Background: Carers of people with eating disorders (EDs) have heightened levels of distress, expressed emotion, burden and accommodation to the ED; factors implicated in maintenance of the ED. Although carers’ skills interventions are helpful, how they effect change, and the processes involved in hypothesised relationships between ED symptoms and carer distress, is unclear. Aims: To determine the processes involved in the beneficial carer and service-user outcomes from a carers’ skills randomised controlled trial (RCT), including by longitudinally examining relationships between ED symptoms and carer distress. Method: This study utilised archival data from a multi-site pragmatic carers’ skills RCT. Primary carers (159) of people presenting for Anorexia Nervosa hospital treatment were randomly allocated to the intervention or treatment as usual. Moderators and mediators of intervention outcomes, and of longitudinal relationships between ED symptoms and carer distress, were examined. Results: The positive association between intervention and reduction in expressed emotion was significant only when more than one carer was involved per service-user. Reductions in expressed emotion and burden statistically mediated positive relationships between intervention and reduction in carer and ED outcomes. Findings from longitudinal mediation models were consistent with positive indirect associations between ED symptoms (at discharge) and carer distress (at six-month follow-up), and between carer distress (at baseline) and ED symptoms (at 12-month follow-up), mediated by carer and service-user factors. Limitations & Implications: Missing data may have introduced bias. Accessing only primary carers of severely unwell service-users limited generalisability. Results support the importance of carers’ skills interventions in addressing ED-related service-user and carer difficulties.

Bakgrund: Ca 1–2 procent av alla kvinnor beräknas någon gång under livet uppfylla kriterierna för anorexia nervosa. Sjukdomen, som innebär en kraftigt förhöjd mortalitetsrisk och kan ge allvarliga kroppsliga och psykiska komplikationer på längre sikt, blir ofta uppenbar någon gång under tonåren. Idag råder uppfattningen att barn och ungdomar med anorexia nervosa eller annan ätstörningsproblematik så långt som möjligt bör vårdas tillsammans med sina   föräldrar. På senare år har olika typer av familjebaserad vård, där föräldrarna tilldelas en central roll som drivande i barnets tillfrisknande, blivit allt vanligare i takt med att evidensen för denna form av ätstörningsvård ökat. Forskning har vidare visat att det innebär en stor påfrestning för övriga familjemedlemmar när ett barn insjuknar i en ätstörning. Utifrån detta vore det värdefullt att få en fördjupad kunskap om vilka erfarenheter föräldrar har av att delta i familjebaserad ätstörningsvård. Ett antal kvalitativa studier finns genomförda på området men sammanställd kunskap saknas i dagsläget. Syfte: Syftet med föreliggande litteraturstudie var att undersöka vilka erfarenheter föräldrar har av att delta i familjebaserad ätstörningsvård. Metod: Kvalitativ litteraturstudie som genomförts enligt Thomas och Hardens (2008) modell för   tematisk syntes av kvalitativ forskning. Resultat: Studien resulterade i fyra deskriptiva teman; Upplevelse av den familjebaserade   ätstörningsvårdens upplägg, Förändring av förhållandet till ätstörningen, Förändringar inom familjen, Att träffa andra i samma situation samt tre analytiska teman; Minskad ensamhet, Att känna sig misslyckad och dömd som förälder samt Att känna att man gör det rätta för sitt barn. Diskussion: Resultatet diskuterades utifrån Dorothea Orems teori om egenvårdsbalans samt i relation   till annan aktuell forskning som berör familjebaserad vård och ätstörningar hos barn och ungdomar. / Background: About 1-2 percent of all women fulfil the criteria for anorexia nervosa at some point of their life. The disorder, which entails elevated mortality and might result in serious somatic and   psychiatric long-term complications, often becomes apparent during the teenage years. Today, the prevailing view is that children and youths with eating disorders should be treated together with their parents as far as possible. During the last decade different types of family-based care, were the parents play a central role in their child's recovery, have become more common in step with growing research evidence. Research has also shown how an eating disorder in a child causes a big strain on the rest of the family members. Regarding this, it would be valuable to achieve deeper knowledge about parents’ experiences of engaging in family-based eating disorder care.  A number of qualitative studies concerning this topic exists, but more compiled knowledge is still missing. Aim: The aim of the study was to investigate parents’ experiences of engaging in family-based eating disorder care. Method: A qualitative literature review on the subject was conducted according to Thomas and Hardens (2008) model of thematic synthesis of qualitative research. Results: The study resulted in four descriptive themes; The experience of the setup of the family-based eating disorder care, A change in the approach to the eating disorder, Changes within the family and To meet other parents in the same situation and three analytic themes; To feel less alone, To experience failure and feel judged as a parent and To feel confident that you are doing the right thing for your child. Discussion: The findings were discussed based on Dorothea Orem’s self-care-deficit theory and in relation to other relevant research concerning family-based care and eating disorders in children and youths.

