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No description available.

Use of language is thought to be particularly important when considering an individual’s motivation to change. The present thesis has expanded on existing knowledge of the relation between motivation to change and psychotherapy outcome for individuals with anorexia nervosa. This was accomplished by rating 148 audiotaped psychotherapy sessions with four measures of motivation to change. Data were derived from an existing clinical trial of three types of psychotherapy (Cognitive-Behaviour Therapy, Interpersonal Therapy, and Specialist Supportive Clinical Management). Three sessions were rated for each of the 53 participants who received up to twenty sessions of psychotherapy, early (sessions 1-5, middle (sessions 6-14), and late (sessions 15-20). Participant expressions of motivation to change were analysed across sessions, within sessions (beginning, mid, and end intervals), by change talk type, and therapy type for those with good and poor outcomes. Resistance and readiness to change, positive psychotherapy process, and readiness to recover from anorexia nervosa were also examined. The main findings were significantly more positive change talk expressed in the beginning than mid and end therapy intervals and significantly more negative change talk expressed in the beginning than end therapy interval and in the mid than end interval. When change talk type was examined, a significant difference in the ratio of positive to negative change talk expressed between change talk types was found. Results from other motivation measures indicated that readiness to change was expressed significantly more frequently in the middle and late than early phase of therapy. There were higher levels of positive process in psychotherapy in the late than early phase of therapy, and higher levels in those with good than poor outcomes. There were significantly higher levels of readiness to recover from anorexia nervosa expressed in the middle and late phases of therapy than in the early phase, and higher levels in those with good than poor outcomes. Limitations to these results include a modest sample size, rater biases, and lack of reliability measures. Notwithstanding these limitations, the present study has produced several potentially important findings that merit further investigation.

Metacognitions play a crucial role in the development and maintenance of psychiatric disorders, such as depression and anxiety. Its function in anorexia nervosa (AN), however, has been neglected. Examining the role of metacognitions in AN may prove useful for developing the AN conceptualization currently lacking. Additionally, it may provide a desperately needed new route for AN treatment, as no efficacious treatment for adult AN is available to date. This study aimed to build on preliminary findings suggesting that individuals with AN are characterized by the cognitive attentional syndrome (CAS), the vital component in the Self-regulatory Executive Function (S-REF) model underlying metacognitive processes. Hence, quantitative and qualitative measures of individuals with AN, dieting, and non-dieting adult women were examined to ascertain whether these groups embodied differences in their metacognitive frequency and nature. ANOVA, bivariate correlation, and ANCOVA were used for data analysis. Findings showed that the AN sample experienced higher overall metacognitions; particularly negative metacognitions and metacognitions around control. When anxiety and depression were controlled for, however, the association became non-significant. Nonetheless, anxious and depressive symptoms are greatly intertwined with eating symptoms and increased metacognitions in the AN sample are still highly plausible. Metacognitive themes endorsed by the AN sample were around sociability and control. Thought control strategies were found to be the same in all groups; however, the AN sample endorsed a higher utilization of punishment and a lower utilization of distraction. Several limitations including small AN sample size and no psychiatric control group should be taken into account. Overall, however, findings suggested that, because the AN sample was characteristic of the CAS and the S-REF model, dysfunctional metacognitions may be worth targeting in AN treatment.

Bakgrund: Anorexia nervosa är en sjukdom som innebär att den drabbade svälter sig själv genom att inta en alltför låg mängd kalorier. Personen har en förvrängd självbild och uppfattar ofta sig själv som tjock. Sjukdomen påverkar både kropp och själ och många känner starkt hat mot sig själva och sin kropp. Anorexia nervosa blir allt vanligare i dagens samhälle. Idealet att vara smal kan leda till att personer tar till ohälsosamma metoder för att gå ner i vikt. Syfte: Syftet med studien är att beskriva hur kvinnor med anorexia nervosa upplever sin livsvärld. Metod: En kvalitativ litteraturstudie som grundas på fem självbiografier. Analysen gjordes utifrån en manifest innehållsanalys. Resultatet bygger på meningsbärande enheter som valts ut från självbiografierna. Resultat: Resultatet utgår från tre huvudkategorier och nio underkategorier. Kroppsliga upplevelser; att känna sig tjock och äcklig, reaktioner på svält samt effekter av matintag och träning. Psykiska upplevelser; förnekelse och kontrollbehov, att styras av röster och tankar ångest och skam samt att dämpa den psykiska smärtan. Att förhålla sig till andra; ensamhet och stöd och rädsla för omgivningens uppfattning. Slutsatser: Kvinnorna med anorexia nervosa upplever både lidande och välbefinnande i sin sjukdom. De uppfattar sig som tjocka trots sin låga vikt och missnöjet över sin kropp finns ständigt kvar. Ångest, skam och ensamhet är känslor som ofta beskrivs.

