The purpose of this study is to operationalize the DSM-III-R criteria for bulimia. This study shows how the lack of DSM-III-R quantification results in high within-group sample variability for bulimic symptomatology and greatly reduces the validity of research outcomes. The study problem for this research is: How can the DSM-III-R criteria for bulimia be measured and quantified in order to procure a more valid sample of bulimics for research and treatment? The first DSM-III-R criterion for bulimia is: "Recurrent episodes of binge eating." This criterion was operationalized using the Binge Eating Quiz and by calculating the mean daily binge caloric consumption of 108 female subjects who met the DSM-III-R criteria for bulimia. The second DSM-III-R criterion for bulimia is: "A strong feeling of lack of control over eating behavior during the eating binges." This criterion was operationalized by administering the Eating Attitude Test to 108 individuals who met the DSM-III-R criteria for bulimia. The third DSM-III-R criterion for bulimia is: "The person regularly engages in either self-induced vomiting, use of laxatives or diuretics, strict dieting or fasting, or vigorous exercise in order to prevent weight gain." Of these several purging variables, the one most commonly used by bulimics in this study (N = 108), and in all previous research studies was self-induced vomiting. Self-induced vomiting was measured by giving 108 female subjects devices to be attached to their toilets in order to measure vomit in cubic centimeters. The fourth DSM-III-R criterion for bulimia is: "Persistent overconcern with body shape and weight." This criterion was operationalized by a test designed and tested by this researcher, the Body Image Scale (BIS). The BIS was administered to 108 female subjects who met the DSM-III-R criteria for bulimia. The fifth DSM-III-R criterion for the diagnosis of bulimia is: "A minimum average of two binge eating episodes a week for at least three months." This criterion is especially vague because a binge to one person may merely infer one candy bar; while to another individual, a binge may suggest a dozen donuts. Although vomiting frequency is also a vague unit of measurement for bulimia, it is perhaps less so than bingeing. Consequently, "a minimum average of two vomiting episodes a week for at least three months" may be a better measurable characteristic for this DSM-III-R criterion. When the DSM-III-R criteria for bulimia was operationalized on 108 female subjects who answered "yes" to the five DSM-III-R criteria, only 46.30% (N = 50) scored significantly on the BEQ, Binge Caloric Value Count, EAT, Vomit Count, and the BIS. Consequently, only 50 out of 108 potential subjects would render valid research subject inclusion in bulimic research. Thus, this study shows that the DSM-III-R criteria for bulimia should only be used as an initial screening device for subject inclusion and treatment in research studies. Other tools, such as those used in this study, should then be employed in order to obtain a more valid study sample in order to procure more empirical research outcomes. (Abstract shortened by UMI).

This diploma thesis deals with the issue of mental anorexia (AN), clinical and laboratory manifestations of the disease. The theoretical part is focused on summarizing the existing knowledge about the diagnosis, complications and treatment of AN. Attention is paid to the effects of the disease on individual organ systems and clinical and laboratory consequences. The practical part deals with the evaluation of laboratory parameters and clinical symptoms of patients monitored at the Department of Pediatrics and Inherited Metabolic Disorders, 1st Faculty of Medicine, Charles University and General Hospital in Prague. The performed clinical examinations include anthropometric measurements, bioimpedance, measurement of resting energy consumption by indirect calorimetry, measurement of skin algae with a caliper and comparison of the results of methods for determining the proportion of adipose tissue using a caliper and bioimpedances. All patients underwent EKG and cardiological examination, blood pressure measurement, heart rate. The laboratory examination was focused on the determination of serum protein levels, lipidogram, electrolyte levels, triiodothyronine and vitamin D. The aim of the practical part of the work was to find out what are the most common clinical manifestations and laboratory...

