[pt] Este trabalho consiste em um estudo sobre a anorexia nervosa sob a ótica psicanalítica. Apresentaremos primeiramente um histórico do conceito, enfocando a trajetória desta patologia, que foi inicialmente rara e atualmente é encontrada na clínica com freqüência. Discutimos as contribuições trazidas pela psicanálise ao estudo e à clínica da anorexia nervosa através das diversas tentativas de explicá-la nessa perspectiva, embora este não seja um conceito psicanalítico. Abordamos ainda a relação entre a anorexia nervosa e a magreza como ideal de beleza contemporâneo sobretudo a ênfase que é atribuída ao corpo magro pela sociedade contemporânea e suas conseqüências psíquicas. / [en] This work consists of a study about anorexia nervosa from a psychoanalytical perspective. Firstly, we will present a historical view of the concept, focusing the trajectory of such pathology, which was originally rare and has become frequent in current clinical practice. We discuss the contributions brought by psychoanalysis to the study and clinical management of anorexia nervosa throughout its various attempts to explain it, even though anorexia nervosa is not a psychoanalytical concept. We also approach the relationship between anorexia nervosa and thinness as a contemporary beauty ideal, especially the emphasis assigned to the thin body in actual society and its consequences.

Historically disordered eating research has been gendered with models focusing on women’s pursuit of a thin ideal, as well as men’s attempts to obtain a muscular ideal. The motivations to achieve these ideals are called the drive for thinness (DT) and drive for muscularity (DM). More recently, a cultural shift has been noted in that ideal bodies are converging across sexes to a lean ideal, with the associated motivation being labeled the drive for leanness (DL). As DL is a nascent construct, little is known about its relationships with DT and DM, or if it predicts or is predicted by the same variables that are associated with DT and DM. This study aimed to expand what is known about DL in four ways: 1) ascertain the uniqueness of DL from DT and DM; 2) explore whether DL is sex neutral; 3) investigate the extent to which DL is more or less adaptive than DT and/or DM in terms of health-related outcomes; and 4) explore associations between DL and established predictors from sociocultural models of disordered eating. Analyses evidenced support for DL’s distinctiveness from DT and DM, partial support for DL’s sex neutrality, partial support discerned via relationships with health-related outcomes for DL’s adaptive nature in comparison to DT or DM, and support for DL’s relationships with sociocultural predictors being similar to that seen between these predictors with DT and DM. This study adds to the literature by broadening what is known about DL’s uniqueness, sex neutrality, adaptive nature, and sociocultural fit in relation to the other drives within a theory based framework, providing a potential basis for future DL model building and research in general.

The current study sought to prospectively explore the potential main effects and interactive relations among drive for thinness, life event stress, and harm avoidance in the prediction of disordered eating in an ethnically diverse sample of women (N = 58). During the initial and follow-up assessments, standardized questionnaires were utilized to assess drive for thinness, life event stress, and a harm avoidant temperament. Additionally, semi-structured diagnostic interviews were administered to assess disordered eating. Results revealed a significant interaction between drive for thinness and life event stress in the prediction of eating pathology. Neither the two-way life event stress x harm avoidance interaction nor the three-way drive for thinness x life event stress x harm avoidance interaction were significant predictors of eating pathology. These findings suggest that the previously suggested relation between drive for thinness and pathological eating is dependent upon the degree of life event stress experienced.

The current study sought to prospectively explore the potential main effects and interactive relations among drive for thinness, life event stress, and harm avoidance in the prediction of disordered eating in an ethnically diverse sample of women (N = 58). During the initial and follow-up assessments, standardized questionnaires were utilized to assess drive for thinness, life event stress, and a harm avoidant temperament. Additionally, semi-structured diagnostic interviews were administered to assess disordered eating. Results revealed a significant interaction between drive for thinness and life event stress in the prediction of eating pathology. Neither the two-way life event stress x harm avoidance interaction nor the three-way drive for thinness x life event stress x harm avoidance interaction were significant predictors of eating pathology. These findings suggest that the previously suggested relation between drive for thinness and pathological eating is dependent upon the degree of life event stress experienced.

No description available.

