Man har genom forskning inte kunnat dra någon generell slutsats angående orsaksfaktorer bakom anorexia nervosa. Alla drabbade har egna erfarenheter och tankar om varför just hon eller han blivit sjuk. Vårt syfte var att i möjligaste mån återspegla de i studien utvalda kvinnornas beskrivningar av tankar och erfarenheter kring sitt sjukdomsförlopp, utifrån familjeförhållanden och individuella faktorer. Vi ville veta vad de ansåg vara orsaken till just deras insjuknande, men också vad som var anledningen till att de slutligen bestämde sig för att bli friska. Detta syfte ledde oss till frågeställningar som: Hur kan familjen påverka ett insjuknande i anorexia nervosa? Vilka individuella faktorer kan influera? Vad ansåg de vara vändpunkten för sitt tillfrisknande? För att få en så tydlig bild som möjligt av kvinnornas tankar och erfarenheter behövde vi se en helhet, varför vi valde att göra en kvalitativ studie med djupintervjuer. I arbetet framförs tidigare forskning om familjeförhållanden och individuella faktorer som kan ha en inverkan på insjuknandet, samt om vändpunktsprocesser. Vår granskning gick ut på att tolka kvinnornas berättelser i jämförelser med den forskning vi använt oss av. I vårt resultat framkommer att berättelserna till viss del liknar varandra, och att vissa jämförelser kan ses med forskningen, men att erfarenheterna trots allt är unika och därmed skiljer sig för de fyra kvinnorna.

Fitting in is something that many strive for in today’s society. In order to do this, more or less all of us use impression management. The illness Anorexia contradicts the norms of society since eating is a fundamental need, and to refrain from this is therefore a major discrepancy. It is the impression management among anorectics we have chosen to put our emphasis on in this survey in which about ten people have been interviewed with a qualitative method. Three of these are former anorectics while the rest comes in contact with anorectic people through their profession in one way or another. We can state that anorectics prove to behave self-deceitfully. To start with, the ill person lacks insight of his/her problems and denial is not uncommon. When at last realised, the illness is often so well rooted in the identity that the ill is afraid of losing it. Due to this, he/she feels forced to hide the disease at any price. From our interviews we can see how some respondents, among other things, hid food, worked out on the sly and used laxatives.

En av de viktigaste aspekterna i omvårdnad är betydelsen av mänsklig kontakt i interaktionen mellan patienter och vårdgivare. Anorexia Nervosa är en komplex sjukdom av psykisk och fysisk karaktär och vårdpersonal spelar en viktig roll för dessa patienters tillfrisknad. Målet med denna studie var att nå en djupare förståelse för den mänskliga kontaktens betydelse i omvårdnaden av patienter med Anorexia Nervosa samt att belysa essensen i en vårdande relation. Syftet med studien var att beskriva Anorexia Nervosa patienters erfarenheter av den mänskliga kontaktens betydelse i möten med vårdpersonalen. En kvalitativ ansats valdes och datainsamlingen grundade sig på sex självbiografier, skrivna av sex unga kvinnor som har varit sjuka i Anorexia Nervosa. En kvalitativ textanalys användes för att tolka data. Åtta teman framkom i resultatet: ”att känna förtroende” ”att få hjälp med att gå till botten med problemet”, ”att inte bli förstådd”, ”att inte våga öppna sig”, ”att inte bli sedd”, ” att få bekräftelse”, ”att känna maktlöshet” och slutligen, ”att någon talar till den friska delen”. Dessa teman speglade dessa personers erfarenheter av den mänskliga kontaktens betydelse i möten med hälso- och sjukvårdspersonal. Denna studie kan bidra med att ge en ökad förståelse för den mänskliga kontaktens betydelse i omvårdnaden av patienter som lider av Anorexia Nervosa samt att hjälpa vårdpersonal att tillmötesgå dessa patienters behov.

