Obesity and eating disorders are pervasive concerns among young adult women, and profoundly impact physical and psychological functioning. Weight-related disorders are typically chronic conditions; their treatment is often complex and frequently ineffective. Moreover, Black and Latina women have disproportionately high rates of obesity, and experience rates of eating disorders comparable to those of their White peers; yet, they are less likely to be referred to appropriate treatment. Given the intractability of weight-related concerns and their detrimental consequences, attempts to prevent unhealthy eating attitudes and behaviors are essential. To date, few prevention programs have significantly reduced both obesity risk and eating disorder symptoms. The purpose of the current study was to develop and pilot an intervention designed to prevent obesity and eating disorders among young adult women (age 18-25). In the first phase of the study, focus groups were conducted with 30 young adult women to explore disparate racial and ethnic appearance ideals and assess cultural acceptability of the proposed intervention. Additionally, an innovative manualized intervention informed by the qualitative data and grounded in social psychological principles and dialectical behavior therapy was developed. In the second phase of the study, 29 young adult women were recruited to participate in the intervention. Participants completed a battery of questionnaires at pretest (baseline), posttest (8-weeks), and 4-week follow-up. Findings reveal vast differences in beauty standards among disparate racial/ethnic women and demonstrate the need to enhance the cultural sensitivity of current intervention approaches. Results suggest the feasibility and acceptability of a culturally sensitive prevention program intended to reduce the risk of both unhealthy weight gain and eating pathology.

This diploma thesis focuses on the relations between attachment quality and eating disorders. The main goal is to map how girls with an eating disorder understand their illness and what the disorder signifies to them within their family system. In the theoretical part of the thesis, eating disorders are delineated. There is an emphasis on risk factors for eating disorders, and a comprehensive approach to their explanation is presented in terms of different theoretical schools. The next part is devoted to the attachment theory with an emphasis on the development from childhood to adulthood. The theoretical foundations of the Parental Bonding Instrument are presented. Furthermore, the attachment theory is linked to the occurrence of eating disorders. In the empirical part of the thesis, the methodological aspect of the research, which was carried out with three girls who have experienced eating disorders, is first introduced. The research design combines the method of semi-structured interviews with the method of using a tool measuring the quality of bonding with parents, specifically the Parental Bonding Instrument. It has been shown that the quality of the relationship with parents influences the onset, course, and duration of eating disorders in a child, adolescent, or young adult. The...

Little is known about health care professionals' perceptions of eating disorder etiology among African American (AA) women. The purpose of this quantitative research study was to examine the associations among health care professionals' race, cultural awareness, and perceptions of media influence on eating disorder-related factors in AA women. Festigner's social comparison theory; Bandura's social learning theory; and Garcia, Cartwright, Winston, and Borzuchowska's transcultural integrative model served as the theoretical frameworks for this study. Specifically, this study examined whether race and cultural awareness of health care professionals relate to their perceptions of the extent to which media influences AA women's eating disorders, and whether cultural awareness moderates the association between their race and media influences. Data were obtained through a researcher-created demographic questionnaire, the Multicultural Counseling Inventory, and a modified Sociocultural Attitudes Toward Appearance Scale-3 with a purposive sample of 49 participants. Data were analyzed using descriptive statistics, Spearman's Rho correlation, Pearson correlation, and a hierarchical multiple linear regression. Compared to their Caucasian American counterparts, AA health care professionals perceived greater media pressure on AA women's body image concerns. Additionally, participants' cultural awareness was positively correlated with their ratings of AA women's desire to have more athletic bodies. The implications for positive social change stemming from this study are directed at health care professionals as additional training may increase their awareness, early detection, diagnosis, and treatment of eating disorders among AA women.

Eating disorders are among the most prevalent psychiatric conditions in both developed and developing countries. In Turkey, eating disorders have been increasing in prevalence among adolescents. Family relations and parenting have been studied as sociocultural influences that shape individuals' eating behaviors and relationships with food. Eating behaviors have psychosocial outcomes for adolescents' development and are affected by parental warmth and care. This study investigated the relationship between fathers' parental attitudes and young individuals' emotion regulation skills and eating behaviors. It focused on fathers' parental attitudes in Turkey, where a collectivistic and patriarchal culture typically has father figures playing an important role in family as well as in society. The Eating Attitude Test (EAT-26), Difficulty in Emotion Regulation Scale (DERS), and Parental Acceptance-Rejection Questionnaire-Child Form (PARQ-C) were used to collect data from 401 Turkish adolescents. Correlation analyses showed positive correlations between 2 combinations of variables: adolescents' eating behaviors and emotion regulation skills, and fathers' parenting and adolescents' eating behaviors. Multiple regression analysis showed that father's parenting was predictive of adolescents' eating behaviors and emotion regulation skills. Based on the results, this research may promote positive social change by identifying the importance of fathers' parenting attitudes on adolescent health and by raising awareness of eating disorders in Turkey. The study will guide researchers and counselors in designing eating disorders prevention programs and identify tools for involving fathers in developing healthy parenting attitudes and awareness of eating disorders.

