This ethnographic study explores the everyday experiences of recovery from an eating disorder. The fieldwork took place in Toronto and Ottawa, Ontario, Canada over a 4 month period in 2013. It involved interviews and participant observation with 12 women who were in various stages of recovery, as well as a reflexive component based on the researcher’s own experiences of recovery. The aim of the study was to uncover what it meant to recover from an eating disorder in terms of everyday eating. Specifically, “How did those in recovery learn to eat?” and “Were they learning to eat in an ‘ordered’ way?” The findings reveal there is a complex and challenging route to ‘ordered’ eating in Canadian society. Contemporary dietary practices compete for authority and popularity while simultaneously offering completely different ways of relating to and knowing food. Those in recovery are therefore lost in a maze of options telling them how to eat ‘right’ which further isolates them. The study shows however that learning to eat in recovery is not about eating in an ‘ordered’ way but more so about situating one’s self in contexts and within relationships; moving with food. It suggests that a way of moving forward in recovery is to let go of the correct ‘order’ to eating and to move forward in its continual making and unmaking.

Emerging adult college women are at particular risk for developing unhealthy eating habits. Despite this, methods of intervention in this population are understudied. This study sought to test whether an implicit, cognitive retraining program could alter how women approach foods. Specifically, the researcher wanted to determine if the Behavioral Activation System (BAS), which encourages individuals to approach positive goals, and the Behavioral Inhibition System (BIS), which helps individuals avoid negative outcomes, could be manipulated. Thus, this study examined whether a dot-probe retraining program could significantly alter women’s approaches to healthy foods. Dot-probe programs present two pictures side-by-side; when the pictures disappear, a stimulus, in this case a “+”, appears where one of the pictures was previously located. In this project, participants assigned to an experimental training program would have the “+” located under healthy foods most of the time, in order to encourage BAS activation and approach behaviors. In addition, because it is imperative to understand how women’s families affect their thin ideal internalization (i.e., drive for thinness and restraint) and their approach/avoidance habits, the quality of past and current parent-daughter relationships were examined. Indeed, no known research has examined how the parent-child relationship may affect BAS/BIS usage. Forty emerging adult women were recruited; half were assigned to an experimental training group, while the other half completed a sham training group, in which they equally reacted to all foods. Participants were asked to complete five sessions on their own devices, in their chosen environment. By the final training sessions, those in the experimental group (n = 15) reacted to healthy foods two times faster than those in the sham group (n = 15). In addition, a series of moderation analyses found that, even when participants had high levels of thin ideal internalization, positive parenting characteristics such as a current high-quality mother-daughter relationship and past low paternal control improved participants’ reaction times to healthy foods. These findings suggest that a combination of both a biologically-based method of intervention and a family systems intervention may lead women to have healthier approaches to foods, thereby potentially preventing the development of unhealthy eating habits.

This study compared the prevalence of eating disorder behavior between collegiate athletes (n = 206) and college female nonathletes (n = 197). Numerous eating disorder studies conducted on the female college population have shown this population to be at greater risk of developing eating disorders than the general population. Furthermore, some studies have found that women athletes are even at higher risk of eating disorders, but the research has produced conflictual and inconclusive evidence. In this study, it was hypothesized that athletes would have higher rates of disordered eating. However, a reverse outcome occurred. The t-test conducted on the EAT-26 scores from the two groups showed that the nonathletes females displayed significantly higher eating disordered behavior than the female athletes. Additionally, relationships between sports advocating body leanness as possible risk factors of eating disorders were investigated and no significance was found. The study did find a link between age and eating disorder behavior among nonathletes. Traditionally, it has been assumed that collegiate female athletes are more likely to develop an eating disorder because of the intense training and performance demands that are added to the normal stressors of college life. This study challenges this assumption. The implications from the current study suggest additional research is needed to further investigate the specific environmental elements that may predispose subpopulations of college women to develop eating disorders. / Ph. D.

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En idrottslärare behöver mer kunskaper och förståelse angående elever med ätstörningar. / A Sportteacher need more knowledge and understanding concerning students with eating disorders.