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Bakgrund Ätstörningar är en växande sjukdom i dagens samhälle och den mest utsatta gruppen är unga kvinnor mellan 15 och 25 års ålder. Ätstörningar är en global sjukdom men som framförallt ses i västvärlden där det smala idealet länge betraktats som det vackra och det framgångsrika och kan vara en stor riskfaktor för insjuknandet. Sjukdomens uppkomst kan bero på biologiska, psykologiska och/eller sociokulturella faktorer. För att kunna skapa ett fördelaktigt möte mellan hälso- och sjukvårdspersonal och individen med ätstörning är det viktigt att se personen bakom sjukdomen samt att relationen innehåller kunskap, tillit, trygghet och hopp. Syfte Syftet var att belysa vad patienten upplever främjar tillfrisknandet från en ätstörning i mötet med hälso- och sjukvårdspersonalen. Metod Metoden som användes var en icke-systematisk litteraturöversikt. Sökandet efter vetenskapliga artiklar utfördes på databaserna Cinahl, PubMed och PsycINFO. 16 artiklar med övergripande kvalitativ metod, men även mixad och kvantitativ metod, inkluderades i resultatet. Resultat Det framkom sex huvudkategorier som patienterna med ätstörning upplevde vara viktiga i en vårdrelation för att kunna främja ett tillfrisknande: Behovet av att överlämna kontrollen till vårdpersonalen, Vikten av att känna tillit i mötet, Modergestaltens betydelse, Hälso- och sjukvårdspersonalens kunskap och erfarenhet, Se personen bakom ätstörningen samt Hoppets betydelse. Slutsats Hälso- och sjukvårdspersonalen bör ha en fördomslös inställning i vårdandet av en patient med ätstörning. Det är viktigt att vårdpersonalen har kunskap och är bekant med sjukdomen samt att lyckas förmedla tillit, hopp och trygghet i relationen för att främja behandlingen. Patienten med ätstörning vill separeras från sin ätstörning och bli sedd som personen bakom ätstörningen. Det är ytterst viktigt att som vårdpersonal och sjuksköterska kunna skilja på sjukdom och person för att kunna skapa en patientnära relation och vara en hjälpande hand i att främja hälsa. / Background Eating disorders are an increasing problem in the current society. Although it is considered a global disease, it is most common in the western world, and the highest prevalence is seen among young females aged 15-25. The ideal of being slim is considered equivalent to beauty and success and can easily be a risk factor of becoming ill. The onset of eating disorders could be connected to biological, psychological and/or sociocultural factors. In order to create a positive encounter between the ill person and the healthcare professionals, it is important to see the person behind the disease as well as to create a relationship with knowledge, trust, comfort and hope. Aim The aim was to illuminate the patient experience of what promotes recovery from an eating disorder when meeting healthcare professionals. Method The method used was a literature review. Databases Cinahl, PubMed and PsycINFO was used to find relevant scientific articles. 16 articles with mainly qualitative design, but also quantitative design and mixed methods, were chosen for the result. Results Six main categories constitute what patients with an eating disorder found was important in the interrelationship to promote recovery: The need of surrendering control, The importance of feeling trust in the relationship, The meaning of a maternal figure, Health care professionals’ knowledge and experience, To see the person behind the disease and The meaning of hope. Conclusions Health care professionals should carry a non-prejudiced attitude while caring for a patient suffering from an eating disorder. To be able to support recovery it is shown to be important for caregivers to possess knowledge about eating disorders and to convey trust, hope and the feeling of being safe in the relationship. The patient with an eating disorder wish to be distinguished from the eating disorder and for caregivers to see the person behind the disease. It is of great importance for health care professionals, including nurses, being able to distinguish the person from the eating disorder in order to establish a trusting relationship and promoting health.

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När en person drabbas av ätstörningar påverkas oundvikligen den sociala kontexten; inte minst hens familj och andra anhöriga. Innebörden i hur det är att vara anhörig till en person med psykisk ohälsa, såsom ätstörningar, är fortfarande ett relativt outforskat ämne. Syftet med föreliggande studie är att skildra upplevelser hos anhöriga till personer med ätstörningar. Vidare undersöks hur medberoende kan ta sig uttryck hos de anhöriga, och deras stödbehov identifieras. Åtta anhöriga till personer med ätstörningar intervjuades, och olika anhörigperspektiv åskådliggjordes då de hade olika positioner inom sina respektive familjer. Intervjupersonernas utsagor utgör studiens empiriska material. Intervjuerna var kvalitativa och semistrukturerade i syfte att fånga de anhörigas subjektiva perspektiv. Det empiriska materialet analyserades med hjälp av två teoretiska utgångspunkter; systemteori och medberoendebegreppet, samt relevant tidigare forskning. Resultatet belyser det faktum att anhörigskap till en person med ätstörningar innebär påfrestningar och stort lidande. Ätstörningen påverkar utan tvekan hela familjesystemet på olika sätt, och medberoende ges uttryck i olika strategier. Gällande anhörigstöd visar resultatet att det finns behov av olika former av stöd, eftersom anhöriga är en heterogen grupp med varierande behov. / An individual suffering from eating disorders will inevitably affect his or her social context; especially relatives within in the context of the family. The signification of being a relative of a person with mental illness, such as eating disorders, is still a relatively unnoticed topic. The purpose of this study is to describe and illustrate the experiences of being a relative of a family member suffering from eating disorders. Furthermore the aim is to examine how co-dependency can be expressed by the relative. Additionally the specific support needs in terms of being a relative is to be identified. Eight relatives of a family member with an eating disorder were interviewed, each providing us with a different perspective, as they had various positions within their families. Their statements constitute the empirical material of this study. The interviews were qualitative and semi-structured in order to capture the world as it is understood by their individual point of view. The analysis of the empirical material was based on two theories; systemic theory and concepts of co-dependency, as well as relevant previous research. The result highlights that being a relative of a family member with an eating disorder can be very stressful, and involves a great deal of suffering. The eating disorder affects the whole family-system in various ways, and co-dependency manifests in different strategies. Regarding relative support the result shows that various approaches are needed, as all relatives are different and hence have different needs.

