This master's thesis deals with the topic of social causes of bulimia nervosa. In the first part of my thesis I focus on the theoretical introduction. I present the matter of eating disorders in general, which I consider to be an important basis for another part of my work. I am dealing here with the general introduction - what are eating disorders, which eating disorders are known to us, I introduce their causes, consequences, sexuality issues in patients with eating disorders and, last but not least, eating disorders in men and children. For a better understanding of the disease, the theoretical introduction is supplemented by brief client testimonials from my practice. In the next part of the thesis I deal with the topic itself, the social causes of bulimia nervosa. I focus on the issue of the family and its possible influence on the origin of the illness. Furthermore, the influence of society as such, especially the relationship of society to the ideal of beauty and the development of the ideal of beauty in history. I explore the influence of the printed media, television, advertising on bulimia nervosa as well. The last part of my work is a qualitative survey. It consists of three case studies and an interview with four respondents.

Introduction: Results of previous studies have shown a significant association be- tween alcohol abuse and eating disorders which often co-occur as a comorbidity. The co-occurrence of these diseases brings significant medical, social, and psychological complications and predicts a worse course of both disease and outcomes. Objectives: The aim of this thesis is to verify the association between the alcohol abuse and eating disorders by detecting the prevalence of anorexia nervosa, bulimia nervosa and binge eating disorder in women who are receiving the treatment for alcohol abuse. Methods: The survey includes 51 women hospitalized for alcohol abuse in PN Bohnice. The data were obtained during the questionnaire survey using the Munich Eating Disorder Questionnaire (Munich ED-Quest) and the Alcohol Use Disorders Identifi- cation Test (AUDIT), supplemented by socio-demographic questions. The data were analyzed using descriptive statistics in SPSS. Results: In total, 25.5% of respondents suffer from eating disorders at some point. Currently, 9.8% of women with an average age of 38.6 years with a median of 40 years suffer from eating disorder. In the past, 23,5% of respondents were affected by eating disorders. For the current period, 1.96% of women have met the diagnostic criteria for anorexia nervosa and...

Syftet med denna kvalitativa studie är att närmare undersöka den fronetiska kunskapen kring vad det är iterapeutisk behandling som hjälper människor i riskzonen att utveckla eller redan har utvecklat långvariganorexi. Genom tre material – min teoretiska och praktiska kunskap och tidigare kvalitativa forskning, enfallstudie från den kliniska verksamheten vid Anorexiamottagningen i Stockholm samt en fältstudie medintervjuer med en forskare och fem terapeuter från två olika enheter. Denna studie utforskar gemensammanämnare i behandling med särskilt fokus på vikten av terapeuternas perspektiv. Informanterna har ett holistisktperspektiv och arbetar med olika existentiella, integrativa och systemiska modeller. Det som står ut iinformanternas svar, och som bekräftas av familjen och klientens egen röst, är att personen bakom symtomentonas fram – särskilt inför sig själv – och att sjukdomen tonas ner. Viktigt är också att terapeuterna kan förmedlabåde sin tro på att det är en mänsklig möjlighet att bli fri från anorexi och att det även finns anledning att tro påden enskilda klientens möjligheter att återhämta sig. Andra teman av betydelse är hur man hanterar ångest,negativa självbilder, ambivalens och rädsla för förändring och hur man inviterar till reflexion över alternativasätt att komma vidare i livet utan sin ”bästa” vän Anorexia. Denna studie föreslår mitt material och familjernasberättelse och informanternas bidrag tillsammans frambringar en kollektiv fronetisk kunskap. Det öppnar för attfortsatt forskning går vidare med de aspekter som diskuteras i slutreflektionen. / The aim of hisqualitative study is to examine more closely the fronetic knowledge of what it is in a therapeutic treatment thathelps people who are on the edge to develop, or already have developed, long term anorexia. Through threematerials –my own theoretical and practical knowledge and previous qualitative research, one case study fromthe clinical praxis at the Anorexiamottagningen in Stockholm and one field study where one researcher and fivetherapists from two different unities are interviewed. The study has explored common denominators in treatmentwith special focus on the importance of the therapists ́ perspective. All informants have a holistic view and workwith different existential, integrative and systemic models. What stands out in the answers of the informants, andis confirmed by the family and the voice of the client, is that the person behind the symptoms is tuned up –especially for herself – and the illness is downplayed. It is also important that the therapists can mediate boththeir belief that it is a human possibility to become free from anorexia and that there is also good reason tobelieve in the possibility for the individual client to recoup. Other themes of importance are how to deal withanxiety, ambivalence, negative self-images and fear of change, and how to invite to reflection on alternativeways to proceed in life without their “best” friend, Anorexia. This study suggests that my material together withthe account of the family and the contribution of the informants at the treatment units and bring forth aconsiderable amount of collective phronetic knowledge. This suggests that future research look further into someof the aspects discussed in the final reflection.

