This study examined collegiate swimming coaches' knowledge and attitudes towards eating disorders and unhealthy weight loss practices within their athletes along with their perceptions of sport specific pressures in swimming. I used a modified version of the 2003 NCAA Questionnaire for Collegiate Coaches of Female Student-Athletes developed and utilized by Sherman, Thompson, Dehass, and Wilfret. I used email to distribute the link to an online version of the survey, and used SPSS to analyze the data. The results suggest that NCAA Division I, II, and III collegiate swimming coaches are aware of the prevalence along with the fact that that athletes do participate in unhealthy weight loss practices and suffer from eating disorders. This study suggests that many coaches are knowledgeable about this topic, but I was unable to conclude whether swimmers experience sport specific pressures that put them at higher risk for or lead to eating disorders. Both participant gender and NCAA division coached were found to present statistically significant differences in survey responses. Despite results being statistically significant, results are consistent with previous research examining eating disorders in sport. Results were not able to conclude if swimmers experience sport specific pressures leading to the development of eating disorders. It is hoped that future research will continue to examine the link between specific sports and the development of ED, as well as focus on providing coaches with more knowledge and education on this topic. / Kinesiology

"The Gordita's Guide to Body Positivity" is an autobiographical documentary reflecting on society's expectations of the female body image and how it affects Latinx women. Through personal recollections, media content, and archival material, the film explores beauty expectations, body discrimination, and body positivity. The document analyzes the documentary styles such as autoethnography and narration incorporated into the film and provides historical and theoretical context to body image in the Latinx culture and how the media has affected body image, beauty ideals, and eating disorders. In addition, the pre-production, production, and post-production process is detailed.

Ätstörningar är ett allvarligt problem inom sport som kan drabba manliga samt kvinnliga idrottare på alla nivåer. Idrottare möter ofta höga prestations- och kroppsuppfattningskrav, vilket kan resultera i ett ohälsosamt förhållande till mat och kroppsuppfattning. Detta leder till hälsoproblem som exempelvis undernärning, nedsatt prestationsförmåga och, i allvarliga fall, livshotande tillstånd. Arbetet ämnar identifiera vilka kunskaper elittränare och tränare på elitförberedande nivå inom lagidrott har gällande ätstörningar. Detta undersöks genom semistrukturerade intervjuer med sex tränare inom tre lagsporter. Resultatet av intervjuerna visade att tränare hade grundläggande kunskap om ätstörningar. Deras kunskaper gällande symptom, djupgående kunskap av ätstörningarnas innebörd och hur sjukdomarna ska hanteras visades dock vara otillräcklig. Resultatet visade även att yttre faktorer påverkade både adepterna och tränares upplevelser och därmed tränares möjligheter till att agera. I diskussionen konstateras att kunskapen är grunden till flera problem, samt att förbunden behöver hjälpa föreningen hantera dem. Både genom att tillhandahålla mer kunskap, men även riktlinjer för hur personer som utvecklat eller är på väg att utveckla ätstörningar kan hjälpas. / Eating disorders is a serious problem within sports that can affect both male and female athletes on various levels. Athletes often encounter high performance- and body image requirements, which can result in an unhealthy relationship to food and body image. This leads to health problems such as malnourishment, impaired performance and, in serious cases, life threatening conditions. The work aims to identify what knowledge elite coaches and coaches on elite prepatory level within teamsports have regarding eating disorders. This is explored through semi-structured interviews with six coaches in three teamsports. The results of the interviews showed that coaches have basic knowledge of eating disorders. Their knowledge of symptoms, in-depth knowledge of the meaning of the eating disorders and how to handle the diseases was shown to be insufficient. The results also showed that external factors affect both adepts and coaches experiences and thereby coaches opportunities to act. In the discussion it is established that knowledge is the foundation to several problems, and that the sportunions must help the sports association to handle them. Both by providing more knowledge, but also guidelines for how people who have developed or is about to develop a eating disorder can be helped

