The diploma thesis deals with anorexia nervosa as one of the basic forms of eating disorders, with emphasis on the very common chronic progression of this serious psychiatric illness. This thesis is based on the scientific fact, that conspicuous eating habits, constant control of thinking and behavior, as well as self-perception disorders, are observed in most cases, even in already cured patients. Long-term stress in common with a prone personality, can result in the acute phase of anorexia nervosa. The diploma thesis is qualitatively focused. The chosen methods of data collection are a questionnaire survey and a following semi-structured interview. The condition for participation in the research is the past experience with anorexia nervosa, without the current presence of the acute phase of this disease. The main goal of the diploma thesis is to map the burning issues of individuals who have gone through the acute phase of anorexia nervosa in the past, their current feelings and needs. The output of the diploma thesis are the specific recommendations, coming from the results of research survey, which would help to reduce the probability of relapse of the acute phase of mental anorexia in stressful situations. KEYWORDS Anorexia nervosa, eating disorders, chronicity, relapse prevention, addictive...

The most common eating disorders (EDs) according to DSM-5 are anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). These disorders have received increasing attention in psychiatry due to rising prevalence and high morbidity and mortality. The diagnostic category “anorexia nervosa,” introduced by Ernest-Charles Lasègue and William Gull in 1873, first appears a century later in a German textbook of psychiatry, authored by Gerd Huber in 1974. However, disordered eating behavior has been described and discussed in German psychiatric textbooks throughout the past 200 years. We reviewed content regarding eating disorder diagnoses but also descriptions of disordered eating behavior in general. As material, we carefully selected eighteen German-language textbooks of psychiatry across the period 1803–2017. Previously, in German psychiatry, disordered eating behaviors were seen as symptoms of depressive disorders, bipolar disorder or schizophrenia, or as manifestations of historical diagnoses no longer used by the majority of psychiatrists such as neurasthenia, hypochondria and hysteria. Interestingly, 19th and early 20th century psychiatrists like Kraepelin, Bumke, Hoff, Bleuler, and Jaspers reported symptom clusters such as food refusal and vomiting under these outdated diagnostic categories, whereas nowadays they are listed as core criteria for specific eating disorder subtypes. A wide range of medical conditions such as endocrinopathies, intestinal or brain lesions were also cited as causes of abnormal food intake and body weight. An additional consideration in the delayed adoption of eating disorder diagnoses in German psychiatry is that people with EDs are commonly treated in the specialty discipline of psychosomatic medicine, introduced in Germany afterWorld War II, rather than in psychiatry. Viewed from today’s perspective, the classification of disorders associated with disordered eating is continuously evolving. Major depressive disorder, schizophrenia and physical diseases have been enduringly associated with abnormal eating behavior and are listed as important differential diagnoses of EDs in DSM-5. Moreover, there are overlaps regarding the neurobiological basis and psychological and psychopharmacological therapies applied to all of these disorders.

Editorial on the Research Topic. Extreme Eating Behaviours.

Research suggests that, similar to individuals with an Autism Spectrum Disorder, people with Anorexia Nervosa demonstrate an inability to utilize Theory of Mind concepts. Theory of Mind allows healthy control populations to attribute mental states to others by accurately predicting and understanding the behavior of others. This study's intent was to further explore the relationship between eating disorders and Theory of Mind. Using an online survey management system (Qualtrics), 210 female students from a large metropolitan southeastern university completed the Drive for Thinness subscale of the Eating Disorder Inventory and the Reading the Mind in the Eyes task. It was predicted that higher Drive for Thinness would be associated with a diminished capacity for Theory of Mind concepts. Using a bivariate correlation, the findings were not found to be statistically significant in support of the hypothesis, but provide strong implications for future research.