Studien ”Den tunna verkligheten” är ämnad att undersöka hur influencers på Instagramkommunicerar det tunna kroppsidealet visuellt. Studiens syfte är att genom en semiotiskbildanalys undersöka hur det tunna kroppsidealet tar sig uttryck visuellt på sociala medier. Detteoretiska ramverket som används för att diskutera studiens resultat och analys är Ferdinand deSaussure, Charles S. Peirce och Roland Barthes teorier inom semiotiken och teckenläran, samtLeon Festingers teori om social jämförelse. Studien har använt sig av semiotisk bildanalys sommetod och utgår från en deduktiv ansats. Den semiotiska bildanalysen används primärt för attanalysera kroppsliga drag från identifierat från tidigare forskning, parallellt medanalysverktygen denotation och konnotation. De semiotiska verktygen index, ikon och symbolhar också använts i studien för en djupare analys. Analysen påvisade hur det tunna idealet tog sig uttryck på Instagram. Bilderna porträtteradetecken av det tunna idealet. Exempel på dessa tecken är utstickande revben, tunna lår ochnyckelben. Myten om den normativa kroppen avslöjades också som ett socialt budskap ochbilderna tyder på ett medvetet kroppsfokus för att främja det tunna idealet. Resultatet av studienpåvisade även hur en ökad kunskap om hur ideal kommuniceras behövs för att förståproblematiken med det tunna kroppsidealets påverkan, i form av social jämförelse ochinternalisering, som sedan kan leda till en ätstörningsproblematik. / The study "The thin reality" is intended to investigate how influencers on Instagramcommunicate the thin body ideal visually. The purpose of the study is to examine, through asemiotic image analysis, how the thin body ideal is expressed visually on social media, througha semiotic image analysis. The theoretical framework used to discuss the study's results andanalysis is Ferdinand de Saussure, Charles S. Peirce and Roland Barthes' theories in semioticsand the theory of signs, as well as Leon Festinger's theory of social comparison. The methodsapplied to the study is a semiotic image analysis using a deductive approach. The semioticimage analysis is used primarily according to identified body concepts, in parallel with theanalysis tools denotation and connotation. The semiotic tools index, icon and symbol have alsobeen used in the study for a deeper analysis. The analysis showed how the thin ideal expressed itself on Instagram. The pictures portrayedsigns of the thin ideal, examples of these signs are protruding ribs, thin thighs and collarbones.The myth of the normative body was also revealed as a social message and the images suggesta conscious body focus to promote the thin ideal. The results of the study also demonstratedhow an increased knowledge of how ideals are communicated is needed to understand theproblem with the influence of the thin body ideal, in the form of social comparison andinternalization, which can then lead to an eating disorder problem.

