Bakgrund: Ett stort antal patienter fullföljer inte sin behandling av ätstörningar på grund av att de känner sig missförstådda av vårdaren vilket kan leda till ett vårdlidande. Sjuksköterskors arbete är betydelsefullt då den vårdande relationen som hen fokuserar på anses vara mer läkande än den medicinska behandlingen. En väletablerad kontakt mellan vårdpersonal och patient är av stor betydelse för en god omvårdnad och en lyckad behandling. Syfte: Syftet med studien är att belysa sjuksköterskors erfarenheter av att vårda patienter som lider av ätstörningar. Metod: En litteraturstudie har gjorts med utgångspunkt i Evans (2002) analysmetod. Analys av 10 vetenskapliga studier som har svarat till studiens syfte. Resultat: Fyra teman framkom som belyser sjuksköterskors erfarenheter kring attityder och beteenden, en vårdande relation, kunskap och känslor. Slutsats: Relationen mellan patient och vårdare är mycket viktig men också mycket komplext. Det är vår uppfattning att alla sjuksköterskor försöker med bästa möjliga förmåga sträva efter att lindra patienters lidande däremot är kunskapen om hur detta ska uppnås inte tillräckligt tydlig. Att sjuksköterskor ibland frångår principer som formar omvårdnaden, så som empati, kärlek och förståelse; är ett faktum. Klinisk betydelse: Sjuksköterskorna sökte många gånger stöd och hjälp från andra mer erfarna kollegor för att ta del av deras erfarenheter och kunskaper för att kunna ge en bättre vård. Studien är därmed ett viktigt bidrag då det ger en översikt över erfarenheter i en större utsträckning än den samlade erfarenheten som kan finnas inom endast en avdelning. / Background: A large number of patients do not fulfill the treatment provided for eating disorders due to a feeling of misunderstanding from the nurse; this can lead to a suffering for the patient. The works of nurses are significant since the therapeutic relationship is seen as more healing than the medical treatment. A well-established relationship between care provider and caretaker is of great importance for a good quality care and a successful treatment of the patient suffering from an eating disorder. Aim: The aim of the study was to shed light on nurses' experiences of caring for patients suffering from an eating disorder. Method: A literature review was conducted with support of Evan's (2002) method of analysis. An analysis of 10 scientific studies which contributed to the aim of this study. Findings: Four main themes were identified that shed light on the nurses' experiences regarding attitudes and behaviors, a therapeutic relationship, knowledge and feelings. Conclusion: The relationship between patient and caregiver is very important but also very complex. It is our opinion that all nurses try to ease the patients suffering at the best of their ability although the knowledge of how to achieve this is not very specific. That nurses sometimes abandon core values like compassion, love and understanding; is a fact. Clinical impact: The nurses often sought support and help from other, more experienced colleagues to take note of their experiences and knowledge to be able to provide better care. The study is there for an essential contribution since it gives an overview of experiences on a greater scale than the collected experience that can be found in just one ward.

Muscle dysmorphia is a relatively new psychological disorder primarily affecting males who engage in weightlifting or bodybuilding. Individuals with this disorder are obsessed with the idea that their body is not sufficiently lean or muscular when compared to others and engage in several, risky behaviors (i.e., frequent exercise sessions, anabolic steroid use, structured diets) to increase muscularity. As obtaining and maintaining a muscular physique is so important to his or her self-worth, an individual may have little insight to how their behaviors are affecting their social and occupational lives and are reluctant to seek out psychological treatment. The purpose of this study was to assess obligation to exercise, motivation and reason to exercise, athletic identity, and behaviors of muscle dysmorphia and examine their relationship to insight and recognition of criteria for muscle dysmorphia through correlation and regression tests. Participants (N = 85) completed a series of questionnaires to assess the independent variables and were then administered two questionnaires designed for the study to assess insight to any criteria participants might be experiencing and recognition of criteria in a case vignette also designed for the study. Analyses of results showed that participants with a higher athletic identity and more behaviors of muscle dysmorphia had a higher level of insight than participants with low athletic identity and fewer behaviors of muscle dysmorphia; on the other hand, individuals with more behaviors of muscle dysmorphia had a lower recognition of criteria of muscle dysmorphia than those with fewer behaviors. These findings support the notion that individuals participating in athletics and exercises to enhance muscularity have varying levels of insight to their preoccupation with improving their body shape.