Eating disorders can lead to a negative impact on students' academic growth, nutrition and can cause death (Claude-Pierre, 1997; Manley, Rickson, & Standeven, 2000; Romeo, 1996). Early intervention by referring students to professional counseling might help counter these negative consequences. The teacher is in the position to assist students by providing health information, identifying those with problems, and intervening for a variety of dysfunctions that may include the eating disorders called anorexia nervosa and bulimia nervosa (Myers-Clark & Christopher, 2000). However teachers are in a difficult position to know when to address student concerns and judge what action to take (Ransley,1999). Teachers' engagement seems crucial (Smolak, Harris, Levine, & Shisslak, 2001) since eating disorders are being identified in younger children.The purpose of this study was to examine (a) the relationships of the theoretical constructs, attitude, subjective norm, and perceived behavioral control of the theory of planned behavior as predictors of behavioral intention (Ajzen & Fishbein, 1980) of middle school teachers to identify and refer suspected anorexia nervosa (AN) and/or bulimia nervosa (BN) students for professional help; and (b) the actual behavior of middle school teachers who reported having ever referred a student suspected of having AN and BN and those teachers who reported not having made such a referral. One hundred fourteen middle school teachers in Broward County, Florida volunteered to participate in the ex post facto research. Data were collected from a questionnaire. Multiple regression analysis revealed that the constructs of subjective norm (perception of what others think about one's performance of behavior combined with motivation to comply) and perceived behavioral control (perception regarding the extent of the difficulty of performing the behavior) were predictive of teachers' intent (likelihood of engaging in a behavior) to refer. However, the analysis revealed that attitude (overall positive or negative feeling with respect to performing the behavior) was not predictive of teachers' intent. Discriminant function analysis revealed that both intent and perceived behavioral control were predictive of group membership, either having referred a student suspected of having an eating disorder for counseling or not having made such a referral. Attitude and subjective norm were not predictive of group membership.

No description available.

This project discusses the problem of eating disorders in dancers. The development of eating disorders can be attributed to sociocultural development, and psychological factors. Dance places an emphasis on thinness, and the pressure to obtain ideal standards of thinness appear to be particularly salient in the development of eating disorders in dancers.

Objective: Body image disturbance is one of the main characteristics of anorexia nervosa (AN). It is present in different stages of the disease, often persisting even after the end of the treatment, and is one of the predictors of a relaps. Body image is composed of two main components - the perceptual component, and the attitudinal component. Anorexia nervosa patients show a disturbed attitudinal component of the body image. The perceptual component disruption hasn't been completely proven yet. Many authors do, however, warn about the overestimation of bodily proportions of patients with AN and it's possible relation with characteristics such as BMI. Goals: The main goal of the dissertation thesis was the objectivization of the body image disturbance of the patients hospitalized with anorexia nervosa, the comparison of their results with a group of healthy girls of the same age, and the search for factors connected to the defect of the body image. A side goal of the dissertation thesis was the measurement of the effect of kinesiotherapy on the anxiety level of AN patients. Methods: As a part of the practical section, the measurements of 27 hospitalized patients and 20 healthy girls were completed. Probands underwent body size estimation of 4 bodily segments. They estimated the length of their arm,...

Anorexia nervosa (MA) is serious psychiatric disease associated with significant mortality. One of the main causes of mortality in these patients is cardiac complications. In 2003 - 2010 we examined 30 patients with established diagnosis of MA. Routinely used nutritional parameters are normal even in severe malnutrition in MA patients and we can ́t use them to diagnose or monitor nutritional status. Therefore we evaluated plasma aminoacids levels to detect minor changes of protein metabolism. According to our results we found mild hyperaminoacidemia and significant elevation of Gly/Val and Phe/Tyr ratio. In the second part of our research we performed non invasive examination s in risky patients with AN to consider possible cardiac complications. Results of ECG and echocardiography confirm results of the previous published studies. Original finding is significant decrease in flow mediated dilatation of brachial artery and its normalization after realimentation. We found also in ambulatory blood pressure monitoring significant decrease in blood pressure during the active period which was the consequence of changes in the heart rate variability. Decrease of the blood pressure in patients with AN in standing position was associated with increase of HF power in supine position and particularly with the lack of...