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This essay explores two fictional works about problematic eating by female writers in Sweden published in 2022: Bröd och mjölk by Karolina Ramqvist and Ut ur min kropp by Sara Meidell. The study aims to analyze how bodies and subjects are shaped through food, eating, and starvation. The questions of the essay are: How do the fictional works use emotions to show how bodies are formed? How are bodies shaped through contact with human, non-human, and abstract objects? How do the fictional works use aesthetics to negotiate the borders of the bodies? To answer my questions, I use Sara Ahmed's theory about the relationality of emotions and affective economies; I use Judith Butler's theory about performativity, bodily ego, and culturally intelligible subjects; I also use Donna Haraway's theory about situated knowledges and the hybrid cyborg figure. I use a close textual analysis to explore the works, which are handled like extended material. Therefore, this is not a comparative study. This study shows that Bröd och mjölk uses Julia Kristeva's psychoanalytic construction of the semiotic to show how a subject can be created by a continuous flow of pleasure. It also shows how the semiotic and the intake of food can be regarded as a discourse, and therefore a regulating force. By that, food takes place as an agent of the inside of cultural discourse. Ut ur min kropp uses single narrative stories in a subversive way to show how the female protagonist uses autonomy as a resistance against a patriarchal society. Through starvation, the protagonist claims herself as a transcendental agent free from the body. The resistance shows itself as contradictory, and by that Ut ur min kropp says that autonomy is a story available for bodies that fit in a certain narrative. Therefore the study shows how food, eating, and starvation can be viewed as material, psychic, and fictional relationships between women and their surroundings.

<p>Listening (Janusik, 2002; Miller, 2018; Wolvin & Coakley, 1996) and eating disorders (EDs; National Centre for Eating Disorders (NCFED), 2018) are often not taught within schools, especially among adolescents. To address this, a school-based brief motivational interviewing (MI) intervention on listening when talking about EDs was created, implemented, and evaluated among adolescents (<em>n</em> = 260) from two middle schools within the Midwestern part of the United States. Specifically, School 1 (<em>n</em> = 100), and School 2 (<em>n</em> = 160) and three teachers (i.e., Teacher 1, Teacher 2, Teacher 3) allowed the researcher to present and collect data. In other words, three total teachers between the two schools, and one teacher, Teacher 1 (<em>n</em> = 100), was from School 1, and the other two teachers, Teacher 2 (<em>n</em> = 120) and Teacher 3 (<em>n</em> = 40) were from School 2. Participants were randomly placed into either the 1) the EDs listening intervention (education-plus) with an MI component (<em>n</em> = 6 classes) or 2) an education-plus Q&A intervention (<em>n</em> = 7 classes). All the participants were involved in the guest lecture and the pre-test and post-test survey, but data was only saved and analyzed from participants that had guardians/parents who consented (<em>n</em> = 75). The methodology for this dissertation project was a 2 (pre/post, unmatched) X 2 (condition) subject’s design. This dissertation project had two independent variables: (1) experimental condition (e.g., education plus MI and education plus Q&A), and (2) time (e.g., pre and post). This dissertation project had five dependent variables: (1) knowledge of listening, (2) knowledge of EDs, (3) listening self-efficacy, (4) knowledge of OARS, and (5) knowledge of the righting reflex. This dissertation project also had the random factor of schools (e.g., School 1 (A) and School 2 (B), and the fixed factor of gender identity (e.g., male and female). The results revealed a promise of efficacy and increased knowledge regarding EDs and aspects of listening, specifically through MI (e.g., OARS). Other areas of knowledge improved but not significantly. In other words, there were no significant differences in knowledge gains between MI and Q&A, but MI compared to Q&A showed a more extensive influence on self-efficacy. The main limitation of this study was the limited guardian/parental consent, resulting in a small sample size.</p><br><br>