<p>Anorexia nervosa (AN) is a dangerous disorder characterized by unrelenting rigidity that continues even in the presence of deadly outcomes. Despite this, our understanding of factors that promote and maintain rigidity is lacking. The current paper proposes a model suggesting that rigid behaviors in AN can be formulated as maladaptive rule-governed behavior that emerges in contexts of uncertainty and loss of control, such as in the presence of affective arousal. An empirical study examining the differences between individuals weight recovered from AN (AN-WR) and healthy controls (CN) on parameters of rule-governed behavior in neutral and stressful contexts is described. Seventy-four adults (AN-WR: 36; CN: 38) were randomized to undergo either a stressful or neutral mood manipulation and then completed a laboratory assessment of rule-governed behavior, along with questionnaires measuring difficulties with uncertainty. While the AN-WR group demonstrated greater flexibility in rule implementation compared to the CN group, they evidenced greater impairment in behavioral extinction. Furthermore, although affective arousal did not significantly impact rule-governed behavior as expected, difficulties tolerating uncertainty were significantly related to rule-governed outcomes exclusively in the AN-WR group. Taken together, findings provide preliminary support for maladaptive rule-governed behavior in AN and suggest that this is related to an intolerance of uncertainty. Findings and treatment implications are discussed in light of study limitations.</p> / Dissertation

The purpose of this study was to determine what relationship exists between the degree of an eating disorder or "disordered eating" pattern and athletic performance. The subjects were 30 female collegiate swimmers, between the ages of 18 and 22 years, at Ball State University, Muncie, Indiana. The subjects completed the Eating Disorder Inventory (EDI) questionnaire, which assesses several psychological and behavioral traits associated with bulimia nervosa and anorexia nervosa, and the Bulimia Test-Revised (BULIT-R) questionnaire which measures symptoms of bulimia in adolescents and adults. A performance score was calculated from each swimmer's best event.The results of this study supported the research hypothesis that there would be a negative relationship between the swimming performance of athletes and degree of eating disorder or "disordered eating" pattern as measured by the two questionnaires. "Disordered eating" patterns predicted 20 percent of the variance in athletic performance. / School of Physical Education

Anorexia nervosa is an eating disorder that occurs almost exclusively in women, with its prominent features being caloric restriction, excessive exercise, and emaciation. Research has found that women with anorexia nervosa generally have less sexual experience and more negative sexual attitudes when compared to "normal" women. There has been little research, however, on the potential relationship between sexuality and anorexic-like symptoms among women who do not meet diagnostic criteria for an eating disorder. Therefore, this study employed a population of college women to investigate the hypothesis that anorexic-like symptoms would be related to less sexual experience and more negative sexual attitudes. The correlations that were obtained did not support the hypotheses. Results are discussed with regard to directions for future research. / Department of Psychological Science

The purpose of the study was to better understand nutrition knowledge, disordered eating and body dissatisfaction among middle school females, in hopes of disseminating this information to parents, teachers, and others with an interest in the well-being of young women. The design of the study determined prevalence of disordered eating and body dissatisfaction, and the level of nutrition knowledge among middle school females. 134 subjects completed a 66-item questionnaire. Descriptive statistics along with an independent t-test, chi square, and Pearson product moment correlation coefficient were used to analyze the data. Prevalence of disordered eating among 7th graders was 18.8%, and 15% for 8" graders. High levels of body dissatisfaction were observed in 35% of 7"' graders and 26% of 8t' graders. A significant relationship was found between nutrition knowledge and disordered eating (r=-.309). There was no statistically significant difference between 70' and 8th graders for either disordered eating or body dissatisfaction. / Department of Physiology and Health Science

A variety of health organizations, including the American Academy of Pediatrics and the American Dental Association, have employed the concept of anticipatory guidance to avert potential health risks among their patients. The application of anticipatory guidance with underclass collegiate athletes, however, has not been identified in the literature. The purpose of this mixed-methods, quasi-experimental study was to assess the eating disorder risk and nutrition knowledge of underclass Division I collegiate athletes at a Midwestern university and to determine the viability of using the theory of anticipatory guidance to identify the athletes' nutrition education needs related to six nutrition related key topics. Of the forty athletes who completed three assessments, results indicated a desire and a need for more nutrition information. The Sports Nutrition presentation significantly increased the sport nutrition knowledge among the collegiate athletes compared to the control group. Analysis of the EAT-26 survey indicated seven of the 40 athletes were at risk for an eating disorder; of these, almost half (43%) were female gymnasts. Applying anticipatory guidance early in an athlete’s career may potentially prevent future health problems and enhance performance. / Department of Family and Consumer Sciences