Cette recherche porte sur l’impact et la caractérisation des difficultés socio-affectives dans l’anorexie mentale (AM). Les difficultés intéroceptives et introspectives, telles qu’appréhendées par des mesures d’alexithymie, pourraient être liées à la sévérité des tableaux cliniques des AM et impacter non seulement leur état somatique mais également leur fonctionnement interpersonnel. Par ailleurs l’alexithymie et l’évitement social sont des déficits retrouvés dans les troubles du spectre autistique. L’Institut de Psychiatrie de Londres a d’ailleurs proposé un modèle mettant en cause un partage d’endophénotypes entre ces troubles et l’anorexie mentale qui rendrait compte de leur chevauchement phénotypique. Le manque de flexibilité et de cohérence centrale font l’objet d’une littérature grandissante et semblent bien être commun aux deux pathologies. Des difficultés socio-affectives communes sont aussi discutées, mais encore peu étudiées. Un axe de notre travail a été d’étudier les liens entre l’alexithymie, les facteurs cliniques (e.g âge de début, durée d’évolution, nombre de rechutes, évolution de l’état globlal) et l’anxiété sociale en prenant en compte d’éventuels facteurs de confusion mis en cause dans la littérature (état nutritionnel,, affects anxio-dépressifs). Le deuxième axe de notre travail a porté sur la caractérisation du chevauchement existant entre les troubles du spectre autistique et l’anorexie mentale en comparant les profils socio-affectifs d‘anorexiques et de personnes atteintes du syndrome d’Asperger. Pour répondre au premier axe de recherche, nous avons réalisé deux études : une 1ère auprès de 60 patientes ; une 2ème auprès de 213 patients. Les sujets des deux études étaient des patients hospitalisés pour un épisode d’anorexie dans une unité spécialisée dans la prise en charge des troubles des conduites alimentaires. La première étude a porté sur une population homogène d’adolescentes anorexiques, malades depuis moins de 3 ans et toutes hospitalisées dans le même centre parisien. La participation à la deuxième étude a été proposée à tous les patients âgés de 13 à 65 ans hospitalisés pour un épisode d’anorexie au sein de 11 services spécialisés en France. Pour les deux études, nous avons utilisé les scores à des instruments psychométriques mesurant l’alexithymie (TAS-20 ou BVAQ), la symptomatologie alimentaire (EDI, ou EDE-Q et EAT) et les affects anxio-dépressifs (SCL-90 ou HAD). L’état global des patients, l’anxiété et l’évitement social ont été évalués lors d’entretiens semi-structurés (respectivement Morgan et Russell, LSAS). De ces deux études, il ressort que l’alexithymie semble jouer un rôle péjorant, non seulement sur les symptômes alimentaires, mais également sur l’évitement social. L’impact de l’alexithymie existe au-delà de l’effet de l’état nutritionnel et des affects dysphoriques. Le fonctionnement alexithymique semble par ailleurs influencer négativement l’évolution de l’état clinique des personnes ayant nécessité une hospitalisation pour anorexie mentale dans une unité spécialisée. Pour répondre à notre deuxième axe de recherche, nous avons réalisé une étude psychométrique comparative auprès de 15 personnes présentant un Syndrome d’Asperger, 15 anorexiques et deux groupes de témoins appariés à chaque groupe clinique. Nous avons utilisé des entretiens semi-structurés pour confirmer les diagnostics du Syndrome d’Asperger et d’AM (ADOS et MINI). Les participants ont complété des échelles d’alexithymie (BVAQ), de traits autistiques (AQ), d’empathie (IRI, EQ), de dépression (BDI) ainsi que de symptomatologie alimentaire (EAT). Cette étude comparative montre que les anorexiques se rapprochent des personnes souffrant du Syndrome d’Asperger en ce qui concerne l’alexithymie et certains traits autistiques, notamment cognitifs. (...) / This work concerns the impact and the nature of socio-affective difficulties in Anorexia Nervosa (AN). Interoceptive and introspective difficulties, as apprehended by measures of alexithymia, could be linked to the severity of clinical profiles among AN patients, and have an impact not only on their somatic state but also on their interpersonal functioning.Alongside, alexithymia and social avoidance are deficits that are encountered in disorders in the autistic spectrum. The London Institute of Psychiatry has indeed proposed a model involving shared endophenotypes between these disorders and AN, thus concluding to a phenotype overlap. The lack of flexibility and central coherence among these patients are issues that are being increasingly broached in the literature, and these features do indeed appear common to both pathologies. Socio-affective difficulties are also widely discussed in this respect, but as yet there have