Disordered eating in men is said to be uncommon with men forming less than ten per cent of reported cases. Yet it has been suggested that the number of males with eating disorders is beginning to increase, affecting more men than ever before. This presents problems for healthcare services that have created previous models of support around women. Current research offers pathological and epidemiological data, including information about testing men for eating disorders using male-centred instruments. However, understanding is aetiolated due to a focus on medical accounts of male disordered eating, rather than focusing on the stories that men themselves have to tell. This exploratory qualitative study addresses this problem by focusing on men’s stories of disordered eating. Four men share their accounts of living with an eating disorder and these are analysed using a hermeneutic approach, in order to glean insights into their experiences with food, body and self. These insights include an examination of the meaning of fat male bodies, analysis of the phenomenon of gender ambivalence that prevails in men with disordered eating and the fragmented and colonised nature of the male eating disordered self. These represent an original contribution to understanding as they have not been considered elsewhere in the literature to date. Additionally, an extensive analysis of the male eating disorder literature, use of a hermeneutic methodology and the positioning of male eating disorders within the context of masculinities studies further add to the novel value of this research.

Metatheory, a study of theories, was the focus of this research study. A qualitative, grounded theory research design was used to examine documents on systems theory found outside the field of Clothing and Textiles (CT) and the social psychological theories used within CT. Recognizing the dynamic, complex nature of the human system and its interaction with multiple other systems led to the question of: What multidimensional theoretical framework would address this complexity and provide an expanded view for research and education in the field of CT? Data were collected from documentary materials pertaining to systems theory and CT theories by the researcher in a library search of the literature. Four domains were identified from the data that were collected and analyzed. The domains were Relationship, Process, Organization, and Outcomes. Then, a holistic, systemic theoretical framework and the Human-Environment Systems model were developed from the integration of systems theory and the CT theories. The model was designed to give a general, abstract visual representation of the theoretical concepts of a holistic, systemic view of the human-environment unit. A discussion of the complex societal issue of body image and eating disorders in females served to illustrate the use of the proposed theoretical framework and model. Recommendations were made for future exploration of the use of a holistic perspective for research and educational practices in the field of CT in order to address dynamic, complex human-environment problems. / Ph. D.

The treatment of eating disorders (EDs) presents many challenges. Therapists' reactions towards clients (countertransference) may further complicate treatment. Countertransference may be partially due to the therapist's own vulnerabilities. Due to the personal connection to the work, countertransference towards ED clients may be pronounced among therapists with eating disorder lived experience (EDLE). Previous research indicates that 25-50% of ED therapists have EDLE; yet, minimal research examines how therapists negotiate their experiences while treating ED clients. The existing literature largely operates from the assumption that EDLE is a liability. While therapists with EDLE have some distinct challenges, therapists with EDLE may also have a unique perspective to offer the ED profession. The present study sought to understand how therapists with EDLE use their EDLE as a resource in their clinical work with ED clients. The study was guided by the theoretical frameworks of social constructivism and symbolic interactionism, as well as the person-of-the-therapist clinical training philosophy. Using constructivist grounded theory methodology, semi-structured interviews (Mtime = 89 minutes) were conducted with 22 therapists with EDLE, who work with ED clients. Participants explored how they use and manage their EDLE during key tasks of treatment with their ED clients. Results revealed that therapists engaged in two, interconnected constellations of processes (systems) in order to use and manage their EDLE in clinical practice. The first system (The Central System) helps therapists transform their personal experiences into clinical guidance that they can use to inform their work. The second system (The Checks and Balances System) helps the therapist find a balance between connecting with the client, while also allowing for differences of experiences to emerge. Lastly, personal processes (personal meaning making, values surrounding authenticity, and stigma surrounding EDLE), existing outside of these systems, were also found to impact the ways in which therapists use and manage themselves. Findings have implications for the EDLE literature, by providing novel ways therapists can use their EDLE. Findings also have implications for the POTT framework by exploring how POTT can be adapted for therapists who share lived experiences with their clients. A POTT-EDLE is proposed for training therapists with EDLE. / Doctor of Philosophy / The treatment of eating disorders (EDs) presents many challenges (e.g., frequent comorbidity, high rates of relapse, and the life-threatening nature of the disorder). Therapists' reactions towards clients (countertransference) may further complicate treatment. Countertransference (e.g., worry, frustration, hopelessness) may be partially due to the therapist's own unresolved issues and vulnerabilities. Due to the personal and professional connections to the work, countertransference towards ED clients may be particularly pronounced among therapists with eating disorder lived experience (EDLE). Previous research indicates that 25-50% of ED therapists have EDLE; yet, minimal research examines how therapists use and manage their experiences while treating ED clients. The existing literature largely operates from the assumption that EDLE is a liability and therapists with EDLE are working from a deficit. While therapists with EDLE have some distinct challenges, therapists with EDLE may also have a unique perspective to offer the ED profession. The study sought to understand how therapists with EDLE use their EDLE as a resource in their clinical work with ED clients. Interviews were conducted with 22 therapists with EDLE who work with ED clients. Results revealed that therapists engaged in two systems in order to use and manage their EDLE in clinical practice. The first system (The Central System) helps therapists transform their personal experiences into clinical guidance that they can use to inform their work. The second system (The Checks and Balances System) helps the therapist find a balance between connecting with the client, while also allowing for differences of experiences to emerge. The Central System and The Checks and Balances System work in tandem in order for the therapist to both use and manage their EDLE. Results describe the multiple processes informing these systems. Lastly, personal processes (personal meaning making, values surrounding authenticity, and stigma surrounding EDLE), existing outside of these systems, were also found to impact the ways in which therapists use and manage themselves. Findings have clinical and training implications for how therapists with EDLE can use and manage their EDLE to inform their clinical work with ED clients.