Munkesjö, Maria: "Okej, jag kan sitta och lyssna på musik men jag tänker inte äta!" En kvalitativ intervjustudie om musikens funktion för patienter som gått i musikterapi för ätstörningsproblematik. Uppsats 15 hp inom ramen för Magisterprogrammet i musikpedagogik med inriktning musikterapi vid Kungl. Musikhögskolan i Stockholm. Syftet med denna kvalitativa intervjustudie har varit att undersöka hur patienter som gått i musikterapi för ätstörningsproblematik upplever och använder sig av musik. Frågeställningarna har handlat om vilken funktion musik har i deltagarnas liv och om detta har förändrats av musikterapi. I uppsatsen presenteras en genomgång av relevant litteratur och tidigare forskning inom områden som: musikterapi, musik och hälsa och ätstörningsproblematik. Sex kvinnliga patienter (medianålder 25 år) som genomgått musikterapeutisk behandling (i snitt 2,6 år) för sin ätstörningsproblematik intervjuades med hjälp av semistrukturerade dialogintervjuer. Utifrån ett hermeneutiskt perspektiv och med Health Musicking som teoretisk utgångspunkt, tolkades sedan de transkriberade intervjuerna. Metoden som användes var tematisk kvalitativ analys vilket kompletterades med konstnärlig form (bild och musik). Resultatet presenteras i form av fyra huvudteman: Musikens funktion som följeslagare genom livet; Musikens funktion som allierad med dikotomin; Musikens funktion som redskap för transformation och Musikens funktion som bundsförvant med känslan. Resultatet diskuteras utifrån syfte och frågeställningar. Med utgångspunkt i teorifältet Health Musicking visar denna studie att musik används och har en mångfald av funktioner för deltagarna under barndom och uppväxt. Under sjukdomstiden förändras detta markant och speglar ätstörningsproblematiken. I den musikterapeutiska behandlingen får musik genomgående en mer eller mindre central funktion som terapeutiskt redskap. Efter musikterapin återgår musikens funktion till en större mångfald men nu används musik i betydligt större utsträckning som medveten hälsoresurs; Health Musicking, i det dagliga livet. / Munkesjö, Maria: "Okey, I can sit and listen to music but I will not eat !" A qualitative study of music´s function for patients with eating disorders. A study carried out within the context of the Master Program in Music Education, profile Music Therapy at the Royal College of Music in Stockholm. The purpose of this qualitative interview study was to investigate how patients in music therapy for eating disorders perceive and use music. This by examining the function of music attributed to the participants' lives and if it has been altered by Music Therapy.The paper presents a review of relevant literature and previous research in the fields of Music Therapy, Music and Health and Eating Disorders. Six female patients (median age 25 years) were interviewed after music therapeutic treatment (average 2.6 years). With a hermeneutical approach the transcribed interviews was analyzed using thematic qualitative analysis and artistic interpretation (music and image). The result presented in four main themes; The music's function as a companion through life; The music's function as ally with the dichotomy ; The music's function as tool for transformation and The music's function as associate with feelings. The results are discussed on the basis of objective and issues. This study shows, based on the theory of Health Musicking, that music is used and has a multitude of functions for the participants during childhood and adolescence. When the eating disorders develop the use of music are significantly modified and reflect the eating disorders. During the music therapy sessions the music take a more or less central role as a therapeutic tool. After music therapy the function of the music return to a multitude of functions. But now the participants are more aware of music as a health resource; Health Musicking, in their daily lives.