Introduction. Anorexia nervosa (AN) is an eating disorder with one of the highest mortalityrates of all psychiatric illnesses. One county hospital in Sweden has seen an increase in theprevalence of adolescent AN over the last year. To meet these heightened demands, thecounty’s child and adolescent psychiatric (CAP) clinic established a new level of care for thesepatients. The main component of the intervention was mealtime support. Aim. The aim of the study was to evaluate the experiences of adolescent patients and theirparents regarding a day-patient treatment for AN in a county hospital in Sweden. Methods. Patients and their legal guardians were interviewed separately or in dyads, accordingto their wishes. An interview guide with open-ended questions was used. The audio files weretranscribed verbatim, and the texts were then studied with inductive content analysis. Fivepatients and nine parents from seven different families participated in the study. Results. The participants painted a nuanced picture of the intervention. The four overarchingthemes that emerged were ambivalence, distinguishing the person from the disease, parentalstruggling and perceptions of the treatment and the staff. Strict rules around food combinedwith an empathetic and flexible attitude towards the child were described as successful carestrategies. The treatment was depicted as time-consuming and strenuous, but parents alsoexperienced the intervention as relieving. Conclusions. The intervention was for the most part experienced as well-functioning, and theintensive nature of the treatment was described as a key factor.

Depuis les dernières années, le taux d’hospitalisation d’adolescentes avec de l’anorexie mentale (AM) est à la hausse (ICIS, 2022). Si non traitée, l’AM peut mener à une détérioration continue de la santé physique et psychologique (Herpertz-Dahlmann et Dahmen, 2019). Par conséquent, l’accompagnement et l’établissement d’une relation thérapeutique sont nécessaires pour favoriser le rétablissement. Toutefois, en les accompagnant, les infirmières peuvent faire face à de nombreux défis. Notamment, devant la nature de l’AM et la complexité des soins, certaines infirmières peuvent vivre une expérience d’accompagnement particulière. Par conséquent, afin d’avoir une meilleure compréhension du vécu des infirmières, à l’aide d’un examen de la portée, le but de cette recherche est de décrire les éléments pouvant influencer l’expérience des infirmières travaillant auprès de la clientèle pédiatrique hospitalisée pour de l’anorexie mentale. Les bases de données sollicitées sont PubMed, MEDLINE, All EBM, PsycINFO, Google Scholar et CINAHL. Au total, 15 articles majoritairement qualitatifs ont été retenus. Pour la plupart, les articles provenaient d’Australie, des États-Unis et du Canada. Parmi les résultats, les infirmières peuvent vivre un sentiment d’inefficacité, d’incompétence, et d’impuissance, de l’inconfort, de l’incertitude et de l’anxiété, de la tristesse, de l’indifférence, de la perte d’espoir, de la frustration et de la trahison, de l’épuisement, mais aussi de l’empathie, de la satisfaction et de la joie. Ce vécu émotif est le reflet de nombreux éléments liés à l’environnement, liés à l’AM, liés aux soins et liés à l’infirmière. À la lumière des résultats, de nombreuses recommandations pertinentes pour les sciences infirmières ont émergé et elles ont notamment comme objectifs de conscientiser les infirmières à ce vécu émotif qu’elles pourraient vivre lors de l’accompagnement qui se vit à travers les soins et la relation thérapeutique. / In recent years, the hospitalization rate of adolescents with anorexia nervosa (AN) has been increasing (ICIS, 2022). If left untreated, AN can lead to continued deterioration of physical and psychological health (Herpertz-Dahlmann & Dahmen, 2019). Therefore, support and the establishment of a therapeutic relationship are necessary to promote recovery. However, in providing support, nurses may face numerous challenges. Specifically, given the nature of AN and the complexity of care, some nurses may live a unique experience of care. Consequently, to gain a better understanding of nurses' experiences, using a scoping review, the purpose of this research is to describe the factors that may influence the experience of nurses working with pediatric patients hospitalized for AN. The databases searched include PubMed, MEDLINE, All EBM, PsycINFO, Google Scholar, and CINAHL. A total of 15 primarily qualitative articles were selected. Most articles were from Australia, the United States, and Canada. Among the findings, nurses may experience feelings of inefficacy, incompetence, and powerlessness, discomfort, uncertainty, and anxiety, sadness, indifference, loss of hope, frustration, and betrayal, exhaustion, but also empathy, satisfaction, and joy. This emotional experience reflects many elements related to the environment, AN, care, and the nurse. Considering the results, numerous relevant recommendations for nursing sciences have emerged, with the main objective being to raise awareness among nurses of the emotional experiences they may encounter during support provided through care and therapeutic relationships.

