Background: Motivation to change is a core variable in understanding and treating women with both anorexia and bulimia nervosa. The transtheoretical model (TTM) has been put forward as a framework for the assessment and treatment of motivation to change for a variety of disorders, including eating disorders. Even though motivation and ambivalence should be assessed with regard to specific symptoms in eating disorders, there is a lack of validated measures in the German language. Due to the importance of motivation to change in women with eating disorders, several studies have used the TTM to develop, and test the effectiveness of face-to-face motivational programs for this clientele. However, no randomized controlled trial for an internet-based program enhancing motivation to change has been conducted. The present thesis aimed to establish symptom-specific measures of motivation to change and ambivalence, and to develop and evaluate an internet-based therapy program for women with eating disorders. Methods: Two observational studies and one randomized controlled trial including a total of N=460 women with eating disorders were performed. The first study tested the psychometric properties (reliability and validity) of a questionnaire assessing motivation to change in a sample of N= 63 inpatients. In the second study, the psychometric properties of a questionnaire assessing ambivalence in a sample of N =195 women with eating disorders were investigated. The third study comprised a randomized controlled trial with N =202 women assessing the effectiveness of an internet-based motivational program for women with eating disorders. The fourth study systematically investigated the dropout from this program using survival analysis. Results: In the observational studies, the questionnaires showed satisfactory psychometric properties, with good reliabilities and validities. The randomized controlled trial showed significant time x group interactions, demonstrating that the internet-based program was effective in enhancing motivation to change, and in reducing some eating disorder symptoms. However, the dropout from the program was 51 %, with participants with more severe eating disorder pathology and depressive mood being more likely to terminate the program prematurely. Discussion: The results demonstrate the feasibility of both symptom-specific assessment of motivation to change and measurements of ambivalence across eating disorder diagnoses, enabling novel research questions and supporting clinical work. Evidence for the efficacy of the internet-based program in enhancing participants’ motivation to change and reducing eating disorder symptoms support the wider adoption of such programs. The results from the dropout analysis offer new perspectives for future research on additional treatment modulesm for women at risk of terminating treatment prematurely.

To provide a basis for electroencephalography (EEG) neurofeedback protocols for bulimianervosa (BN), binge-eating disorder (BED), and obesity, this systematic review investigates alterations in EEG-measured brain activity, specifically frequency bands. A systematic literature search with pre-defined search terms yielded N = 7 studies meeting the inclusion criteria. The risk of bias was assessed for all studies. In resting-state EEG, the beta activity was elevated in fronto-central regions in individuals with obesity and comorbid BED. In food-cue conditions, both obese individuals with and without BED showed increased beta activity, suggesting increased awareness of food cues and a heightened attentional focus towards food stimuli. The level of beta activity was positively correlated with eating disorder psychopathology in resting and food-cue conditions. In individuals with BN, there was no evidence for altered EEG spectral power. The results indicate specific alterations in EEGbased brain activity in individuals with BED and obesity. More high-quality studies are needed to further confirm these findings and to transfer them into EEG-based interventions.

A dissertation submitted to the Faculty of Arts, University of the Witwatersrand, in partial fulfilment of the requirements for the Degree of Master of Arts, Clinical Psychology. Johannesburg, September 1992 / No abstract provided.