been few studies. Our first line of research was the study of the links between alexithymia, clinical factors (such as age at onset, duration of illness, number of relapses, evolution of global state), and social anxiety, taking into account any possible confounders highlighted in the literature (nutritional state, anxious-depressive affects). The second line of research was an exploration of the overlap between disorders in the autism spectrum and AN, by way of a comparison of the socio-affective profiles of AN patients and patients with Asperger's syndrome. To address the first line of research two studies were conducted. The first involved 60 female patients, and the second included 213 male and female patients. The patients in both of these studies were hospitalised for an episode of anorexia in units specialised in the care of eating disorders. The first study explored a homogenous population of anorexic adolescent girls with an illness duration of three years or more, all hospitalised in the same facility in Paris. Participation in the second study was proposed to all patents aged between 13 and 65 years hospitalised for an episode of anorexia across 11 specialised units in France. For both studies the scores used were derived from psychometric measures of alexithymia (TAS-20 or BVAQ), eating disorder symptoms (EDI or EDE-Q and EAT), and anxious-depressive affects (SCL-90 or HAD). Global state, anxiety and social avoidance were assessed in the course of semi-structured interviews (GOAS and LSAS respectively). From these studies it emerged that alexithymia appears to have an aggravating role, not only on eating symptoms, but also on social avoidance. The impact of alexithymia extends beyond that of the nutritional state and dysphoric affects. Alexithymic functioning also appears to have a negative impact on the evolution of clinical state among individuals having required hospitalisation in a unit specialised in AN. To explore the second line of research we performed a comparative psychometric study on 15 individuals presenting Asperger's syndrome, 15 anorexic patients, and two control groups matched to the two clinical groups. Semi-structured interviews were used to confirm the diagnoses of Asperger's Syndrome and AN (ADOS and MINI). The participants completed the scales for alexithymia (BVAQ), autistic traits (AQ), empathy (IRI,EQ), depression (BDI) and eating symptoms (EAT). This comparative study showed that AN subjects exhibited similarities with Asperger subjects for alexithymia and certain autistic traits, in particular cognitive. In contrast, important differences were observed for social skills, with anorexics exhibiting more empathy and greater concern for others that the patients with a disorder in the autism spectrum. From a clinical point of view in the field of the care of AN, this research shows the value of developing new approaches centred on the recognition of emotional states and the improvement of social skills. (...)

Eating disorders (EDs) cause irreversible physical damage, including organ failure and death. Although EDs receive considerable attention, the number of affected young women who seek help remains low. The purpose of this phenomenological study was to understand the sociocultural and socioenvironmental factors influencing ED development from the perspective of young women, and to explore why the rate of EDs continues to rise in this population. The sociocultural model served as a guide for the study. Ten young women 18-24 years old from Southwest Ohio participated in in-depth, semi structured, face-to-face interviews. Data coding and analysis revealed recurring themes, with findings indicating that family relationships and social media were major factors influencing young women's perceptions of personal image and attractiveness. Participants described that social media's negative portrayal of beauty leads to internalization of the thin-ideal, leading to body dissatisfaction, with subsequent negative dieting behaviors that increase the risk for eating disorder development. Family relationships were described as the main source of positive support to neutralize these external negative forces by creating environments where these young women are accepted. A combination of media, availability of fast food, and society's portrayal of beauty, had significant influences on ED development by creating "constant internal struggles" on body image, good food choices and acceptance in society. The study impacts social change by adding new information for public health program developers and policy makers that may be used to introduce ED programs in local schools that will empower these young women to seek help without fear of stigma or alienation.