Bakgrund: Media har en allt större roll i det dagliga livet och prevalensen för ätstörningar ökar hos både män och kvinnor. I takt med att tekniken gör media mer lättillgänglig kan det finnas en större risk att påverkas. Syfte: Att sammanställa kunskap från vetenskaplig litteratur kring hur media påverkar risken att insjukna i en ätstörning, bland unga människor från 12 till 30 år. Metod: Strukturerad litteraturöversikt där resultatet baserades på 11 kvantitativa originalartiklar från PubMed, MeSH, SBU och MEDLINE genom PsycINFO. Resultat: Sinnesstämningen, ätmönster och kroppsbild kan förändras vid exponering för media som framhäver en idealistisk kroppsfigur som sedan kan påverka till att drabbas av ätstörningssymtom. Individer som avviker i synen på sig själv jämfört med den som de tycker att de borde ha eller de som tidigare haft ätstörningssymtom har en större risk att internalisera det idealiserade budskapet från media. Slutsats: Denna översikt visar på att media kan påverka risken för insjuknanden av en ätstörning och påverkan blir starkare då individen har ätstörningssymtom eller en förändrad syn på sig själv eller på den som samhället utstakat sedan tidigare. Kroppsmissnöje, internalisering av det smala idealet, förändrad ätmönster, inverkan på sinnesstämningen samt självkänslan är faktorer som media omedvetet kan påverka hos både unga män och kvinnor. Här kan kunskap kring media spela en stor roll i preventionen. Det krävs även mer forskning med fokus på pojkar och ätstörning då den nuvarande forskningen till större del fokuserat på kvinnor. Då ätstörningar är ett fortsatt stigande problem bland unga människor så borde detta område även inkluderas i sjuksköterskans grundutbildning. / Background: Media has an increasing role in the daily life and so is the prevalence of Eating Disorders, for men and women. In the light of technological advances, the media becomes more approachable which increases the risk of impact. Aim: To gather knowledge through scientific literature about how media impact the risk of onset in an Eating Disorder, among young people ages 12 to 30. Method: Structured literature study based on 11 quantitative original articles. Result: Affect, eating patterns and body image can change when exposed to appearance media, which idealizes an unrealistic body image which can lead to a disordered eating pathology. The Individuals with discrepancies between the self-image and the idealized one they think they ought to have, or those who have previously had disordered eating pathology are at greater risk of internalizing the idealized message. Conclusion: This literature review shows that media can impact the risk of the upbringing of an eating disorder and the impact strengthens when the individual has disordered eating pathology or has distorted view on their selves or on how society previously dictated. Body dissatisfaction, internalization of the thin ideal, changed eating patterns, impact on affect and self-esteem are factors, which unconsciously affect young women and men. Media literacy can play a big part in preventing eating disorders. More research connected to eating disorders and men is needed since previous studies focused more on women. This ought to be included in the curriculum of nursing training as eating disorders are rising.

This study takes a social constructionist approach, using narrative inquiry methods to analyse posts made by teenager girls on an online eating disorder forum. The study draws upon the sociology of childhood, which argues that children should be recognised as social actors, and as both ‘beings’ in the present, as well as future ‘becomings’. The study also draws upon the sociology of diagnosis, which recognizes the contested nature of diagnoses and medical authority in contemporary society. As lay people have increasing access to information, they have more power to challenge the ways in which their bodily experiences are constructed, as well as their potential medicalisation and demedicalisation.The study makes use of data from a website called TeenHelp, focusing specifically on the ‘eating disorders’ forum. Posts were selected from those made by girls aged 13 to 19 over the two years prior to the study (i.e. 1 April 1014 – 1 April 2016). Posts from 12 girls were analysed using narrative inquiry methods.The study identified the following six narratives: 1) identity narratives; 2) health narratives; 3) diagnostic narratives; 4) lay and expert narratives; 5) demedicalisation narratives and 6) recovery narratives. Importantly, these narratives do not exist in isolation from one another, but interact resulting in the ‘co-construction’ of eating disorders. These narratives are also not static, but are contested – constantly being challenged and negotiated on the forum.Overall, the posts analysed in this study showed that these teenage girls are always walking a fine line between being and becoming. They occupy a liminal space between being ‘thin’ and ‘fat’; between being ‘sick’ and ‘healthy’; between being ‘lay patients’ and ‘expert advisers’; between ‘treatment’ and ‘recovery’. The narratives analysed here show how these young women are wrestling with the complex notion of eating disorders as a potential source of identity, a medical diagnosis and condition which they may or may not ever fully recover from.