Bakgrund: Ätstörningar blir allt vanligare i samhället och drabbar främst unga kvinnor. Två av de vanligaste ätstörningsdiagnoserna är Anorexia Nervosa och Bulimia Nervosa, i båda fallen är orsakerna okända. Återhämtningen från en ätstörning kan vara en svår utmaning på grund av sjukdomens komplexitet som kan ha en negativ påverkan på det dagliga livet. Arbetsterapi kan främja återhämtningen vid ätstörning till exempel genom att tillgängliggöra meningsfulla aktiviteter. Genom att utgå från den arbetsterapeutiska teoretiska modellen Model of Human Occupation (MOHO) underlättar det för arbetsterapeuten att få en helhetsbild av människan även i komplexa sjukdomstillstånd. Syftet var att ur ett arbetsterapeutiskt perspektiv beskriva återhämtningsprocessen hos kvinnor som levt med någon form av ätstörning. Metod: En litteraturstudie för att sammanställa resultaten från tidigare forskning. Samtliga artiklar som valdes var kvalitativa och grundar sig på kvinnors upplevelser. De databaser som användes var Cinahl with full text och PsychInfo. Artiklarna analyserades utifrån Fribergs analysprocess i fem steg. Analysen gjordes deduktivt med förutbestämda teman utifrån MOHO med målet att identifiera olika upplevelser i återhämtningsprocessen. Huvudresultatet: Resultatet utgick från MOHO’s centrala begrepp: vanebildning, miljö, viljekraft och utförandekapacitet. Kvinnorna som befinner sig i eller har befunnit sig i återhämtningsprocessen upplevde att vanor, strategier och omgivningen är betydelsefull för tillfrisknandet. Slutsats: Återhämtningsprocessen av en ätstörning kan beskrivas ur ett arbetsterapeutiskt perspektiv utifrån MOHO. Vidare forskning inom arbetsterapi kan vara hur arbetsterapeutiska insatser kan tillämpas i återhämtningsprocessen av ätstörning.

No description available.

No description available.

Bakgrund: Ätstörningar finns i dagens samhälle i en stor utsträckning. Forskning visar på de allvarliga konsekvenser som uppkommer av tillstånden, både medicinskt, psykiskt och socialt. Att leva med en ätstörning skapar en stor problematik för personen som till slut inte kan kontrollera sig själv, sin vardag eller sitt liv. Trots den forskning som finns som visar hur djupgående dessa tillstånd är, så uppvisas fortfarande brister i vården och omvårdnaden av dessa personer. Syfte: Att beskriva personers upplevelse av att leva med en ätstörning. Metod: En litteraturstudie som bygger på en kvalitativ innehållsanalys med induktiv ansats på 10 vetenskapliga artiklar. Resultat: Ur analysen framställdes 5 slutkategorier: Att känna skam och skuld inför sig själv och andra, Att känna sig dömd och missförstådd av utomstående och samhället, Att använda sjukdomen som coping-strategi när de negativa känslorna tar över, Att uppleva ambivalens inför sitt destruktiva beteende och inför sin kroppsbild och Att inte kunna kontrollera sig själv och sina val. Slutsats: Att förstå att varje person med en ätstörning är unik och har olika föreliggande orsaker trots sina likheter i uttryck. Därav vikten med att inkludera alla delar av den drabbades liv för att kunna bilda sig en uppfattning om hur den drabbade kan nå återhämtning.

No description available.

This research study examined the prevalence rates and longitudinal course of eating disorder risk among undergraduate females at BYU, and compared the identified prevalence rates at BYU with identified rates at other colleges and universities. Almost 2,000 undergraduate females, in three cohort groups, filled out the Eating Attitudes Test (EAT) once a semester for four to eight semesters. Clinical cut-off scores were used to determine what percentage of participants were at high risk for eating disordered behaviors and symptomology. Overall eating disorder risk prevalence rates at BYU ranged from 9-11%. These rates were significantly lower than identified rates at other colleges and universities. The results also showed notable decreases in the percentages of women who fell in the at-risk range as participants progressed through their college years. Freshmen women had the highest risk for disordered eating behaviors.

The Eating Survey is a new screening instrument for adolescent eating disturbances. The purpose of this study was to empirically examine how the Eating Survey functions as a total screening instrument and to find a clinical cutoff score for the current 17 items. The participants were 2,569 non-clinical adolescents with a comparative sample of 41 inpatient adolescents aged 14-17. More specifically, this study examined the age and gender differences of the 2,569 non-clinical adolescent males and females. It also compared the 1,662 non-clinical females to a sample of 41 inpatient females. Specificity and sensitivity analyses were conducted to find the most efficient clinical cutoff score while maintaining a balanced approach and a high efficiency rating. The findings of the current study suggests that the Eating Survey appears to function as expected with analysis results showing trends similar to current research. A clinical cutoff score of 51 was found to be the most efficient cutoff while keeping a balanced approach regarding specificity and sensitivity. With a clinical cutoff score of 51, a 14% at-risk base rate was found, which matches both research literature and other screening instruments.