Background Previous studies have suggested that individuals recovered from anorexia nervosa (AN) are characterized by increased serotonergic (5-HT) activity that might be related to elevated levels of anxiety. Assuming these traits to be also present in individuals at risk for AN, it was further hypothesized that restricting food intake might be a means to temporarily alleviate dysphoric affective states by reducing central nervous availability of tryptophan (TRP), the sole precursor of 5-HT. One study that supported this hypothesis found anxiolytic effects in individuals with a history of AN during an experimentally induced short-term depletion of TRP supply to the brain. Methods In this placebo-controlled, double-blind cross-over study, 22 patients weight-recovered from AN (recAN) and 25 healthy control participants (HC) completed questionnaires assessing anxiety and momentary mood during acute tryptophan depletion (ATD), a dietary intervention that lowers central 5-HT synthesis. Results The ATD procedure effectively reduced the ratio of TRP to competing for large neutral amino acids in the peripheral blood, indicating decreased TRP supply to the brain. Effects of ATD on anxiety and mood did not differ between recAN and HC. Bayesian null hypothesis testing confirmed these initial results. Discussion Our results do not support the hypothesis that short-term depletion of TRP and its impact on the brain 5-HT reduces anxiety or improves mood in AN. As the evidence for the role of 5-HT dysfunction on affective processes in patients with AN is limited, further studies are needed to assess its relevance in the pathophysiology of AN.

Research suggests that the associations between femininity, body image and eating disorders are intricate. How these constructs are linked to each other still needs to be determined. The purpose of this study was to gain a deeper understanding of these links, examining the mediational relationship among these constructs. Also, the prediction that bulimia and binge eating disorder symptoms have a similar origin was tested and compared. Some researchers have suggested that the pathways leading to these disorders are equivalent and the main difference between the two is the dietary restriction, while others see them as distinct disorders with different etiology. A total of 355 female college students (ages 18 to 26) completed a set of questionnaires that assessed femininity, feminine gender role stress, body dissatisfaction, bulimia, and binge eating disorder. Results showed that body dissatisfaction mediates the relationship between femininity or feminine gender role stress with bulimia symptoms, as well as the relationship between feminine gender role stress and binge eating disorder symptoms. Results indicate that body dissatisfaction related to femininity or to feminine gender role stress may contribute to higher levels of bulimia symptoms. The findings also suggest that body dissatisfaction related to feminine gender role stress may contribute to higher levels of binge eating disorder symptoms. Results did not support the mediational role of body dissatisfaction between femininity and binge eating disorder. However, the mediational role of feminine gender role stress between femininity and body dissatisfaction was partially supported, suggesting that feminine gender role stress might only be one pathway by which femininity may have an impact on body dissatisfaction. / Master of Science