The aim of the work is theoretically and empirically to map the interaction of teachers of high schools with students with eating disorders. The theoretical part will contain the definition and description of key concepts and knowledge in the field of eating disorders and the psychology of communication. Empirical part will be focused on the description and understanding of the interactions of the teacher-student intake with a failure. The research will be carried out using qualitative methodology (with an emphasis on in-depth interviews and observations). Obtained data will be adequately analyzed and interpreted to the qualitative manner.

Prevention of eating disorders is important because eating disorders are one of the most common and serious diseases adolescent girls and young women may suffer from, with severe somatic, psychological and social consequences. The treatment of eating disorders is tricky and not always successful. This is a disease for which it is difficult to induce the necessary motivation and cooperation of the patient for treatment. Patients suffering from eating disorders have a distorted image of their body, body weight and body shape. An excessive weight loss has an impact on health. The most serious complications are cardiovascular complications, which may lead up to death. Anorexia nervosa is a psychiatric illness with high mortality, which reaches up to 18%. The first objective of the thesis was to survey the risk of eating disorders occurrence in pupils of the second level of primary school. The second objective was to map the awareness of pupils of the second grade of primary school and to identify the source of information. To meet the objectives quantitative research was used. As a method of data collection the questionnaire technique was chosen. The standardized questionnaire EAT - 26, containing 26 closed questions, was used at the research. Another part of our questionnaire included 5 closed questions to get the respondents' identification data, and 2 semi-closed questions. In the case of a positive answer it was necessary to write down the answer which was given by all the pupils with positive answers, and 1 semi-enclosed question with the possibility to add another answer. The questionnaire was completed by 141 pupils of the 5th ? 9th grades of the Primary school Grünwaldova in České Budějovice. The results show that the risk of eating disorders in girls and boys is comparable. According to the obtained results, the risk of eating disorders development is the least in the 5th grade pupils, because they are less concerned about their own looks, physique and body weight than the respondents from higher grades. Satisfaction with the body weight is the highest in the fifth grades, it decreases in higher grades pupils. In our respondents the risk of eating disorders did not appear, yet it is necessary to avoid an increase of that risk. It is necessary to highlight the educational and preventive role of a nurse. She can prevent the possible increased risk of the development of eating disorders later in life or even the onset of anorexia nervosa or bulimia nervosa.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Esta dissertação pretende discutir o surgimento de casos de anorexia nervosa e bulimia nervosa em homens e sua relação com: a - as questões socioculturais ligadas ao culto à magreza e seus desdobramentos (como a noção de estilo de vida); e b - as discussões sobre masculinidades, experiências corporais e subjetivas desses sujeitos. Seu principal objetivo é compreender como estes transtornos alimentares, tidos como distúrbios de ordem psiquiátrica pela literatura biomédica, não estão restritos somente ao feminino, sugerindo também implicações ligadas ao processo de elaboração do saber médico, seus campos de pesquisa e atuação. A metodologia empregada foi a realização de entrevistas via MSN Messenger, com 20 homens entre 13 e 30 anos, que declaram passar ou ter passado por algum tipo de experiência envolvendo a anorexia e/ou bulimia. / This dissertation aims to discuss the emergence of cases of anorexia nervosa and bulimia nervosa in men and its relation to: a) socio-cultural issues related to the cult of thinness and its consequences (like the notion of lifestyle), and b) discussions about masculinity and bodily and subjective experiences of these subjects. Its main objective is to understand how anorexia and bulimia, seen as psychiatric disorders in the medical literature, are not restricted only to females, also suggesting implications related to the drafting of biomedical knowledge, their fields of research and action. The methodology employed was to conduct interviews via MSN Messenger, with 20 men between 13 and 30 years old, who claim going or have gone through some kind of experiment involving anorexia and / or bulimia.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Os Transtornos Alimentares são caracterizados por graves perturbações no comportamento alimentar. Entre eles, incluímos a anorexia nervosa, a bulimia nervosa e o transtorno da compulsão alimentar periódica. Sua etiologia é multifatorial, estando envolvidos no seu desenvolvimento aspectos biológicos, psicológicos, familiares e sociais. Além das complicações clínicas associadas ao transtorno, encontramos também graves dificuldades interpessoais. Esses déficits contribuem para ocorrência de baixa auto-estima, ansiedade, depressão, retraimento social, e insegurança, dificultando também o desenvolvimento de relações afetivas satisfatórias. O objetivo desse estudo foi investigar as relações entre habilidades sociais, estilos de apego e transtornos alimentares A amostra foi composta por 14 indivíduos com anorexia nervosa (AN), 33 indivíduos com bulimia nervosa (BN), 31 indivíduos obesos com transtorno da compulsão alimentar periódica (TCAP), 31 obesos sem transtorno alimentar, comparados a um grupo controle sem transtornos alimentares, pareados por idade, sexo e anos de estudo. Os instrumentos utilizados foram: Teste de atitude alimentares; Teste de investigação bulímica de Endiburgo, Escala de Compulsão Alimentar Periódica, Inventário de Empatia (IE), o Inventário de Habilidades Sociais (IHS) e a Escala de Apego Adulto (EAA). A avaliação dos dados foi feita através de estatísticas descritivas e inferenciais (Teste T, ANOVA e correlação de Pearson). Os resultados encontrados confirmaram algumas hipóteses desse estudo e corroboraram dados da literatura que sugerem que indivíduos com TA apresentam déficits em habilidades sociais e estilos de apego inseguro, que podem afetar os relacionamentos interpessoais. Ainda foi possível observar que tais deficiências estariam relacionadas a maior gravidade do TA. / Eating Disorders (ED) are characterized by severe disturbances in eating behavior. These include anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). The etiology of ED is multifactorial, being involved in its development biological, psychological, familial and social factors. In addition to the clinical complications associated with the disorder, is also found serious interpersonal difficulties. These difficulties contribute to the occurrence of low self-esteem, anxiety, depression, social withdrawal and insecurity, also hindering the development of satisfactory emotional relationships. The aim of this study was to investigate the relationship between social skills, attachment styles and eating disorders The sample comprised 14 individuals with AN, 33 individuals with BN, 31 obese subjects with BED, 31 obese without eating disorder, compared to a control group without eating disorders, matched for age, sex and years of study. The instruments used were the Eating Attitudes Test, the Bulimic Investigatory Test Endiburgo, Binge Eating Scale, Inventory of Empathy (IE), the Social Skills Inventory (IHS) and the Adult Attachment Scale (AAS). Data evaluation was performed using descriptive and inferential statistics (t test, ANOVA and Pearson correlation). The results confirmed some hypotheses of this study and corroborate data in the literature suggesting that individuals with ED have deficits in social skills and insecure styles of attachment, which can affect interpersonal relationships. Although it was observed that such deficiencies could be related to increased severity of ED.