To gain a better understanding of those struggling with severe eating disorders (anorexia nervosa and bulimia nervosa), the inner life-world and subjective experiences of therapy clients were explored within the South African context. This was an empirical qualitative study. Specifically, the study’s focus was on the psychological construct of perfectionism as experienced during the respondents’ treatment resistant eating disorders. The two objectives of the research were to describe and explain perfectionism, which served to increase an overall improved understanding of perfectionism. The study’s methodology encompassed a combination of phenomenological- and grounded theory methodology, exploring the narratives of six female candidates that were undergoing individual therapy for their eating disorders. These candidates were considered to have a treatment resistant eating disorder, because they had been struggling with this diagnosis for longer than a decade, and/or had previously received multiple treatment interventions without recovering. The therapy sessions were recorded via digital audio recordings, and used in the data analysis process. The discourses pertaining to the study’s focus were transcribed and analysed using phenomenological- and grounded theory methods. The phenomenological analysis produced individual descriptions of the participants’ experiences of their perfectionism, as well as a general description for perfectionism. The grounded theory analysis produced an emerging theory in the form of a cognitive schema. This schema was named The Perfectionistic Eating Disorder Self-schema (PEDSS), and explains the inner psychological process of perfectionism within a treatment resistant eating disorder client. The results of this study, in particular the PEDSS, has implications for those trying to understand, assist, and treat those who suffer from treatment resistant eating disorders, as well as helping those who struggle with perfectionism to understand their own problem more. / Psychology / D. Phil. (Psychology)

This dissertation has multiple goals. First to analyze self-destructive behavior and its relations to ethics. Secondly to evaluate four different ethical perspectives regarding self-destructiveness from a certain position of human nature. The third goal is to construct a position that deals with self-destructive behavior in a way that is improved and well-managed compared to the four ethical perspectives analyzed earlier. The first goal is met by comparing and evaluating different theories concerning self-destructive behavior and discussing the ethical implications surrounding them. Self-destructive behavior is seen as a way of communicating, which puts a moral pressure on both the self-destructive person and the society around her. The four ethical perspectives represented by Robert Nozick and Thomas Szasz, two neoliberals, James B Nelson, a body theologian inspired by Paul Tillich, Gail Weiss, a body feminist and Mary Timothy Prokes, a catholic body theologian, are hence met by the problem of self-destruct, analyzed and critically evaluated. In the final chapter the author constructs an improved ethical perspective concerned with self-destructiveness, based on altruism, responsibility and broad-mindedness.

1 ABSTRACT The master thesis deals with the eating disorders and foreknowledge of high school physical education teachers of this disease. The thesis is divided in the theoretical part and the practical part. The theoretical part includes remarks from scientific literature and it is concerned with anorexia nervosa, bulimia nervosa and eating disorders not otherwise specified. Research was carried out by interviewing secondary teachers. The aim of research was to find out whether the pedagogues know what the eating disorders are, what are their potential causations, possibilities of prevention and competency of teachers for solving these disorders. The results indicate that physical education teachers have only basic knowledge about eating disorders. In view of the fact of these and other findings, a draft of activities for teachers who solve the eating disorders has been developed.

The diploma thesis deals with eating disorders, especially anorexia nervosa. The theoretical background gives a complex picture of this issue and puts mental anorexia in a broader psychological context. The aim is to clarify myths and preconceptions related to anorexia nervosa, to stress the importance of family environment for disorder's origin, course and prevention, and to show current state of treatment in the Czech Republic. These aspects are verified by the survey, based on how women with mental anorexia perceive this disorder.