Thesis (Ph.D.)--Boston University / Research suggests that "eating disorder not otherwise specified" (EDNOS) is particularly prevalent among individuals with borderline personality disorder (BPD). However, longitudinal data concerning course and predictors of outcome among different subtypes of EDNOS are scarce, particularly with comorbid BPD. The purpose of this study was to examine the longitudinal course of ED NOS subtypes and baseline predictors of outcome of ED NOS over 1 0 years of prospective follow-up in borderline patients. Two hundred and ninety patients who met Revised Diagnostic Interview for Borderlines (DIB-R) and Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition, Revised (DSM-111-R) criteria for BPD were followed prospectively over 10 years. Five subtypes of Structured Clinical Interview for DSM-111-R Axis I Disorders (SCID-1) diagnosed EDNOS were identified: subthreshold anorexia nervosa (AN) above the low-weight cut-off; subthreshold AN without loss of menses, subthreshold bulimia nervosa (BN); binge eating disorder (BED); and purging disorder. At baseline, 20% of the sample met criteria for an EDNOS subtype. In the first study, generalized estimating equations were first conducted to determine the prevalence of EDNOS subtypes over time. We used Kaplan-Meier survival analyses to examine time-to-remission, recurrence, and new onsets of the EDNOS subtypes. In the second study, baseline body mass index (BMI), socioeconomic status (SES), global assessment of functioning (GAF), social security disability income (SSOI), polypharmacy, and severity of childhood neglect, sexual abuse, and "other abuse" (e.g., physical, verbal, emotional) were examined as predictors of the course of EDNOS. Findings from the first study indicate that over time, rates of EDNOS were observed to decrease, and remissions were common. Among the EDNOS subtypes, BED was observed to have a particularly slow rate of remission and moderate rates of new onsets. Subthreshold AN without low weight had high rates of recurrence and new onsets. Findings of the second study indicate that borderline patients with EDNOS who were receiving SSDI at baseline were less likely to experience a remission of EDNOS and more likely to experience a recurrence. Additionally, severity of childhood adversity predicted new onsets of EDNOS. Findings suggest that receiving SSOI and severity of childhood adversity importantly impact the course of EDNOS in BPD.

Der Essstörungen im Kindesalter-Fragebogen (Eating Disorders in Youth-Questionnaire; EDY-Q) ist ein aus 14 Items bestehendes Instrument zur Erfassung von restriktiven Essproblemen bei 8-13-jährigen Kindern im Selbstbericht. Die Items basieren auf den Kriterien der Störung mit Vermeidung oder Einschränkung der Nahrungseinschränkung (Avoidant/Restrictive Food Intake Disorder; ARFID), definiert im Diagnostischen und Statistischen Manual Psychischer Störungen, 5. Auflage (DSM-5; American Psychiatric Association, 2013), auf den „Great Ormond Street“-Kriterien (Bryant-Waugh & Lask, 1995) und auf der Literatur zu restriktiven Essproblemen mit Beginn im frühen Lebensalter. Zwölf der 14 Items des EDY-Q erfassen Symptome von ARFID, inklusive der drei vorgeschlagenen Varianten (Bryant-Waugh, Markham, Kreipe & Walsh, 2010) Nahrungsvermeidung mit emotionaler Störung (food avoidance emotional disorder; FAED), selektives Essen (selective eating; SE) und funktionelle Dysphagie (functional dysphagia; FD). Zwei zusätzliche Items erfassen Pica und die Ruminationsstörung, zwei weitere Fütter- und Essstörungen mit Beginn im frühen Lebensalter, die im DSM-5 beschrieben sind (American Psychiatric Association, 2013).

The Eating Disorders in Youth-Questionnaire (EDY-Q) is a 14-item instrument for assessing early-onset restrictive eating disturbances in 8-13 year old children via self-report. The items are based on: the criteria for Avoidant/Restrictive Food Intake Disorder (ARFID) in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5; American Psychiatric Association APA, 2013); the Great Ormond Street criteria (Bryant-Waugh & Lask, 1995); and literature on early-onset restrictive eating disturbances. The EDY-Q consists of fourteen items, twelve of which cover ARFID symptomatology, including its three proposed variants (Bryant-Waugh, Markham, Kreipe & Walsh, 2010), food avoidance emotional disorder (FAED), selective eating (SE), and functional dysphagia (FD). Two additional items briefly address Pica and Rumination Disorder, two other early-onset feeding or eating disorders described in the DSM-5 (APA, 2013). The English version of the EDY-Q was translated from the German version (van Dyck & Hilbert, 2016) by AH. This translation was controlled by a retranslation procedure through a licensed translator.

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