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Idag är unga kvinnor den grupp som utgör majoriteten av ätstörningsdrabbade, där anorexia nervosa, bulimia nervosa och EDNOS (eating disorder not otherwise specified) är de vanligast förekommande diagnoserna. Mando Group AB behandlar patienter med ätstörningar och har till patienternas hjälp utformat datorprogrammet Doktor Cecilia som är en virtuell behandlare till vilken patienterna kan ställa frågor. Användandet ligger enligt Mando Group AB inte på önskvärda nivåer och programmet har inte heller tidigare genomgått en utvärdering. Syftet med detta arbete var att ta fram potentiella förbättringar av programmet och att av patienterna få dessa tillsammans med programmet utvärderade. Vidare utfördes en enkätundersökning på två Mandometerkliniker för att kartlägga patienternas åsikter om programmet och de framtagna potentiella förbättringarna. Resultatet visade att patienterna var positivt inställda till implementerandet av bland annat röstsvar, tvåvägskommunikation och möjlighet till att se till programmet vanligt ställda frågor. Detta resultat användes sedan för att framställa rekommenderade implementationer som skulle kunna förbättra programmet och på sikt kunna öka dess användning. / Today, adolescent females represent the majority of people suffering from eating disorders with anorexia nervosa, bulimia nervosa and EDNOS (eating disorder not otherwise specified) being the most common diagnoses. Mando Group AB treats patients with eating disorders and has for the sake of the patients developed the computer software ‘Doctor Cecilia’ which is a virtual caretaker to whom patients may direct their queries. Mando Group AB has stated that the usage of the software has not reached the desirable level amongst their patients. Moreover, the software has not been subject to an evaluation. The purpose of this thesis has been to produce suggestions of potential improvements for ‘Doctor Cecilia’ by consulting patients in order to evaluate these improvements as well as the software in general. As such, an investigation was conducted at two Mandometer-clinics in order to clarify the opinions of the patients regarding the software itself and the potential improvements which are presented by this thesis. The results showed that the patients were in favor of the implementation of for instance voice response, two-way communication and the opportunity to see frequently asked questions. The results of this thesis have been used to produce recommended implementations that could improve the software and eventually increase its usage.

Eating disorders involve the inability to appropriately regulate a behavioral response to food due to impaired reward sensitivity, affect regulation and cognitive control, resulting in deleterious effects on the individual's physical and mental well-being. In this way eating disorders may be analogous to addictive disorders (e.g. alcoholism). Furthermore, eating and addictive disorders co-occur at very high rates and appear to have similar contributing mechanisms (impaired reward sensitivity, impaired affect regulation and impaired cognitive control). Overvaluation of weight and shape concerns appears to be one unique characteristic of eating disorders, not shared with addiction. The current study examined the relationship between impaired reward sensitivity, impaired affect regulation and impaired cognitive control with addiction vulnerability. Furthermore, weight and shape concerns were examined as a potential moderator of the relationship between addiction vulnerability and binge eating. A total of 1000 undergraduate students completed self-report measures examining the three posited mechanisms for addiction vulnerability and disordered eating. A subset of 101 students (50 binge-eaters and 51 non-binge eaters) also completed behavioral measures of the three posited mechanisms. The results of this study support the proposed model that weight and shape concerns moderate the relationship between addiction vulnerability and binge eating. Results also demonstrated on a behavioral task that individuals who endorsed binge eating were more likely to act impulsively and quit the PASAT-C task faster than control subjects. Furthermore, they demonstrated a greater increase in irritability while completing the task which may have resulted in their desire to quit the task earlier. No differences were found on behavioral measures of reward sensitivity (delay discount task) or cognitive control (stop signal task). Future studies should continue to examine the construct of addiction vulnerability to provide additional validity for the construct as well as examine it in the context of all forms of disordered eating. / Psychology

