Thesis advisor: William Stanwood / This research study seeks to answer the question of whether or not televisions advertisements’ depictions of female body image influences eating disorders in the young women who view such advertisements. The role of the cognitive processes social comparison theory and thin-ideal internalization was also explored as mediators in this relationship, as well as the efficiency of various programs aimed at correcting the problem of eating disorders in young women. Results were obtained by coding and observing the advertisements of various television programs popular among such a demographic. Messages encouraging thinness were recorded, as well as the percentage of thin actresses viewed. After analyzing the results and reviewing recent research on the problem, the conclusion was made there is likely a relationship between eating disorders and the depiction of the thin-ideal in advertising, however such a relationship is largely dependent on the female viewer herself, andmany other factors. / Thesis (BA) — Boston College, 2011. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: Communication Honors Program. / Discipline: Communication.

Eating Disorders are a range of disorders marked by abnormal eating habits. These habits can often have a detrimental effect on the body and have the potential to complicate acute medical problems if they are a pre-existing condition. Due to this, it is important that members of the healthcare team be aware of the nature of these disorders from both a physical and mental health perspective in order to provide the best, most holistic care. In this study, individuals with nursing experience in acute medical and acute psychiatric care were asked 11 questions concerning the assessment and knowledge of eating disorders along with demographic information such as age, area of practice and years of experience. The results of this study showed the average score of the questions involving treatment (7-11) were higher than that of the assessment questions (1-6) and that years of practice experience had no correlation, positive or negative, to overall score. These findings are consistent with the literature that suggests that nurses could potentially benefit from additional education regarding their disorders and their unique presentation, as it can be inferred that years of practice alone does not determine competency in the area especially, according to this study, in terms of assessment and identification.

Eating disorder clients show low motivation, poor follow-through, and inordinate premature dropout rates in treatment. Earlier studies support the use of pretherapy training to help clients understand the tasks and challenges of therapy. However, a pretherapy intervention, such as showing prospective clients a video that outlines recovery issues and themes, had not yet been developed specifically for the prevalent, recalcitrant problem of eating disorders. Thus, of particular interest to clinicians who treat eating disorders may be the development of a theoretically sound, pretherapy videotape that outlines recovery issues. One of the purposes of this study was to review prior investigations of the effects of pretherapy films/videos on therapy outcomes. However, the central focus of this dissertation was to develop a pretherapy video for use with eating disorder clients, and using quantitative methods, assess the quality and likely therapeutic utility of the pretherapy video. The video was developed to be theoretically consistent with Bandura's modeling paradigm, social learning theory. Eating disorder clients, a comparison group of college women, and professional clinicians who are experienced at treating women with eating disorders were asked to view and evaluate the video (developed to orient prospective clients to recovery issues during treatment for eating disorders). All three groups reportedly found the recovering women portrayed in the video credible, believable, and persuasive. All groups of observers indicated that the video presented an understandable and hopeful message possessing emotional impact, and they avowed that the video created expectations for improvement. Also, the viewers believed the pretherapy video would likely increase knowledge of eating disorder recovery, and that future eating disorder clients viewing the video would likely learn new information that would facilitate their recovery. Additionally, the three groups indicated the video seemed to be of general relevance and therapeutic utility to women with eating disorders.

Problematic levels of eating disorder (ED) spectrum problems are becoming increasingly pervasive on college campuses, especially among female college students. Research suggests that ED cognitions and a lack of body image acceptance are linked to diminished psychological flexibility (PF), which is linked to ED and other negative health symptoms. Two hundred thirty-six undergraduates completed an online survey, and mediation analyses were conducted. PF fully mediated the relation between ED cognitions and non-specific psychiatric symptoms and partially mediated the link between ED cognitions and ED symptoms. PF also partially mediated the link between body image acceptance and non-specific psychiatric symptoms, but not the relation between body image acceptance and ED symptoms. Findings suggest that clinical symptoms and one’s coping style are both important factors to take into consideration in case conceptualization and treatment, and suggest that therapies such as ACT that target PF may be beneficial in treating ED spectrum problems.

Eating disorders are chronic, disabling illnesses associated with significant mortality rates (Crow et al., 2009). Body dissatisfaction has been demonstrated as a prominent risk factor for adolescent eating disorders. However few studies have examined psychological factors that predict body dissatisfaction. The present study examined maladaptive perfectionism and anxiety as possible risk factors for body dissatisfaction in adolescents with eating disorders and controls. Participants completed measures of body dissatisfaction, maladaptive perfectionism, and anxiety. Results demonstrated that maladaptive perfectionism and anxiety were significantly and positively associated with body dissatisfaction. However, these factors did not interact to predict elevated body dissatisfaction in eating disordered adolescents. These findings suggest that current body image treatments for adolescents with eating disorders and from nonclinical populations may be improved by including a focus on maladaptive perfectionism or anxiety. Future research should endeavour to conduct prospective, longitudinal studies that assess whether risk factors for body dissatisfaction are also causal factors. Finally, it is also important that researchers investigate whether body image treatments that target maladaptive perfectionism or anxiety effectively reduce body dissatisfaction in adolescents with and without eating disorders.

Thesis (Ph.D.) -- University of Rhode Island, 2007 / Typescript. Includes bibliographical references (leaves 112-118).