Ätstörningar har blivit mer välkäntoch är en återkommande sjukdominom vården. En ohälsosam relation till mat finns i alla åldrar och relationen till mat utgör stor del av människors liv. Syfte: Syftet var att belysa hur patienter med ätstörningupplever vården. Metod: Studien är en allmän litteraturstudie där en innehållsanalys använts för att få framresultatet. Resultat: Resultatet består av tre ämnen:relationer, behandling och kunskap. Relationen med vårdpersonalen upplevdes hastorbetydelse för patienternas återhämtning. Inför behandlingen upplevde patienterna ambivalens,därför var det viktigt att patienterna fick vara delaktiga. Vårdpersonalens erfarenheter och kunskap innebar vägledning för patienterna att ändra sittbeteende. Konklusion: Relationer är behandlingensgrund och vårdpersonalen behöver ge ett braförstaintryck hos patienterna eftersom detförsta intrycket tenderaratt hålla sig kvar hos patienterna. Kontinuitet i vårdpersonalskapartrygghet och förtroende. Patienterna belyste vikten av att bli hörda och attindividenbakom ätstörningenuppmärksammades. Deupplevde ambivalens mot behandling då de var rädda att förlorakontrollen över ätstörningen, genom delaktighet upplevde patienterna en personcentrerad vård. Kunskap och erfarenheter hos vårdpersonalen belystes vara en viktig beståndsdel i behandlingen av ätstörningar. / Eating disorders are well-known and is a reoccurring concept within health care. An unhealthy relationship towards food is found within all ages, and the relationship to food constitutes a large part of human’s lives. Purpose: The purpose was to shed light on how patients with eating disorders experience health care. Methods: The study is a literature study where a content analysis was used. Results: The results consist of threesubjects: relationships,treatment and knowledge. The relationship to the care personnel was experienced to have a big impact on the patient’s recovery. Before treatment the patients experienced ambivalence, therefore it was important for them to be included in the treatment process. The care personnel’s experiences and knowledge meant guidance for the patients to change their behavior. Conclusions: Relationships are the foundation for thetreatment process and the care personnel should make a good first impression as it stays with the patients. Continuity among the personnel created safety and trust. The patients highlight the importance of being heard and seen as individuals. Patients experienced ambivalence towards treatment as they were afraid to lose control over the eating disorder. Knowledge and experience among the care personnel was an important part of the treatment.