Background: Family members of people with eating disorders are often involved in caregiving. To better understand the impact on them, outcomes such as burden, distress, and less frequently quality of life (QoL) are taken into consideration. Despite advancements in the knowledge base surrounding the experiences of adult and parental caregivers of individuals with eating disorders, particularly Anorexia Nervosa, there is a scarcity of qualitative exploration from the sibling perspective, particularly that of adolescent siblings. Objectives: The systematic review aimed to identify research and synthesise findings relating to informal caregivers’ quantitative ratings of quality of life in the context of eating disorders. The primary study aimed to explore in detail the lived experience of adolescent siblings with a brother or sister with Bulimia Nervosa or Eating-Disorder-Not-Otherwise-Specified. Method: Applying a priori inclusion and exclusion criteria to papers identified from a combination of systematic searches of electronic databases and hand searches of other pertinent literature, revealed eight studies to be included for review. Within the qualitative study, eight semi-structured interviews were carried out with siblings (aged 12-19-years) who had a brother or sister with an eating disorder. An interpretative phenomenological analysis approach was utilised to analyse interview data. Results: The review highlighted low ratings for aspects of quality of life for informal caregivers of individuals with eating disorders, and some emerging comparative and subgroup differences. Three super-ordinate themes emerged from the qualitative exploration: Sibling Identity, The Vulnerable Social ‘Self’, and Intra- and Inter-Personal Coping. Discussion: Overall the findings provide particular insight into the quality life of informal caregivers and the unique experiences, feelings and various roles of adolescent siblings of people with eating disorders. Implications regarding caregiver support and the needs of siblings specifically are considered. Strengths and limitations, as well as future research possibilities are outlined for both the systematic review and empirical study.

The compilation of information on the incidence of eating disorders in South African university residence women has been identified as an urgent matter by the National Eating Disorders Coordinating Committee (NEDCC). This study was undertaken to determine the degree of eating disordered behaviour across cultures in female university residence students from the University of Natal, Durban and Pietermaritzburg campuses, and the University of Durban Westville. The Eating Disorder Inventory (EDI) was completed by 39 black, 41 white, 6 Indian and 4 Coloured students. It was hypothesised that white women would show higher rates of disordered eating; that black women in more advanced years of study ie. those who are more acculturated, would show more disordered eating behaviour than first year black students; that black females would demonstrate higher Body Mass Index (BMI) scores than white students; and that a positive relationship would be found between Socio-economic status (SES) and disordered eating. The results of this study indicated that there was no significant difference in disordered eating among black and white female students. Degree of disordered eating did not increase with year of study. Although black students demonstrated significantly higher BMI scores than white students, there was no difference in body dissatisfaction scores. Furthermore there was no relationship found between SES and degree of disordered eating behaviour. An attempt is made to explain these results by exploring the role of acculturation to Western appearance standards.

The apparent increase in the incidence of both anorexia nervosa and bulimia nervosa worldwide has resulted in a surge of interest in effective treatment, prevention programmes and health promotion. Health promotion and the primary prevention of eating and body image problems among young people, and in particular adolescents, is emerging as one of the most desirable achievements in contemporary health and nutrition education. Eating disorders usually have their origin during the teenage years, and as such, high schools provide useful sites for the implementation of prevention programmes. Educators can play an important role in the prevention of eating disorders and act as socialization agents who either reinforce or buffer the dominant societal discourses that shape young women’s views of themselves. There are calls, however, for caution in the design and implementation of school-based eating disorder curricula as school educators may inadvertently do more harm than good. It has also been suggested that female educators, as other women, are likely to possess a degree of normative discontent with their body shape and size, and that this dissatisfaction and negative beliefs about food may be unknowingly transferred to the learners within their care. The current study used an exploratory, descriptive research design to investigate the knowledge, attitudes and behaviours related to eating disorders, body image and weight control of a group of Life Orientation educators. A biographical questionnaire, a questionnaire designed for the purposes of the current research and two standardised paper-and-pencil questionnaires, namely the Body Shape Questionnaire (BSQ) and the Eating Attitudes Test (EAT), were administered to 50 female Life Orientation educators in the Nelson Mandela Metropole. A non-probability purposive sampling technique was used in the selection of participants and descriptive statistics were used to explore and describe the data. The results of the current research study indicated a lack of knowledge in those Life Orientation educators assessed regarding eating disorders and healthy diet. The results also indicated inaccurate knowledge amongst those educators assessed regarding effective and safe teaching practices of eating disorder pathology. The results of the two standardised questionnaires reflected an internalisation of the dominant societal ideals regarding weight and body shape, with 18% of the sample xi demonstrating attitudes and behaviours that could be indicative of eating disorder pathology of either clinical or subclinical proportions. Suggestions were made regarding future research and the need for further training of Life Orientation educators. Finally, the limitations as well as the value of the research were outlined.