This study examined the links among child maltreatment (i.e., child sexual abuse, child physical abuse, child emotional abuse, and child neglect), eating disorder symptoms, problematic use of drugs and alcohol, coping strategies, and emotion regulation in women. This study also examined coping strategies and emotion regulation as potential moderators of the links among child maltreatment, eating disorder symptoms, and problematic substance use. Maltreatment in childhood is linked with numerous adverse outcomes across the lifespan. For instance, the development of maladaptive coping styles, poor emotion regulation, substance use problems, and eating disorders all are linked to a history of child maltreatment, but how these factors interact has yet to be investigated. These constructs were examined through hierarchical multiple regressions in a sample of 383 women age 19 or older, recruited online. Results indicated that women who experienced greater overall child maltreatment engaged in more problematic drug use and more problematic alcohol use and women with child sexual abuse (CSA) engaged in greater levels of problematic drug use. Avoidance coping was associated with greater levels of problematic drug use, dieting, bulimia and food preoccupation, and overall eating disorder symptoms. Women with more severe eating disorder symptoms and who used greater expressive suppression, also engaged in more problematic alcohol use. When considered together, all forms of child maltreatment were associated with greater avoidance and problematic drug and alcohol use, CSA survivors used less avoidance and expressive suppression, and child neglect (CN) survivors used more avoidance and expressive suppression. These findings suggest that health care professionals working with women survivors of child maltreatment should be aware of increased risk of developing substance use problems as well as less effective coping and emotion regulation strategies that may be stemming from victimization experiences. In addition, it may be helpful for clinicians working with women with eating disorders or problematic substance use to focus on improving coping and emotion regulation skills. / Graduate

Eating disorders have a dramatic effect on the lives of people who struggle with them, including cardiovascular and gastrointestinal problems, and death. Individuals with these diagnoses are also often struggling with comorbid diagnoses such as depression, anxiety, and substance abuse/dependence. Building on a conceptualization of eating disorders as a means to dysfunctionally regulate negative affect and escape unwanted thoughts, psychological flexibility, the ability of a person to contact unwanted thoughts or feelings and behave without escape or avoidance, is investigated as a tool for treatment. Additionally, because quantitative analysis of the construct of psychological flexibility has often employed the use of college samples, this study employed a sample of participants drawn from a residential treatment facility dedicated to the treatment of eating disorders. Through regression and modeling, psychological flexibility demonstrates its utility in the treatment of eating disorders through its relationship with body dissatisfaction and quality of life.

Introduction: Defensive functioning may play an important role in the development and treatment of binge-eating disorder (BED). The Defense Mechanism Rating Scale (DMRS) is a widely used observer rating measure of defensive functioning. However, there is little research on defensive functioning and the DMRS in BED. This dissertation includes three studies on defensive functioning in individuals with BED. Study one assessed the validity and reliability of the DMRS when used to rate Adult Attachment Interview (AAI) transcripts, and compared defensive functioning between women with and without BED. Study two compared change in defensive functioning in women with BED who received Group Psychodynamic-Interpersonal Psychotherapy (GPIP) versus those in a waitlist no treatment control condition. Study three assessed the impact of other group therapy members’ defensive functioning on an individual group member’s treatment outcomes (i.e., binge-eating frequency and interpersonal functioning). Thus, the overall goals of this dissertation were to better understand the role of defensive functioning in BED, the degree to which defensive functioning changes due to group therapy, and the impact in the context of the therapy group’s defensive functioning on individual outcomes. Method: Participants with for this study were recruited from three previous investigations. Two clinical trials of group psychotherapy provided data of individuals with BED: (1) a randomized trial (N = 85) in which participants were assigned to GPIP (n = 35) or a waitlist control (n = 50), and (2) an uncontrolled study in which all participants with BED (N = 101) received GPIP. A total of 17 therapy groups were formed across both studies, with each group consisting of five to 11 members. In addition, a third study provided data from two comparison groups without BED: women who were overweight/obese (body mass index [BMI] > 27 kg/m2; n = 47) and women who were normal weight (BMI = 20 to 25 kg/m2; n = 49). Participants with BED completed a battery of questionnaires and the AAI at two time-points (i.e., pre-treatment/pre-waitlist and six months post-treatment/post-waitlist). Participants without BED completed the same battery of questionnaires and the AAI at one time-point and did not receive treatment. All AAI audio recordings were transcribed and used to code defensive functioning. Results: In study one, the DMRS coded from AAI transcripts demonstrated acceptable inter-rater reliability; good convergent validity, as it was significantly correlated with other related constructs (i.e., interpersonal functioning, reflective functioning, and attachment insecurity); and acceptable predictive validity, as women with BED had significantly lower defensive functioning than normal weight women without BED. In study two, those who received GPIP had significantly greater improvements in defensive functioning from pre-treatment to six months post-treatment compared to the waitlist control group. Follow-up analyses revealed that the average number of High Adaptive defenses significantly increased from pre-treatment to six months post-treatment in the GPIP condition, but not in the waitlist control condition; and significantly more participants assigned to the waitlist control condition deteriorated in their defensive functioning from pre-waitlist to six months post-waitlist than those assigned to GPIP. In study three, individual defensive functioning scores at pre-treatment were not significantly associated with either treatment outcome (i.e., binge-eating frequency or interpersonal distress) at six months post-treatment. However, other group members’ mean defensive functioning scores at pre-treatment were significantly associated with individual interpersonal distress, but not binge-eating frequency, at six months post-treatment. Discussion: Overall, this dissertation lends further support to the role of defensive functioning in the maintenance and treatment of BED. Individuals with BED tend to use less adaptive defensive functioning, but this can be improved through GPIP. Further, context of the therapy group in terms of defensive functioning is particularly important for improving treatment outcomes in individuals with BED. These findings should be replicated across more diverse samples and other types of group psychotherapy. Group therapists can help their patients with BED confront their maladaptive defense mechanisms and binge-eating by tackling their interpersonal distress, and placing sufficient emphasis on the group’s composition in terms of defensive functioning.

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