Anorexia nervosa is a serious mental disorder with high mortality. It has the lowest prevalence compared with other eating-disorder diagnoses and the onset is related to adolescence, with a majority of female patients. The focus of this thesis is anorexia nervosa and the aim is to study adolescent and adult patients' comprehension and the course of treatment in order to make a contribution to the clinical work relating to these patients. The areas that were studied are expectations of treatment, outcome, predictors of outcome and satisfaction with treatment. Four research papers are included; three originate from work at a specialist eating-disorder unit at Queen Silvia Children's Hospital, Göteborg, Sweden and one from a multicentre study comprising 15 specialised eating-disorder units in Sweden. Paper I has a qualitative design, where participants, 18-25 years of age, were interviewed about their expectations while on the waiting list at a specialist eating-disorder unit. Three main categories of expectations emerged: "Treatment content," "Treatment professionals" and "Treatment focus." The participants expected to receive the appropriate therapy in a collaborative therapeutic relationship and to recover. Paper II evaluated the outcome of a family-based treatment for adolescent patients, 13-18 years old, and their parents. The results indicate that the treatment that is offered appears to be effective, as 78% of the patients were in full remission with less distance and a less chaotic family climate at the 36-month follow-up. Paper III examined the importance of motivation to change eating behaviour, treatment expectationsand experiences, ED symptomatology, self-image and treatment alliance for predicting weight increase in adult patients, 18-46 years of age. Patients' motivation to change eating habits, social relations, self-image, body image and duration of illness were found to predict weight increase both in both the short term (six months) and the long term (36 months). PaperIV studied adolescent patients' and their parents' satisfaction with a family-based treatment a tan 18-month follow-up. The majority of patients (73%) and parents (83%) stated that their expectations had been fulfilled and individual sessions for patients and parents respectively were of great help. Family-based treatment with a combination of individual and family sessions corresponds well to patients' and parents' treatment expectations. Young adult patients' expectations before treatment are multifaceted and should be taken into account in the therapeutic relationship. From the start of treatment, issues relating to patients' motivation, self-image, body image and social relationships should be continuously addressed in order to establish positive collaboration and a weight increase. Anorexia nervosa treatment for adolescents and their parents should be family-based and include family sessions as well as individual sessions for patients and parents. In addition, prevention programmes with the emphasis on early detection should be a prioritised area.

Women in general seem to have a complicated relationship with their bodies and their body image. A small percent of the female population develop a serious pathological eating pattern which is characterized by a disturbed image of body size and shape. This disturbance has been investigated by many researchers and the quest of finding the underlying neural correlates has progressed enormously during the last decade. The relationship between disturbed eating patterns and body image distortions is highly complicated. The purpose of this review article is to give an overview of current research literature and scientific results. The aim is to find a framework for the phenomenon of body image distortions among both healthy and non-healthy women. Differences between genders and how food intake affects body image will also be addressed. The focus lies on behavioral traits and the underlying neural correlates, with focus on both the perceptual and the cognitive-affective component.

<p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p><strong>Objective:</strong> When caring for a patient with Anorexia Nervosa (AN) it is difficult for the registered nurses to develop a good nurse-patient relationship due to a lack of understanding for the illness.  It is important for the nurse to understand the suffering that the AN patients experience, and what makes them feel better, to be able to improve the patient-nurse relationship. This study aims to explore what makes patients with AN feel better during the illness and the process of recovery.</p><p><strong>Method: </strong>A qualitative scientific approach was used. Eight autobiographies were selected as data for this study. Both English and Swedish books were used. The data was analyzed using a qualitative method of data analysis.</p><p><strong>Results:</strong> The ways patients with AN could feel better are presented in seven themes: being seen as a whole individual behind the illness, being able to trust and find security, taking responsibility for recovery, finding motivation to keep fighting towards recovery, when one's suffering is noticed, filling a void, and the strengthening of the relationship between care giver and patient. This study may help registered nurses understand the needs of the patient recovering from AN and help them meet these needs in a better way.</p> / <p><strong>Avsikt:</strong> För sjuksköterskor är det svårt att utveckla en bra sjuksköterske-patient relation när de vårdar patienter med anorexia nervosa (AN), eftersom det finns brister i deras förståelse för sjukdomen. För att kunna stärka relationen mellan sjuksköterskor och patienter är det viktigt för sjuksköterskan att förstå det lidandet som patienter med AN upplever och vad som kan lindra det.  Syftet med denna studie är att utforska vad som får patienter med AN att må bättre under sjukdomens lopp och tillfrisknandet.</p><p><strong>Metod: </strong>En kvalitativ metod valdes för att utföra studien. Sex självbiografier valdes som data till studien. Böcker skrivna på svenska och engelska användes. En kvalitativ dataanalys, enligt Dahlberg, användes för att tolka data.<strong></strong></p><p><strong>Resultat: </strong>Resultatet presenteras i sju teman: att bli sedd som en individ bakom sjukdomen, att kunna känna tillit och hitta trygghet, att ta eget ansvar för tillfrisknandet, att hitta motivation för att fortsätta kämpa mot tillfrisknandet, att ens lidande uppmärksammas, att fylla ett tomrum efter sjukdomen och att stärka relationen mellan vårdare och patient. Denna studie kan hjälpa allmänna sjuksköterskor att förstå de behov patienter med AN har och hjälpa dem att bemöta deras behov på ett bra sätt.</p>