Dream theorists propose that dreams can balance conscious reality, and provide clues to unconscious processes complicating psychosomatic conditions. Little research has been done in the area of dreams and eating disorders. Based on data from a pilot study, and reports of eating-disordered women's dreams in the literature, the researcher hypothesised that eating-disordered women's dreams would contain a significant number of themes symbolizing the psychological states underlying their condition. Of particular interest was a sense of ineffectiveness, which has been the subject of many recent studies of eating-disordered women. The exploratory study compared the dream content of 12 eating-disordered and 11 normal women, aged 20 to 35 years. The 275 dreams were rated by 8 "blind" raters according to a 91-item eating disorder specific dream rating scale, which registered dream content such as attitudes of helplessness, images of anger, self-hate, and affect. A high level of inter-rater reliability was obtained. A questionnaire assessing motivational states (General Causality Orientation Scale; GCOS) was also administered. The data were analyzed by the independent t-test. The results showed strong significance in the occurrence of themes of ineffectiveness in the eating-disordered women's dreams (p = .001), which corresponded with the findings on the GCOS (p< .001). Also significantly present in the target group's dreams were themes of self-hate, anger, inability to nourish themselves, an obsession with weight, and the presence of negative emotions. An additional finding was a strongly significant presence of a sense of impending doom at the end of eating-disordered women's dreams (p < .001). These results suggest that dreams may provide an additional resource in understanding eating disorders. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

Shape- and weight-based self esteem was proposed to be a central cognitive component of the eating disorders. In this thesis, the psychometric properties of the Shape- and Weight-Based Selfesteem (SAWBS) Inventory, a newly-developed measure of the influence of shape and weight on feelings of self-worth, were determined. A preliminary examination of possible developmental precursors of shape- and weight-based self-esteem was also performed. SAWBS scores were stable over 1 week, and correlated with women's negative perceptions about their bodies in eating disorder and undergraduate control groups (EDG and UCG, respectively). In the UCG, SAWBS scores correlated with one of two measures of shape and weight cognitive schemata. The validity of shape- and weight-based self-esteem as a central feature of eating disorder symptomatology was supported in a number of ways. SAWBS scores correlated positively with eating disorder symptom scores in the UCG, and were significantly higher in women identified as "possible or probable" eating disorder cases than in women not suspected of having an eating disorder. SAWBS scores were also higher in the EDG than in the UCG or a psychiatric control group (PCG), even after controlling for age, socioeconomic status, Body Mass Index (BMT), selfesteem, and depression. Interestingly, a differing relationship between depression and SAWBS emerged as a function of group. Follow-up investigations revealed that SAWBS scores differed significantly between depressed, but not nondepressed women from the three groups. With regard to discriminant validity, SAWBS scores were uncorrelated with BMI and socioeconomic status in UCG and EDG women, and were uncorrelated with the tendency to respond in a socially sanctionned manner in UCG women. Although the tendency to respond in a socially sanctionned manner was related to SAWBS scores in EDG women, SAWBS scores remained higher in EDG than in UCG women after the effect of social desirability was controlled. The proposed developmental precursor variables of SAWBS included endorsement of stereotyped beliefs about thinness, perceived SAWBS in friends, siblings, and parents, and perceived importance placed by parents and romantic partner on the woman's own shape and weight. In both EDG and UCG women, endorsement of societal beliefs about shape and weight, and perceived importance placed on their own shape and weight by mother and father were significantly related to SAWBS scores. In sum, the SAWBS Inventory showed early promise as a reliable and valid measure of shape- and weight-based self-esteem, and may be a useful tool in the assessment of eating disorders. Theoretical and clinical implications with regard to the role of SAWBS in the development and treatment of eating disorders are discussed. / Arts, Faculty of / Psychology, Department of / Graduate