Although research has shown that poor emotion awareness is significantly related to disordered eating, the majority of studies that have examined this relation have significant limitations. These limitations include lack of longitudinal data, little focus on the specificity of emotion awareness in predicting disordered eating versus general emotional distress, little focus on the roles of other emotional deficits, such as emotional avoidance and fear of emotions, an over-reliance on self-report data, a lack of research with sub-clinical populations, and a failure to examine possible interactions between emotion awareness and other known risk factors for disordered eating. The current study addressed some of these limitations by using a two-time point, prospective design to examine a variety of emotional processes, stress, dysfunctional appearance beliefs, and disordered eating in undergraduate females. At Time 1, participants (N = 187), ages 18-22, completed measures of emotion awareness, emotional avoidance, fear of emotions, depression, anxiety, dysfunctional appearance beliefs, life events/stress, and disordered eating. Three months later, at Time 2, participants (N = 158) repeated many of the Time 1 measures, in addition to completing a measure that assessed the frequency and subjective negative impact of life events experienced during the prospective period. Six main hypotheses were tested. As expected, emotion awareness was stable over time and was related to disordered eating cross-sectionally. Contrary to expectations, emotion awareness did not predict disordered eating prospectively, emotion awareness related more to depression and anxiety than to disordered eating, emotion awareness did not relate to disordered eating cross-sectionally or prospectively once emotional avoidance and fear of emotions were controlled, emotion awareness did not interact with life events/stress and dysfunctional appearance beliefs to predict disordered eating cross-sectionally or prospectively, and the ability to repair mood did not mediate the relation between emotion awareness and disordered eating. A notable finding involved the lack of specificity of emotion awareness to disordered eating versus depression and anxiety. In fact, depression and anxiety fully mediated the relation between poor emotion awareness and disordered eating. Following a review of the results, strengths and limitations, as well as clinical implications and potential future research directions are discussed. / Psychology

Over the past two decades, a large body of research has examined the issues of eating disorders as well as compensatory behaviors in collegiate competitive athletes. Up to 49.1% of student-athletes engage in disordered eating and compensatory behaviors, while up to 7.1% of athletes have symptoms that reach the threshold of formal psychiatric diagnoses. Greater symptoms are linked to reduced athletic and academic performance, both of which may impact physical and psychosocial functioning later in adulthood. However, most athletes suffer from these symptoms in isolation, as these behaviors are often undetected by athletic trainers and coaches. The purpose of the current study was: (a) to examine the prevalence of both formal eating disorders and disordered eating symptomatology in a sample of collegiate student-athletes; (b) to explore the frequency of compulsive exercise occurrence; (c) to investigate the differences in athletes’ disordered eating, compulsive exercise, and body image concerns by gender, sport type, and level of athletic participation; and (d) to assess the relationships among athletes’ disordered eating, compulsive exercise, and body image concerns, as well as associations between athletes’ age and each of these three variables. In total, 128 NCAA Division I varsity and club athletes completed the Eating Disorder Examination Questionnaire (EDE-Q), Compulsive Exercise Test (CET), and Multidimensional Body Self-Relations Questionnaire – Appearance Scales (MBSRQ-AS). Correlational analysis, Independent two-sample, and Welch’s t-tests were conducted to establish statistical significance for the relationships of interest. Out of 128 athletes, 11 athletes (8.6%) scored in the clinically significant range on at least one EDE-Q subscale. Four athletes (3.2%) met criteria for Bulimia Nervosa, 3 athletes (2.4%) met criteria for Binge Eating Disorder, and 2 athletes (1.6%) met criteria for Unspecified Feeding or Eating Disorder. In addition, 40 athletes (31.3%) reported subclinical symptoms of an eating disorder. Nineteen athletes (14.85%) scored above the clinical cut-off score for compulsive exercise behavior. Female athletes reported greater disordered eating symptomatology and body image dissatisfaction than males. In addition, lean-sport athletes had a higher prevalence of maladaptive eating behaviors than non-lean sport athletes. Age was not associated with athletes’ disordered eating, compulsive exercise, and body image scores. Also, no differences were found between club and varsity athletes for the same variables. Positive correlations were found between athletes’ eating pathology and their compulsive exercise behaviors, suggesting that greater eating disorder symptoms were associated with greater excessive exercise engagement. In contrast to athletes with no symptoms of an eating disorder, athletes with symptoms of an eating disorder reported using exercise as a weight control measure. Higher levels of body image dissatisfaction were also associated with greater eating pathology. This study addressed a number of methodological shortcomings across the body of eating disorder research (e.g., studies with insufficient sample sizes, lack of group comparisons by age and level of athletic participation, and suboptimal psychometric measures) and underscored the need for a new generation of studies. The study also explored the frequency of compulsive exercise, a compensatory behavior which is highly prevalent, but often overlooked among athletes. The study findings may aid coaches, athletic administration, and mental health professionals in identifying at-risk athletes. The study findings also inform the development of prevention and treatment efforts. / Kinesiology