Thesis (M.A.)--East Carolina University, 2009. / Presented to the faculty of the Department of Psychology. Advisor: Susan McCammon. Title from PDF t.p. (viewed May 3, 2010). Includes bibliographical references.

Thesis (M.A.)--Marshall University, 2002. / Title from document title page. Document formatted into pages; contains 179 p. Includes bibliographical references (p. 178-179).

This qualitative study is based on the reality that disordered eating such as anorexia nervosa, bulimia nervosa, and compulsive overeating resulting in obesity represent a major and growing problem in community health. Treatment models using cognitive behavioral therapy suggest that those diagnosed with an eating disorder tend to judge themselves in terms of their body shape, weight, and eating habits. However, the recovery rate for those treated for an eating disorder that only addresses those three issues identified above is less than 60%. A number of quantitative studies have provided evidence that other maladaptive schema may contribute to bulimic and anorexic behaviors. Fewer studies have addressed this issue in relationship to compulsive overeating resulting in obesity. This collective case study further explored and identified other maladaptive schema associated with anorexia nervosa, bulimia nervosa and compulsive overeating resulting in obesity that interfere in the long term recovery. This case study will allow the participants to express thoughts and emotions surrounding their disordered eating in their own voices. This collective case study provides evidence that persons diagnosed with disordered eating have carried early life events into adulthood and that these events have created maladaptive schema which may be interfering in their recovery process.

Body, weight and shape related obsessions and ruminations are characteristic traits of individuals with eating disorders (ED) that are found to predate the onset of the disorder. Individuals with chronic ED display altered neural activation in response to food stimuli, and are reported to have volumetric differences compared to healthy individuals, which is likely an effect of prolonged starvation. ED individuals are also seen to dispose an attentional bias to food stimuli, even when perceived sub-consciously, which are reported to interfere with cognitive tasks, including working memory (WM). However, whether the differences in neural activation and structure are present in adolescents with a recent ED diagnosis is not known. In paper I we describe how images of high- and low-calorie foods resulted in greater responses in the prefrontal circuitry in ED adolescents compared to healthy controls (HC). Obsessive-compulsive symptoms in ED individuals were associated with prefrontal circuitry and cerebellar activation, whereas faster reaction times to the WM were associated with greater superior frontal gyrus activity. The findings indicate that ED cognitions may be linked to WM abilities, both of which are associated with frontal cortex functioning. WM performance is examined further in paper II, where we found that the presence of subliminal food images were seen to disrupt WM performance in terms of slower reaction times and less correct responses in ED but not HC. The WM interference was associated with increased activity in the parietal and superior temporal cortex. WM interference caused by subliminal food stimuli may reflect a pre-attentive bias to food in adolescents with ED, which could be a risk factor for further development of an ED. The structural differences in brain volume between adolescents with ED and HC were examined in paper III. ED symptoms were found to be associated with volume differences in insular cortex and superior temporal gyrus, whereas obsessive-compulsive symptoms were associated with reduced volumes in the putamen and cerebellum. These volumetric differences in regions implicated in restraint, obsessions and WM are likely to precede structural variations caused by starvation as seen in chronic ED’s. Connectivity from these regions, in addition to other regions believed to be implicated in ED, was studied in paper IV. Fronto-parietal regions as well as the insula showed increased connectivity in ED, whereas connectivity from the mesolimbic reward regions did not differ from HC. Regions with increased connectivity in ED are involved with self-awareness, body image and ED related ruminations, connections that could influence how one’s body is perceived. In conclusion, the studies included in this thesis describes changes in functional activity, connectivity and brain volume in regions involved with ED cognitions, eating behaviour, and body image in adolescents recently diagnosed with an ED.