The first aim of this study was to develop a research based, integrated, secondary prevention programme, called the Weight Over-concern and Well-being (WOW) programme, for the reduction of Subclinical Eating Disorder (SED) symptoms, associated traits and negative mood states, and the promotion of psychological well-being (PWB) in female students. Consequently the second aim was to determine the effectiveness of the WOW-programme on its own, in comparison with a combined Tomatis Method of sound stimulation (Tomatis, 1990) and WOW-programme, regarding the reduction of SED-symptoms, associated traits and negative mood states; the promotion of PWB; and outcome maintenance. The last aim was to obtain a deeper understanding and "insiders' perspective" of the lived experience of SED, through an interpretative phenomenological inquiry (Smith & Osborn, 2003). The motivation for the current study is a need for research based, integrated, risk-protective, secondary prevention programmes from a social-developmental perspective for female university students (Garner, 2004; Phelps, Sapia, Nathanson & Nelson, 2000; Polivy & Herman, 2002), given their risk status (Edwards & Moldan, 2004; Senekal, Steyn, Mashego & Nel, 2001; Wassenaar, Le Grange, Winship & Lachenicht, 2000). Concurrently in-depth descriptions from an "insiders' perspective" on the lived experience of SED are non-existent and require interpretative phenomenological study (Brocki & Wearden, 2006). Consequently this thesis consists of three articles, namely: (i) Development of a secondary prevention programme for female university students with Subclinical Eating Disorder, (ii) A secondary prevention programme for female students with Subclinical Eating Disorder: a comparative evaluation; and (iii) Lived experiences of Subclinical Eating Disorder: female students' perceptions. The research context comprised Subclinical Eating Disorder, secondary prevention and Positive Psychology. The first article, Development of a secondary prevention programme for female university students with Subclinical Eating Disorder (Kirsten, Du Plessis & Du Toit, 2007a), is qualitative in nature, and narrates a process of participatory action research followed to develop the WOW-programme. This social process of knowledge construction, embedded in Social Constructivist theory (Koch, Selim & Kralik, 2002), gradually revealed best clinical practice, and in retrospect, evolved over four phases. Phase One comprised experiential learning based on personal experiences with SED as undergraduate student and interaction with "participant researchers" as scientist practitioner (Strieker, 2002), resulting in a provisional risk model of intervention. Phase Two, a formal pilot study (Du Plessis, Vermeulen & Kirsten, 2004), afforded an evaluation of ideas generated in Phase One through a three-group pre-post-test design. Outcomes of Phase Two informed Phase Three, an integration of prior learning with Positive Psychology theory and clinical practice, resulting in a risk-protective model of prevention. Theoretical assumptions previously constructed were integrated and operationalised during Phase Four, into the final 9-session WOW-programme. In conclusion the process of knowledge construction was rigorous, despite the small overall sample size (n=28), since data saturation occurred within that sample. Although the multitude of aims involved in each session of the WOW-programme could be seen as unrealistic, in some direct or indirect way, they were addressed by means of relevant interventions due to the integrative approach. Thus future refinement is essential. Finally, despite aforementioned concerns, the WOW-programme proved to be robust on its own in reducing SED-symptoms and associated traits and enhancing PWB, as described in the second article of this thesis. The second article, A secondary prevention programme for female students with Subclinical Eating Disorder: a comparative evaluation (Kirsten, Du Plessis & Du Toit, 2007b), describes the outcomes of the WOW-programme on its own, evaluated comparatively with a combined Tomatis sound stimulation and WOW-programme. In this article the research aims were to determine: (i) whether participation in the combined sound stimulation and WOW-programme (Group 1); and (ii) participation in a WOW-programme only (Group 2), would lead to statistically significant reductions in SED-symptoms, psychological traits associated with eating disorders and negative mood states, and enhancement of PWB; (iii) whether results of Groups 1 and 2 would exceed results of a non-intervention control group (Group 3) practically significantly; and (iv) whether programme outcomes for Groups 1 and 2 would be retained at four-month follow-up evaluation. A mixed method design (Creswell, 2003; Morse, 2003) was used, including a three-group pre-post-test (n=45) and multiple case study (n=30) design. Various questionnaires measuring SED-symptoms, associated traits, negative mood states and PWB were completed. Qualitative data were obtained by means of metaphor drawings, letters to and from the "SED-problem", focus group interviews, the researchers' reflective field notes and individual semi-structured feedback questionnaires (Morse, 2003). Participation in Groups 1 and 2 proved effective, since decreases in SED-symptoms, associated traits, most negative mood states, and increases in PWB differed practically significantly from the results of Group 3. Outcomes for Groups 1 and 2 were maintained at four-month follow-up evaluation. Qualitative findings provided depth, support and trustworthiness to quantitative findings in light of the small sample size, and highlighted the value of using a mixed method design in prevention programming. It was concluded that the WOW-programme on its own, was an effective secondary prevention programme, since it led to reduced SED-symptoms, associated psychological traits and enhanced PWB, with retention of gains at four-months follow-up evaluation. The combined programme involving Tomatis stimulation and WOW-intervention proved to be even more effective, thus the complimentary role of Tomatis stimulation was demonstrated. However, the cost-effectiveness and comparative brevity of the WOW-programme rendered it the programme of choice regarding individuals with SED. Findings showed that conceptually, pathogenic and salutogenic perspectives can be successfully combined into a risk-protective model of secondary prevention. Lastly, the WOW-programme may even prove useful as an enrichment programme for female students in general. The third article, Lived experiences of Subclinical Eating Disorder: female students' perceptions (Kirsten, Du Plessis & Du Toit, 2007c), provides a qualitative, in-depth perspective on the lived experience of SED of 30 white, undergraduate females, purposively sampled. In this interpretative phenomenological, multiple case study (Brocki & Wearden, 2006), Groups 1 and 2 of the aforementioned primary study in the second article were used, since they fitted the criteria of "good informants" and were able to answer the research question (Morse, 2003). Further sampling was deemed unnecessary since data saturation occurred within their written and verbal responses and no negative cases were found. Rich individual qualitative data, further clarified through focus groups, emerged from graphic colour representations of lived SED, explanatory written records and "correspondence" with and from their "SED problem" (Gilligan, 2000; Loock, Myburgh, & Poggenpoel, 2003; White & Epston, 1990). Four main categories, characterised by serious intra-, interpersonal, existential and body image concerns were subdivided into seven subcategories, namely: Personal Brokenness, Personal Shame, Perceived Personal Inadequacy and Enslavement, Existential Vacuum, Perceived Social Pressure, Perceived Social Isolation and Body-image Dysfunction. Results were indicative of underestimation of SED-severity, its comprehensive detrimental impact on participants' PWB and high risk for escalation into full-blown eating disorders. It was concluded that the lived experiences of SED depicted the severity of SED-symptoms; descriptions resonated well with most of their pre-programme mean scores; and their risk status and need for contextually and developmentally relevant secondary prevention programmes were highlighted by the findings. / Thesis (Ph.D. (Psychology))--North-West University, Potchefstroom Campus, 2008.

