics experience during eating. / Arts, Faculty of / Psychology, Department of / Graduate

The purpose of this dissertation was to undertake a conceptualization and empirical "mapping" of the ethic-of-care domain - often characterized as self-referential and lacking in rigor. The current focus is upon conventional forms of care, involving notions of moral "goodness" as self-silencing and -sacrificial. Employing a "super" circumplex as a prescriptive and descriptive tool, projected item analyses were undertaken as a theoretico-structural clarification of existing scale items, along with a provisional pool of additional items generated as part of Study 1. Based in part on proposed circular criteria, the Conventional Care Scales (CCS) were developed and submitted to a conjoint principal components analysis along with the battery of other care/dependency scale items. An examination of item circular distributions, factor loadings, alpha-contribution plots, and thematic content revealed several factors expressive of two "faces" of conventional care, submissive and ingenuous. These two forms were shown to have unique correlates with measures of adjustment, interpersonal competencies, other factors of the Five-Factor Model, false-self beliefs, and reported distress in narrated accounts of rejected care giving. Gender differences in the association between indices of adjustment and conventional care were also found. The range of conventional care was also extended through the development of scales reflecting other-directed and socially prescribed dimensions of conventional care. The factor structure for the CSS was also replicated in a second sample (Study 2). Participants for Studies 1 and 2 were composed of undergraduate students (N = 302 in both samples) who completed a battery of questionnaires in the first study and the CCS alone in the second study. Anticipating future clinical directions, secondary analyses using structural equation modelling were conducted on an existing data set (N = 92) which included measures of conventional care and perfectionism, along with indices of psychological adjustment and eating disordered attitudes. Results indicated that conventional care, for which there is little research, was more predictive of adjustment and eating disordered attitudes than perfectionism, for which there exists a large clinical literature. This research contributes to an understanding of ways in which an ethic of care can "go awry," as well as proposes a research platform upon which the clinical implications of morality and self-ideals can be investigated. These findings speak to both the constraints and prescriptions that can inform a philosophical ethic of care. / Arts, Faculty of / Psychology, Department of / Graduate

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Binge eating is a maladaptive eating practice associated with unhealthy weight control methods (vomiting, laxative abuse) and the development of weight gain and obesity. Isolating psychological and environmental variables that trigger binge eating can prevent or potentially moderate eating disturbance. Previous research implicates media exposure as an environmental contributor to psychological and eating disturbance. The current study sought to uncover whether fat stigmatization media exposure is an acute environmental trigger for psychological disturbance and binge initiation by dismantling fat media messages and experimentally manipulating messages. Undergraduate women (N=197) were assigned to one of four media message conditions: a fat negative interaction, fat comedy, control stigmatization, or control comedy condition. Psychological functioning and weight control variables were assessed at baseline, pre-test, and post-test. Results indicated that fat message exposure resulted in significantly greater post-test perceived pressure to lose weight, negative affect, guilt, and anger than control conditions. Participants exposed to fat messages were significantly more likely to restrict food intake. Two subjects engaged in an analogue binge. Weight control intentions were similar across conditions at post-test. BMI was found to moderate the relationship between fat message exposure and negative affect and hostility, with overweight and obese women more vulnerable to negative psychological consequences of fat media exposure. A history of weight related teasing moderated the relationship between fat message exposure and negative mood dependent variables (negative affect, guilt, sadness, fear), with those who had a history of teasing more vulnerable to negative mood induction. The primary significant mediator between fat message exposure and body dissatisfaction was appearance activation. Eating disorder theories were upheld, with suggested minor modifications specific to the context of fat media exposure. Findings are discussed in the context of weight loss and eating disorders treatment. Limitations of the study and directions for future research are discussed.

京都大学 / 0048 / 新制・論文博士 / 博士(医学) / 乙第13385号 / 論医博第2217号 / 新制||医||1048(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 古川 壽亮, 教授 松村 由美, 教授 中山 健夫 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

Researchers have begun to explore the role that family members play in maintaining or recovering from an eating disorder. However, little research has addressed the sibling relationship, including nurturance, quarreling, and favoritism. Self-report questionnaires were collected from 120 girls and 87 boys in middle school (N=161) or high school (N=46). Linear regressions, ANOVAs and mediation analyses were conducted to determine the effects of siblings on adolescents’ disordered eating. Sibling favoritism and modeling of bulimic behavior were the only variables significantly related to relationship quality. Our results indicate that family dynamics and structure may play a larger role in adolescent maladaptive behavior than sibling relationship quality. Additionally, sibling relationship quality, bulimic modeling and sibling favoritism may be part of a very complex process leading to disordered eating behavior. Future research should continue to utilize the sibling subsystem as a means of understanding the development of disordered eating behavior among adolescents.