The purpose of this paper is to explore the experiences in the lives of women with binge eating disorder (BED). Eating disorders affect 5 to 10 million individuals in North America and 70 million worldwide. In Canada, approximately 3% of all women will be affected by an eating disorder during their lifetime. Due to the secretive nature of this illness these statistics are most likely under-reported rendering these illnesses difficult to treat. The complexity of eating disorders and potential for long-term side effects warrants attention from the mental health community. There are many theories as to the origins of this illness but no known causes or cures. BED is the most recent eating disorder included in the DSM-IV, (Diagnostic and Statistical Manual of Mental Disorders). This research explored the phenomenon from the perspective of nine women who suffer from BED. These women were interviewed as to their emotional, psychological, physical, and cognitive experience of this illness and its effects in their everyday lives. The results found a number of distinctive themes emerging from the data; emotional connection to food; loss of control; isolative behaviour and secrets; cognitive obsessions; sense of not belonging/not fitting-in; feelings of not being good enough and weight issues/poor body image. The women felt strongly that BED was often misdiagnosed and misunderstood by both the general public and health professionals. They experienced a lack of adequate resources and support groups that offer relevant information and that were not "diet" related. Some women with BED who were also overweight or obese suffered the additional stigma and negative attitudes of "weight-ism" in North American culture where thinness is equated with success and happiness. This study provides a unique opportunity for these women to express their concerns, and offers valuable insights and information for mental health professionals working with the eating disorder population thus support the development of much needed programs for BED. This paper provides an opportunity for greater understanding of compulsive over-eating and challenges stereotypical attitudes while promoting self-reflection on the part of the reader.

In this essay, I have interviewed six young women about their views on body image and how their views are affected by their surroundings, massmedia and social media. Also the relationship between body image and eating disorders is relevant in this context and has a part in the study. The purpose of this study is to build an understanding of how young women relate to the body ideal that exists around them. Theoretical auxiliary tools used are George Herbert Mead's theory of the generalized other, Erving Goffman's theory of dramaturgical perspective and impression management, and Du Bois's theory of double consciousness. I have also used two scientific articles to get a deeper understanding of the subject. I will discuss the theoretical concepts and previous research by pending between these and the empirical material. Using a qualitative approach, I have been able to show that all the respondents' views on the ideal body is affected by the massmedia, social media and the respondents’ surroundings. The respondents also re2port that they find it difficult to fit into society if they do not live up to the current body ideals. This puts a lot of pressure on the respondents and several of them report recurring eating disorder behaviour. There are also positive aspects of the current body ideals, for example when they affect the respondents to eat healthier food, exercise and live healthier lives in general. The ethnicity of the respondents affects their body ideals and it is common that the respondents seek certain traits in the opposite ethnicity, for example women with foreign origin seeking blond hair and blue eyes. The most prominent finding in my study is the enormous pressure that my respondents experience, when trying to live up to the body ideals, and how this pressure is enhanced by massmedia, social media and the respondents’ surroundings. / I denna uppsats har jag intervjuat sex unga kvinnor om deras syn på kroppsideal och hur dessa kvinnor påverkas av deras omgivning, massmedia och sociala medier. Även relationen mellan kroppsideal och ätstörningar är relevant i sammanhanget och ingår i studien. Syftet med undersökningen är att utifrån mina respondenters svar skapa en förståelse för hur unga kvinnor förhåller sig till det kroppsideal som finns i deras vardag. Teoretiska hjälpverktyg som använts är George Herbert Meads (2007) teori om den generaliserade andre, Erving Goffmans teori om dramaturgisk perspektiv- och intryckstyrning samt Du Bois teori om det dubbla medvetandet. Jag har också använt två vetenskapliga artiklar, Elefant i nylonstrumpor – om kvinnlighet, kropp och hunger (Johansson, 1999) samt Vacker och lycklig? – om identitet, konsumtion och risk (Larsson, 2012) för att skapa en djupare förståelse kring kroppsideal. Jag kommer att redovisa de teoretiska begreppen och tidigare forskning och använda dessa som hjälpverktyg i min analys av det empiriska materialet. Med hjälp av en kvalitativ undersökningsmetod har jag kunnat påvisa att alla respondenters syn på kroppsideal påverkas av massmedia, sociala medier och respondenternas omgivning. Respondenterna upplever också att det är svårt att passa in i samhället om de inte lever upp till de rådande kroppsidealen. Den press som detta skapar gör att flera av respondenterna uppvisar tendenser till ätstörningar och liknande beteenden. Det finns även positiva aspekter med de rådande kroppsidealen, till exempel att vissa av respondenterna har blivit påverkade till att äta nyttigare, träna sina kroppar och leva hälsosammare liv. Respondenternas etnicitet påverkar i viss mån deras kroppsideal och det är vanligt att respondenterna eftersträvar vissa drag hos den motsatta etniciteten, till exempel att kvinnor med utländsk bakgrund eftersträvar blont hår och blåa ögon. Det mest framträdande i studien är den stora press, kopplad till att försöka leva upp till kroppsidealet, som respondenterna upplever och ofta mår dåligt av – och hur denna press förstärks av massmedia, sociala medier och respondenternas omgivning.