Eating disorders are alarmingly prevalent and potentially lethal. The proper assessment of eating disorder symptoms is therefore crucial for the early identification and treatment of those suffering from these serious illnesses. Current measures of eating disorder symptoms are either very narrow in scope (e.g., assess only one aspect of disordered eating, such as bingeing) and/or have one or more serious limitations, such as inconsistent factor structures and/or poor discriminant validity. Because several of the existing measures of eating disorders were created over 20 years ago, many of these limitations are the direct result of out-dated scale development methods and testing.The goal this study was to determine the structure underlying the symptoms of eating disorders and develop a multidimensional measure of eating pathology based on this structure. To accomplish this goal, an initial item pool was developed to assess 20 dimensions of eating pathology. The initial item pool of 160 items was administered to a student sample (N=433) and community sample(N=407) to determine the preliminary structure of the measure using exploratory and confirmatory factor analyses. The revised measure was then administered to independent samples of psychiatric patients (N=190) and students (N=227). Exploratory and confirmatory factor analyses revealed a 7-factor structure that showed excellent convergent and discriminant validity. The final measure was also internally consistent (median coefficient alphas ranged from .84-.89) and reliable over a two- to four-week period (r's ranged from .70-.84). The current study represents one of, perhaps, the most comprehensive scale development project ever conducted in the field of eating disorders and is expected to improve future basic and treatment research focused on eating disorders.

O presente trabalho tem como objetivo refletir sobre a dimensão metapsicológica da obesidade a partir da experiência de um dispositivo psicanalítico de grupo. A constatação de que a obesidade tem aumentado nos últimos anos e, consequentemente, os problemas de saúde a ela associados, reforça a importância de refletirmos sobre as suas causas e sobre os aspectos que dificultam o seu tratamento. Nos deparamos com uma grande oferta de tratamentos, sejam eles cirúrgicos, medicamentosos, esportivos, nutricionais ou mesmo psicoterapêuticos, que não consideram a subjetividade e os fatores inconscientes que sustentam o sintoma da obesidade e, ao contrário, acabam reforçando um ideal de corpo que muitas vezes está pouco ou nada conectado ao desejo do próprio sujeito. Para o desenvolvimento desta pesquisa foi montado um grupo de tratamento psicanalítico na Clínica Psicológica Durval Marcondes, no Instituto de Psicologia da Universidade de São Paulo. As sessões, com uma hora e meia de duração, aconteceram uma vez por semana, durante oito meses. O grupo, que teve início com 12 membros e terminou com quatro, tinha como proposta a sustentação de um espaço no qual os aspectos psíquicos que estão na base da obesidade pudessem ser escutados e trabalhados. Nesta perspectiva, a metapsicologia proposta por René Kaës, que oferece importantes contribuições para a psicanálise grupal, foi utilizada. Após cada encontro, as duas psicanalistas que conduziram o processo discutiam a sessão, levantando o conteúdo que seria registrado posteriormente, lido e discutido pelo grupo de orientação da Pós-graduação, momento compreendido como fundamental para a análise do grupo em função dos aspectos transfero-contratransferenciais envolvidos. Por meio da elaboração dos conteúdos das sessões nesses espaços, foram selecionados trechos dos relatos das sessões, a partir dos quais pudemos discutir aspectos que foram importantes no decorrer de todo o processo do grupo: as ansiedades persecutórias, o vazio, a relação com o objeto primário, as fronteiras, a raiva, os pactos denegativos e a importância da análise intertransferencial. Destacamos o quanto a dimensão relacional com os primeiros objetos é um dos pilares da formação e da manutenção do sintoma da obesidade e que o comer se apresenta, para essas pessoas, como um agir que busca aliviar qualquer tensão interna com a qual o aparelho psíquico não tenha condições de lidar. Concluímos com a hipótese de que aspectos pouco ou nada simbolizados da mente estão na base da constituição do sintoma da obesidade, evidenciando ser fundamental a consideração das comunicações inconscientes que se dão na intersubjetividade para a compreensão e o tratamento desses sujeitos. / This study aims to reflect on the metapsychological dimension of obesity through the experience of a group psychoanalytic device. The finding that obesity has increased in recent years and, consequently, the health problems associated with it, reinforces the importance of reflecting on its causes and on the aspects that make it difficult to treat. We are confronted with many treatment optionssurgical, medicated, sport, nutritional or even psychotherapeuticthat do not consider the subjectivity and unconscious factors that sustain the symptom of obesity and, on the contrary, end up reinforcing a body ideal that is has often little or nothing to do with the person\'s own desire. For the development of this research, a psychoanalytic treatment group was put together at the Durval Marcondes Psychology Clinic, located in the Psychology Institute at the University of São Paulo. The ninety-minute sessions took place once a week for eight months. The group, which started with 12 members and ended with four, proposed the maintenance of a space in which the psychic aspects that are the basis of obesity could be discussed and worked on. Within this perspective, the metapsychology proposed by René Kaës, who offers important contributions to group psychoanalysis, was used. After each meeting, the two psychoanalysts who conducted the process would discuss the session, organizing the content that would later be recorded, then read and discussed among graduate students in group advising, considered fundamental for analyzing the group according to the transfercountertransferences involved. Through the elaboration of the session contents in these spaces, excerpts were selected of the remarks made during the sessions, from which we were able to discuss aspects that were important throughout the group process: persecutory anxieties, emptiness, relationship with the primary object, boundaries, anger, denigrating pacts and the importance of intertransferential analysis. We emphasize how the relational dimension with the first objects is one of the pillars of the formation and maintenance of the symptom of obesity and that eating presents itself to these people as an act that seeks to alleviate any internal tension with which the psychic apparatus is unable to cope. We conclude with the hypothesis that little or not at all symbolized aspects of the mind are the basis for the establishment of the symptom of obesity, evidencing that it is fundamental to consider the unconscious communications that take place in intersubjectivity for the comprehension and treatment of these subjects.