The present study examined whether or not the temporal pattern of symptom change defined as sudden gains is applicable to and has significant ramifications for understanding recovery from eating disorders. Sudden gains were defined as stable and clinically significant changes that take place between two sessions of treatment. Data for the current study were drawn from an efficacy study of CBT for eating disorders which included session-by-session measures of eating disorder symptomatology. Predictors of sudden gains were measured by an observer coded scale that included ratings of therapist use interventions, client change in behaviors and beliefs, client engagement, and homework completion. Three research questions were addressed: First, is the phenomenon of sudden gains present in CBT for eating disorders? Second, do sudden gains in CBT for eating disorders follow the three-stage model proposed for sudden gain recovery in other disorders (i.e., cognitive changes during critical sessions => sudden gains => upward spiral that includes further cognitive changes and greater long-term symptom improvement (Tang & DeRubeis, 1999b)? Third, what are the predictors of sudden gains in CBT for eating disorders that distinguish the critical session that takes place right before the sudden gain? Findings suggest that many eating disordered clients (62%) experienced at least one sudden gain during the course of CBT treatment. Three distinct types of sudden gains were identified: total symptom sudden gains, eating-related sudden gains, and body-related sudden gains. The average magnitude of these sudden gains was large representing on average 35% of total symptom improvement. Clients who experienced total symptom and body-related sudden gains demonstrated fewer eating disordered symptoms than the other clients at posttreatment. During the session preceding the sudden gain, therapists had increased levels of cognitive interventions and empathy, and clients experienced more cognitive changes and increased motivation.

Thesis advisor: Judith Shindul-Rothschild / BACKGROUND: Anorexia nervosa (AN) is a psychiatric disorder associated with extensive medical and psychological comorbidities and limited treatment options. Mindfulness may enhance physical and psychological wellness but research on its usefulness in AN in limited. Foundational research is needed in this field to enhance the science and support the continued use of such practices. PURPOSE: The purpose of this study was to determine to what extent levels of mindfulness correlate with eating disorder symptomology and other clinical indicators of health in persons with AN entering residential treatment. Furthermore, this study assessed for unique variance in eating disorder symptomology that is accounted for by mindfulness and other clinical indicators of health. METHODS: A cross-sectional and descriptive study was conducted. Sixty female, individuals diagnosed with AN were recruited to complete a confidential, web-based, 87-question survey upon admission a residential treatment facility in the Greater Boston area. Additional data from the participants’ charts were also collected. Data were analyzed using simple linear regression and stepwise multiple regression in SPSS. RESULTS: Mindfulness was significantly, inversely correlated with eating disorder symptoms. This relationship appeared to be particularly strong among individuals with AN, and particularly AN BP compared to individuals with OSFED AA. Among the entire sample, mindfulness significantly and inversely predicted shape concern and weight concern but not eating concern or restraint. When considering clinical indicators of health and certain demographic variables, mindfulness did not contribute any unique variance in eating disorder symptoms based on stepwise regression. Only anxiety and pain significantly predicted eating disorder symptoms among this sample. CONCLUSIONS: Level of mindfulness may be related to eating disorder symptomology in acute AN. Future research should explore this pattern over time and across different levels of care and determine what, if any, impact baseline levels of mindfulness and change over time have on eating disorder outcomes. Additional research should examine the mechanisms of actions of mindfulness and variance between subtypes of AN. The role of pain and anxiety on eating disorder symptomology and mediating or moderating effects of mindfulness should also be studied. / Thesis (PhD) — Boston College, 2019. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

The purpose of this study was to examine the relationship between anorexia nervosa and several personality traits. Past research in this area has been contradictory for several reasons. Sociocultural theories have described the media's role in promoting eating disorders by portraying a thin body-type as the ideal. However, they have neglected to describe the personality ideal which our society promotes in women. It is proposed here that anorexics incorporate and oppose this ideal. Therefore, the anorexic personality is one filled with conflict.