Introduction: Recently published reviews and meta-analytic studies have shown increased interest in research of the ADHD and ED comorbidity. We conducted a case-control study (133 ED female patients/93 healthy control), screening for ED among ADHD patients (N=64) and a pilot study of a support group program for adults with ADHD and psychiatric comorbidities. Methods: Adult and childhood ADHD symptoms were assessed by self-report and other- report versions of a Barkley Adult ADHD questionnaire (BAARS-IV). Patients with ED and ADHD comorbidity underwent a structured interview (DIVA 2) and Integrated Visual and Auditory Performance Tests (IVA Plus) to confirm the ADHD diagnosis. Participants of the pilot program were assessed prior to and after the therapy by the Schwartz Outcome Scale (SOS) and Quality of life (SQUALA) questionnaires. Results: Using self-report questionnaire of current symptoms 61 (46 %) of ED patients were detected as likely having ADHD compared to 22 (24 %) from a healthy control group, 37 (28 % ) of ED patients were identified with the high probability of ADHD diagnose compared to 12 (13 %) from a healthy control group with significant differences. Screening for disordered eating behaviors indicated previously documented higher prevalence of overweight among men with ADHD...

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Os Transtornos Alimentares são caracterizados por graves perturbações no comportamento alimentar. Entre eles, incluímos a anorexia nervosa, a bulimia nervosa e o transtorno da compulsão alimentar periódica. Sua etiologia é multifatorial, estando envolvidos no seu desenvolvimento aspectos biológicos, psicológicos, familiares e sociais. Além das complicações clínicas associadas ao transtorno, encontramos também graves dificuldades interpessoais. Esses déficits contribuem para ocorrência de baixa auto-estima, ansiedade, depressão, retraimento social, e insegurança, dificultando também o desenvolvimento de relações afetivas satisfatórias. O objetivo desse estudo foi investigar as relações entre habilidades sociais, estilos de apego e transtornos alimentares A amostra foi composta por 14 indivíduos com anorexia nervosa (AN), 33 indivíduos com bulimia nervosa (BN), 31 indivíduos obesos com transtorno da compulsão alimentar periódica (TCAP), 31 obesos sem transtorno alimentar, comparados a um grupo controle sem transtornos alimentares, pareados por idade, sexo e anos de estudo. Os instrumentos utilizados foram: Teste de atitude alimentares; Teste de investigação bulímica de Endiburgo, Escala de Compulsão Alimentar Periódica, Inventário de Empatia (IE), o Inventário de Habilidades Sociais (IHS) e a Escala de Apego Adulto (EAA). A avaliação dos dados foi feita através de estatísticas descritivas e inferenciais (Teste T, ANOVA e correlação de Pearson). Os resultados encontrados confirmaram algumas hipóteses desse estudo e corroboraram dados da literatura que sugerem que indivíduos com TA apresentam déficits em habilidades sociais e estilos de apego inseguro, que podem afetar os relacionamentos interpessoais. Ainda foi possível observar que tais deficiências estariam relacionadas a maior gravidade do TA. / Eating Disorders (ED) are characterized by severe disturbances in eating behavior. These include anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). The etiology of ED is multifactorial, being involved in its development biological, psychological, familial and social factors. In addition to the clinical complications associated with the disorder, is also found serious interpersonal difficulties. These difficulties contribute to the occurrence of low self-esteem, anxiety, depression, social withdrawal and insecurity, also hindering the development of satisfactory emotional relationships. The aim of this study was to investigate the relationship between social skills, attachment styles and eating disorders The sample comprised 14 individuals with AN, 33 individuals with BN, 31 obese subjects with BED, 31 obese without eating disorder, compared to a control group without eating disorders, matched for age, sex and years of study. The instruments used were the Eating Attitudes Test, the Bulimic Investigatory Test Endiburgo, Binge Eating Scale, Inventory of Empathy (IE), the Social Skills Inventory (IHS) and the Adult Attachment Scale (AAS). Data evaluation was performed using descriptive and inferential statistics (t test, ANOVA and Pearson correlation). The results confirmed some hypotheses of this study and corroborate data in the literature suggesting that individuals with ED have deficits in social skills and insecure styles of attachment, which can affect interpersonal relationships. Although it was observed that such deficiencies could be related to increased severity of ED.

In my Master thesis I summarize up-to-date information on anorexia nervosa. In the theoratical part I introduce casuistics of young females suffering from anorexia nervosa. In the practical part I present the evaluation of research data dealing with particular risk factors that may lead to the development of anorexia nervosa in students of lower stage of grammar school.