The purpose of the present study was 1) to begin exploring the relationship between female gender role stress and eating disorders and 2) to validate the ability of the Feminine Gender Role Stress scale (FGRS; Gillespie, 1990) to distinguish between women who are more likely to evidence behavioral and physiological reactivity to a "feminine" (body image) stressor than a neutral control condition. The FGRS scale was developed to measure the cognitive tendency among women to appraise specific situations as stressful due to commitments, beliefs, and values that are a product of the traditional female gender role. It was proposed that women with high female gender role stress, as measured by this scale, should display more reactivity when female stressors are encountered. This hypothesis was tested by selecting women who scored high and low on the FGRS scale and subjecting them to a situation found to be more stressful for women than for men during which physiological and psychological distress were monitored. The stressor entailed a body-image-threat physical exam and interview which was designed to be a stressor relevant to body image disturbance and eating disorders. The experimental design was a 2 (High verses Low FGRS women) by 2 (Stress condition verses a Control condition) factorial design with cardiovascular reactivity and self-reported anxiety as dependent variables. The results supported the predicted interaction between FGRS and Stress Condition on heart rate reactivity. High FGRS women in the Stress Condition evidenced greater heart rate reactivity than Low FGRS women or participants in the Control Condition. Support for experimental hypotheses was found in a Similar trend for interaction for systolic blood pressure reactivity, whereas diastolic blood pressure reactivity was less supportive. It is believed that the FGRS scale can distinguish which women will evidence stress in situations which challenge traditional female gender role values and beliefs. Therefore, the FGRS may have utility for determining which women are more vulnerable to developing female predominant psychopathology, such as eating disorders. / Master of Science

BakgrundEn ätstörning är en allvarlig sjukdom där en person har en störd relation till mat samt till sin egen kropp. Sjuksköterskan kan möta patienter med ätstörningar i alla kontexter. I omvårdnaden har sjuksköterskan en central roll och bemötandet blir en viktig aspekt. Sjuksköterskan skall arbeta personcentrerat med fokus på delaktighet. Den som lider av en ätstörning kan drabbas av allvarliga konsekvenser, både psykiskt och somatiskt. Sjukdomarna är komplexa i sin natur och patienterna saknar ofta sjukdomsinsikt. SyfteSyftet var att beskriva sjuksköterskans erfarenheter i omvårdnaden av patienter med ätstörningar. MetodEn strukturerad litteraturstudie med inslag av den metodik som tillämpas vid systematiska översikter. 16 artiklar från databaserna CINAHL och PsycInfo användes. Dessa var av kvalitativ- (n=10), kvantitativ- (n=2) och mixad design (n=4). ResultatResultatet som visade på sjuksköterskans erfarenheter delades upp i tre huvudkategorieroch sju underkategorier. Den första var ”Sjuksköterskans relation till patienten” med underkategorierna ”Den terapeutiska relationen” samt ”Rollkonflikten”. Den andra huvudkategorin var ”Sjuksköterskans känslor” med underkategorierna ”Positiva känslor”och ”Negativa känslor”. Den sista huvudkategorin var ”Faktorer som påverkar sjuksköterskans omvårdnad” med underkategorierna ”Utmaningar”, ”Stödjande faktorer”samt ”Utbildning”. SlutsatsLitteraturstudien visar på att sjuksköterskans erfarenheter innefattar en mångsidig komplexitet i omvårdnaden av patienter med ätstörningar. Det innefattar en rollkonflikt, starka känslor och etiska dilemman. Erfarenheterna identifierar stödjande faktorer och utmaningar på såväl personlig- som organisatorisk nivå. / BackgroundEating disorders are serious illnesses where the person has a disordered relationship to food and the body. The affected person can suffer from serious consequences both somatic and psychological which make the care complex. Nurses can meet patients with eating disorders in all different contexts and they have an important role in the care for these patients. Person centered care with a focus on patient participation is a central part of the nurse’s role in the treatment. The patients often lack insight in their disease which adds on further complexity in the comprehensive care. AimThe purpose was to describe the nurse's experiences in caring for patients with eating disorders. MethodA structured literature review with elements of the methodology used in systematic reviews. 16 articles from CINAHL and PsycInfo were used. These were of qualitative- (n=10), quantitative- (n=2), and mixed design (n=4). ResultsThe identified result was split up in three main categories and seven subcategories. The first main category was “The nurse-patient relationship” with the subcategories “The therapeutic relationship” and “Role conflict”. The second main category was “The nurses’ feelings”with the subcategories “Positive feelings” and “Negative feelings”. The last main category that was identified was “Factors affecting the nurses care” with the subcategories “Challenges”, “Supporting factors” and “Education”. ConclusionsThis literature review shows that the nurses experiences include a versatile complexity in the care for patients with eating disorders. This involves role conflicts, strong feelings and ethical dilemmas. The experiences identify supporting factors and challenges on both organizational and personal level.