The primary aim of this study was to investigate the relationship between psychological flexibility, self-concealment, and eating disorder severity. This study also sought to explore the relationship between these variables in a clinical sample. Existing literature has demonstrated that diminished psychological flexibility is likely to play a key role in eating pathology. Additionally, self-concealment has been found to be a common and treatment-interfering aspect of the clinical presentation of eating-disordered individuals. Preliminary evidence has been found linking these variables to severity of eating-disorder pathology. However, this relationship needs further clarification to understand fully the implications for treatment and relapse prevention, for these often treatment-resistant disorders. Participants were 182 respondents to an online survey including demographic information, the Eating Disorder Examination Questionnaire (EDE-Q), the Acceptance and Action Questionnaire (AAQ-16), and the Self-Concealment Scale (SCS). Data were collected via Qualtrics software and analyzed in SPSS using Hayes PROCESS models. Findings included the following. Among a sample of eating-disordered individuals, the less (more diminished) psychological flexibility they reported, the more severe the reported eating-disorder symptoms; in other words, an inverse relationship was found. Additionally, the greater self-concealment participants reported, the more severe were their reported eating-disorder symptoms. These findings held up for overall severity of reported symptoms and also for subscale severity for eating restraint, eating concern, weight concern, and shape concern. Additionally, a moderated mediation model found that greater self-concealment, diminished psychological flexibility, and no treatment were all significantly related to increases in eating-disorder severity. This model also found a significant interaction between psychological flexibility and eating-disorder severity moderated by treatment condition. That is, the extent to which someone self-conceals helps to explain the relationship between psychological flexibility and severity. Furthermore, whether a patient has been in treatment significantly relates to the relationship between psychological flexibility and severity. Implications of these findings are discussed, including a focus on emotion-regulation models of eating disorders and the rationale for adopting a transdiagnostic understanding of eating pathology. Recommendations are proposed for clinical practice, including expanding the utilization of therapies such as Acceptance and Commitment Therapy (ACT) and Dialectical Behavioral Therapy (DBT) for eating disorders, which specifically target psychological flexibility and self-concealment in the hope of preventing future relapse.

Afrikaans: Hierdie proefskrif wil vanuit navorsing met "n postmoderne, pastoraal-narratiewe aanslag iets vertel rondom seksueel-verwante geheime. In hoofstuk 1 val die soeklig op 'n verduideliking van die weg waarlangs die navorsing aangepak is. Deur gebruik te maak van die ABDCE-skryfformule van "n fiksieskrywer, is ruimte geskep waarbinne narratief-gebaseerde navorsing gedoen kon word. Die navorsing word derhalwe langs die weg van aksieverhale (Action), agtergrondsbegrippe (Background), die verdere ontwikkeling van die navorsing (Development), die klimaks (Climax) en einde (Ending) ontwikkel. In hoofstuk 2 word enkele aksie-stories rondom geheime uitgebeeld. Die verhaal van Tim, asook verhale en gesprekke uit Internet-gesprekslyste en verhale uit die media met besondere klem op hedendaagse kletsprogramme, word hier weergegee. Hoofstuk 3 bied 'n agtergrond van bepaalde perspektiewe rondom aspekte soos "language games", paralogie, dekonstruksie, postmodernisme, sosiaal¬konstruksionisme en narratiewe terapie. Betekenisse wat ons handelinge lei en bepaalde vrae wat aan ons praktiese denke lewe gee, word hierin uitgelig. Hoofstuk 4 bied "n dik, breedvoerige beskrywing van menslike seksualiteit. Verhale en perspektiewe rondom seksualiteit, "eksternalisering", seksuele mites in die samelewing asook 'n beskrywing van seksualiteit vanuit die etiese, Bybelse, na¬Bybelse, sistemiese en postmoderne perspektiewe word gegee. Hoofstuk 5 bied "n dik, bree beskrywing van die gesin waarin aangetoon word dat die heIe gesin, die groter gesin sowel as die gemeenskap by geheimhouding betrokke kan wees. Perspektiewe uit die Ou en Nuwe Testament word toegelig en daar word teen verafgoding van die ideaIe gesin gewaarsku. Verbond, skepping, verlossing en pneumatologie word as 'n Bybelse benadering tot die gesinslewe geïdentifiseer. Eienskappe van die moderne gesin sowel as die sogenaamde "tweede familie" word bespreek. Die verhale van Koning Dawid en Isak se gesinne dui op die bevryding van die verlammende effek wat die verlede met sy foute op die huidige gesinslewe het. In hoofstuk ses word aandag gegee aan 'n perspektief op seksueel-verwante geheime. Die geheime seksuele wereld van adolessente word ondersoek en aandag word gegee aan geheime temas wat mag voorkom. Intensiewe aandag word ook gegee aan die posisie van die terapeut in gevalle waar geheimhouding in terapeutiese sessies ter sprake kom. Hoofstuk sewe bied 'n samevattende kritiese refleksie op die navorsing, enkele gevolgtrekkings word gemaak vanuit my eie ervaring rondom die bepaalde navorsing. English: This dissertation attempts to relate something on sexual-related secrets from a postmodern, pastoral-narrative perspective. In chapter one the focus is on an explanation of the manner in which the research is done. By using the ABDCE-formula of an author of fiction, a space is created in which narrative-based research could be done. The research develops through action stories, background concepts, further development, climax and the end. Action stories concerning secrets characterize chapter two. The story of Tim, as well as stories and conversations from Internet discussion lists and stories from the media with the accent on current chat shows are shared. Chapter three supplies a background of certain perspectives on aspects like language games, paralogy, deconstruction, postmodernism, social constructionism and narrative therapy. Meanings guiding our actions and certain questions which gives life to our practical thoughts, are highlighted. Chapter four provides a thick description of human sexuality. Stories and perspectives on sexuality, externalization, sexual myths in the community as well as a description of sexuality from ethical, Biblical, post-Biblical, systemic and postmodern views are given. Chapter five gives a thick description of the family and shows that the entire family, the larger family as well as the community could be involved in secrecy. Perspectives from the Old and New Testament are shared and a warning against idolisation of the ideal family is made. Covenant, creation, salvation and pneumatology are identified as a Biblical approach to family life. The modern family, its characteristics and the so-called "second family" are under discussion. The stories of King David's as well as Isaac's families bring deliverance of the paralysing effect that the past with its mistakes might have on family life in its present form. Attention is focused on a perspective on sexual-related secrets in chapter six. The secret sexual world of the adolescent is investigated and special attention is paid to secret themes which might occur. Intensive attention is also paid to the position of the therapist regarding secrecy in therapeutic sessions. Chapter seven gives a summarized critical reflection on the research. This includes my conclusions from own experience gained in the process. / Thesis (PhD (Practical Theology))--University of Pretoria, 2006. / Practical Theology / unrestricted