Bakgrund: Anorexia Nervosa påverkar individen både fysiskt och psykiskt och är en allvarlig och livshotande sjukdom där många av kroppens olika organsystem påverkas. Det är av stor vikt att sjukdomen upptäcks i tid så att behandling snabbt kan sättas in. Forskning har visat att sjuksköterskor upplevde bristande kunskaper inom psykisk ohälsa och hade därmed svårigheter att vårda patienter med anorexia. Syfte: Syftet var att beskriva familjens erfarenheter av att leva med en familjemedlem med anorexia. Metod: Litteraturstudien baserades på tio vetenskapliga artiklar, fem med kvantitativ ansats och fem med kvalitativ ansats. En integrerad analys utfördes utifrån Kristenssons (2014) beskrivning. Resultat: De kategorier som framkom i analysen var Familjedysfunktion, Psykisk belastning, Familjens hanteringsstrategier, Familjens erfarenheter av bemötande från vårdpersonal och Erfarenheter av att vårda. Familjen upplevde att anorexia påverkade deras psykiska hälsa negativt och de oroade sig för den sjuka familjemedlemmen. De upplevde att de fått otillräcklig information och stöd från sjukvården. Sjukdomen hade trots detta även givit dem värdefulla erfarenheter. Slutsats: Familjer upplevde både psykisk och praktisk belastning av att leva med en familjemedlem med anorexia och de använde olika strategier för att hantera detta. De uttryckte ett behov av hjälp från sjukvården. Sjuksköterskans roll är att se hela familjen och inte enbart den enskilda individen vilket kan möjliggöra att lidande lindras och välbefinnande främjas.

Ortorexia Nervosa (ON) är ett sällsynt förekommande ämne inom dagens forskning. ON behandlar en besatthet av en viss typ av livsmedel som senare leder till social isolering. Studien genomfördes med syfte att undersöka om ON förekommer bland gymnasieelever, om bassjälvkänsla och förvärvad självkänsla, vetskap om sitt eget BMI samt kön är kopplat till fenomenet. Undersökningen genomfördes med enkäter som mätte graden av ON samt självkänsla. Åttiofem gymnasieelever svarade på enkäterna. Resultatet visade att tretton procent av respondenterna fick poäng över tröskelvärdet för ON. Ingen signifikant korrelation uppkom beträffande relationen mellan könen. Undersökningen visade signifikanta samband mellan ON och de två typerna av självkänsla: vid högt behov av förvärvad självkänsla samt låg bassjälvkänsla tenderar individen att ha högre grad av ON.

The series of studies reported in this thesis aimed to improve our knowledge of the cognitive disturbance in anorexia nervosa and bulimia nervosa. Techniques from experimental cognitive psychology were used to test predictions made by cognitive theories of eating disorders. In the first study, subjects performed three tasks related to eating, weight and shape and self-statements were measured using concurrent verbalisation and a selfreport questionnaire. Compared to dieters and non-dieting controls, patients with bulimia nervosa showed greater concern with weight and appearance while patients with anorexia nervosa showed greater concern with eating. In the second study, using an adaptation of the Stroop colour-naming task, patients with eating disorders showed greater selective processing of information related to eating, weight and shape than normal, non-dieting controls and normal dieters. In the third study it was found that this disturbance was more closely related to measures of the specific psychopathology of eating disorders rather than to measures of general psychopathology. In the fourth study information processing before and after treatment was compared. As predicted by cognitive theories, selective processing appeared to be related to the emotional salience of the clour-named words rather than to patients' familiarity with the issues represented by these words. In the fifth study information processing before and after three different psychological treatments for bulimia nervosa was measured. No support was found for the hypothesis that cognitive behaviour therapy operates through mechanisms specific to this treatment. Contrary to predictions, in the sixth study, when colour-naming was measured at the end of treatment and at 12 month follow-up, selective information processing did not predict relapse in symptoms of bulimia nervosa. Finally, a seventh study, which manipulated attitudes to eating, weight and shape experimentally, found evidence for a causal relationship between these attitudes and disturbed eating behaviour. Methodological issues, and the clinical and theoretical relevance of the research findings, are discussed.

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Thesis (Ph.D.)--Tufts University, 1999. / Adviser: Robin Kanarek. Submitted to the Dept. of Psychology. Includes bibliographical references (leaves 172-183). Access restricted to members of the Tufts University community. Also available via the World Wide Web;