Bibliography: leaves 156-165. Electronic publication; full text available in PDF format; abstract in HTML format. Several researchers have indicated that the emphasis placed by young people on body shape and appearance has been greatly shaped by the media. The aim of this research was to investigate this notion specifically with regard to televised media. It was hypothesised that there would be a relationship between media images, eating attitudes and dietary behaviours, particularly for teenagers with body-image self-schemas who were conscious of their appearance. Nine hundred and sixty five senior secondary school students, from 33 country and metropolitan, state and independent, co-educational and single-sex South Australian high schools were surveyed. Electronic reproduction.[Australia] :Australian Digital Theses Program,2001.

Research has shown that elite female athletes competing in competitive sports may experience weight consciousness and face demands to conform to unrealistic standards of body weight. The purpose of this research was to investigate body image and dieting behaviours in adolescent female athletes and non-athletes. A self-reporting questionnaire was administered to 60 athletes aged between 13-16 years derived from eight different sporting populations, and a control group consisting of 60 non-athletes or inactive individuals aged between 13-16 years. Two major areas relating to weight and eating behaviours were examined: disordered eating and distorted body image. Other variables under investigation included current attempts at weight loss, level of acceptance of thin female stereotypes promoted by the media, reasons for dieting, and perception of one’s own body image. Results indicated that the majority of the athletes displayed a positive body image and were generally happy with their overall body shape. This group was less likely to employ weight loss behaviours. However, the non-athletes were more likely to display distorted body image and distorted eating behaviours. Consistent with the cultural expectations of thinness, large proportions of the non-athletes wished to lose weight, even though their actual weight (i.e. Body Mass Index) was normal or underweight. Weight concerns in the non-athlete group related more to attaining a media driven “ideal” of femininity. The weight concerns recorded amongst a small number of athletes were related more to improving sporting performance. Although no clinically diagnosed cases of eating disorders were recorded, eating behaviours, weight reduction practices and body image beliefs indicated that the adolescent female non-athletes may be at risk of developing disordered eating and body image problems.

The affectional bond that develops between caregiver and child during infancy can lead to the development of emotional distress and the manifestation of psychological disturbance if the relationship is severed and a sense of loss is experienced. Furthermore, the caregiver-child relationship formed during infancy can have implications for the development of interpersonal relationships in later life. The secure or insecure attachment relationships developed influence the capacity to form affectional bonds in later life and may lead to the manifestation of psychological disturbance, such as depression. The focus of this thesis is on four case studies of three children and one adolescent who have suffered negative early life experiences. Harrison is an 8 year old Koori boy who has suffered from maternal deprivation. Diana is a 10 year old girl who has a Mild Intellectual Disability and Epilepsy. The influence of second generational trauma on the caregiver-infant attachment relationship will also be explored in the case study of Diana. The third case study focuses on Melanie who is a 9 year old girl who has suffered from paternal sexual abuse and exhibits indiscriminate attachment relationships. Finally, the fourth case study focuses on Tammie who is a 16 year girl who exhibits depressive symptomatology which may have developed as a result of early insecure attachment relationships. The case studies are described with reference to attachment theory, the language and social deficits associated with negative early life experiences, and implications for therapeutic interventions.

<p>The purpose of the present study was to evaluate a day ward treatment program for eating disorders by examining the patients' expectations and experiences of treatment. Previous research suggests that patients' expectations are important variables to be considered in the treatment of eating disorders as they have shown to influence treatment outcome in various ways. The present study included 38 patients who had completed the day ward treatment and fulfilled the criteria for either anorexia nervosa, bulimia nervosa or eating disorder-not otherwise specified. Data was collected using the self report questionnaire Eating Disorder Patients' Expectations and Experiences of Treatment (ED-PEX) which measures patients' expectations prior to treatment as well as their experiences directly after treatment termination. Data was also collected using ten half-structured interviews which were held 3-18 months post treatment. Diagnosis criteria were used to assess the treatment outcome. At treatment termination 23 of 38 patients were diagnosis free. The results indicated that the control-focused interventions were most helpful according to the patients. It was also revealed that the patients desired more specific information about the purpose of the treatment components prior to, as well as during, the treatment process.</p>