« Etre esclave de », perdre son autonomie, voir sa liberté personnelle entravée ; autant de manières de vivre l’asservissement que représente toute addiction. Un comportement répétitif lié à une dépendance entraînant une consommation excessive, c’est ainsi qu’on définit l’addiction, ce qui la rattache à une forme d’esclavage et, par extension, élargit le champ des recherches au domaine des troubles alimentaires. En effet, ceux-ci impliquent le plus souvent un comportement de dépendance vis-à-vis de la nourriture, au point d’en faire une véritable aliénation. Alors même que les patients concernés se présentent plus objets que sujets, un affect émerge dans le transfert : la honte. La honte est une émotion enfouie, secrète, le plus souvent silencieuse. Elle ne s’avoue pas facilement, effectivement « la honte de la honte empêche de dire la honte » qui revient à mettre en évidence l’impossibilité d’exprimer l’indicible. Partant du constat selon lequel les sujets souffrant de troubles alimentaires ressentent majoritairement de la honte, nombre d’auteurs (M. Corcos, G. Apfeldorfer) ont estimé que ce sentiment, en cas d’obésité notamment, était lié à l’image véhiculée, reléguant l’affect de honte au rang de symptôme annexe, quand il sera question ici de le considérer comme à l’origine de celui-ci. Non seulement la honte ne serait pas un symptôme secondaire, mais encore elle constituerait bel et bien un symptôme primaire dont le trouble alimentaire ne serait qu’un avatar. La honte sera ici considérée sous l’angle du trauma, notamment d’un trauma infantile dont nous tentons d’en démontrer les origines. Partant de là nous abordons les demandes formulées par cette clinique spécifique et les ouvertures thérapeutiques dont la médiation artistique. / To be a slave, to lose one’s autonomy, to have one’s freedom curtailed: there are many ways to experience the enslavement that is addiction. Addiction is defined as a repetitive behavior due to dependence and that causes excessive consumption. This definition reveals a form of slavery and, by extension, broadens the scope of research on addictions to the field of eating disorders. Eating disorders involve indeed often addictive behaviors with respect to food, to the point of making the disorder a real alienation. Even though the affected patients behave more like objects than subjects, an affect emerges in the transfer: shame. Shame is a hidden, secret, and most often silent emotion. Patients do not confess it easily. In fact, patients "are ashamed of their shame” and this prevents them of “saying their shame". This brings to light an impossibility of expressing the inexpressible. While noting that a majority of subjects with eating disorders feel shame, many authors (M. Corcos, G. Apfeldorfer) considered that this sentiment, especially in the cases of obesity, was linked to body image, and relegated shame to the rank of a secondary symptom. We propose here in contrast to consider shame as a cause of eating disorder. Not only would shame not be a secondary symptom, but it would indeed be a primary symptom and eating disorder its avatar. Shame will be considered here from the point of view of traumas, including childhood traumas and we will strive to demonstrate its origins. We will use this conceptual basis to discuss the specific requests that arise in the clinical practice of treating patients with eating disorders and how artistic mediation can offer a therapeutic opening.

Research indicates the existence of an eating disorder continuum. The two-component model of disordered eating suggests that certain personality traits may increase an individual's vulnerability to develop more severe variants of disordered eating symptomatology. The present study investigates pre-clinical elevations on a measure of personality based on the Five-Factor Model (FFM) and pre-clinical elevations on a measure of eating disorder symptomatology in a sample of nonclinical undergraduates. The personality dimensions Neuroticism, Extraversion, and Agreeableness accounted for 7% of the variability in Body Dissatisfaction. Subcomponents comprising the personality dimensions of the FFM as determined by Saucier (1998) (see Appendix A) were analyzed. The Self-Reproach and Intellectual Interests subcomponents were the strongest predictors of Drive for Thinness and Body Dissatisfaction. The subcomponent Sociability was the strongest predictor of Bulimia. Findings present implications for prevention and treatment interventions. Longitudinal studies are needed to determine the temporal directionality of personality and disturbed eating.

The purpose of this study was to test the effectiveness of a cognitive-dissonance based intervention in reducing disordered eating attitudes and behaviors. The intervention program created dissonance through discussion, exercises, and homework aimed at addressing and countering internalized sociocultural pressures, beliefs and values about women's bodies, attractiveness, and worth in the U.S. Seventy-seven female undergraduates were randomly assigned to one of four conditions: cognitive-dissonance, combined cognitive-dissonance, healthy weight placebo control, and wait-list control To determine effectiveness of the intervention, MANCOVA procedures were used, with Time 1 scores serving as the covariate. Overall, the women who received the dissonance based interventions produced the strongest effects among measures assessing sociocultural pressures, internalization, and body dissatisfaction in comparison to the control group, and experienced significant reductions in dieting behaviors and bulimic symptoms over the course of the study, suggesting that the creation of dissonance via the intervention assisted the women in reducing eating disorder risk factors.