This thesis is focused on frailty in old age. The frailty syndrome is the newest geriatric syndrome and can be aptly called the ultimate geriatric syndrome due to the complexity of its causes and the wide range of adverse outcomes it may lead to in older persons. Several of the important correlates of frailty, namely falls, underweight and sarcopenia, are discussed in the context of their relationship with frailty. These entities are geriatric syndromes in their own rights, sharing many common risk factors and arriving at adverse health outcomes either directly or via the pathway of frailty. In the publications that arose from this work, the risk factors of falls, in particular the relationship between medications and chronic diseases in causing falls; risk factors and outcomes of sarcopenia, in particular its relation to diabetes mellitus and other chronic diseases; and how underweight poses survival risks in both community-living and institutionalized older people, are discussed. The final publication of this series of studies demonstrated the reversibility of the frailty syndrome, showing that not all who were in the pre-frailty stage will decline. Risk factors associated with improvement or decline in the pre-frail stage were identified in the local population, and a period of relative stability opened for possible interventions was observed. This thesis thus examines the complex interplay of these syndromes in old age. It is hoped that these publications will enable further research into the underlying mechanisms of frailty and to elucidate modifiable risk factors, hence enabling older people, in particular those in the pre-frail stage, to live healthier and longer lives. / Lee Shun Wah Jenny. / Thesis (M.D.)--Chinese University of Hong Kong, 2015. / Includes bibliographical references. / Title from PDF title page (viewed on 15, September, 2016).

Using feminist poststructuralist and postcolonial lenses, I explore how young Lebanese-Canadian women construct health, obesity, and the body within the context of the dominant obesity discourse, which over-emphasizes supposed links between inactivity, nutrition, obesity, and health. Participant-centered conversations were held with 20 young Lebanese-Canadian women between the ages of 18 and 25. The conversational texts were analyzed according to two consecutive methods: a thematic analysis which allowed us to focus on what the participants had to say about health, obesity, and the body followed by a poststructuralist discourse analysis which helped us to decipher how the participants spoke about these topics. The findings of this study attest that the young women construct health, obesity, and the body as matters of individual responsibility. They speak about achieving health and avoiding overweight/obesity through disciplinary practices such as rigorous physical activity and proper dietary restrictions. The participants also construct health in close linkage with the physical appearance of the body; moreover, they conflate the “healthy” and “ideal” female body, which they represent as thin. As such, the young women reject “fat” and portray obesity as a disease, a matter of lack of will, and an “abnormal” physical appearance. Finally, the young Lebanese-Canadian women report their involvement in various practices such as restriction of the quality and quantity of their nutritional intake, rare and non-organized forms of physical activity, and problematic practices such as the use of detoxes, dieting pills, and compulsive exercise, all in the name of health. Throughout this study, I highlight the participants’ multiple and shifting subjectivities: While the young Lebanese-Canadian women most often construct themselves as free neoliberal subjects re-citing elements of dominant neoliberal discourses (of self-authorship, self-responsibility for health, traditional femininity, and obesity), they at times construct themselves as “poststructuralist” subjects showing awareness of, and “micro-resistance” to such discourses. The impacts of the Lebanese and Lebanese-Canadian cultures on the participants’ constructions of health, obesity, and the body comprise an important part of this thesis. The participants accentuate the major importance of beauty and physical appearance—particularly not being fat—in the Lebanese and Lebanese-Canadian cultures. However, they also attempt to distance themselves from “Lebanese” ways of thinking about health, obesity, and the body, and in doing so they replicate homogeneous representations of Lebanese, Lebanese-Canadian, and Canadian women. I offer practical suggestions to inform health and obesity interventions that target Lebanese-Canadian women and women from ethnic minorities and I discuss future research possibilities that may stem from the present thesis.

This study explores the association between media exposure and women’s body perceptions in Egypt. The thin ideal perpetuated through the media, eating disorders and body dissatisfaction and drive for thinness were thought to be a culturally linked phenomena confined to Western societies. This study has contributed to the debate on cultural determinism of eating disorders and body dissatisfaction in women as it has shown that these concepts are on the rise in non-Western societies in general and Egypt in specific. When exposed to media messages, women in Egypt demonstrated eating disordered attitudes, body dissatisfaction feelings and also chose other compensatory behaviors such as veiling, fasting, and following diet.