Women with anorexia nervosa tend to be ambivalent about change and resistant to treatment. A
growing number of researchers suggest that this ambivalence must be targeted early on, before
attempting to engage clients in action-oriented treatment that focuses on immediate symptom
reduction. However, in order to appropriately address client ambivalence, it must be accurately
evaluated with empirically validated instruments. The purpose of this thesis was to develop and
validate a Decisional Balance (DB) measure of readiness for change in anorexia nervosa. In Study 1,
246 women with anorexia nervosa completed the DB, and a subset completed the DB again one week
later. Unlike traditional decisional balance measures that have two factor (pro-con) solutions, factor
analytic techniques indicated that a three factor solution provided the best fit for the DB data in this
study. These factors included general negative consequences of the disorder (Burdens), valued
achievements such as self-control, being very thin, and striving for perfection (Benefits), and using
anorexia nervosa as a means for avoiding aversive emotions, challenges, and responsibilities
(Avoidance Coping). The DB demonstrated good internal consistency and test-retest stability. In study
2, 80 women with anorexia nervosa completed the DB, along with other measures of readiness for
change, as well as measures unrelated to readiness. Support was found for both convergent and
divergent validity. Finally, in study 3, 80 women with anorexia nervosa completed the DB, and a
measure of anticipated difficulty completing symptom-challenging recovery activities. In addition,
participants attempted to complete three recovery activities in the week following initial assessment.
Criterion validity was not well supported, most likely because the concurrent and predictive validity
measures focused on behavior change, when non-behavioral measures may have been more
appropriate. Overall, the results suggest that the DB for anorexia nervosa is a measure of awareness or
insight about the functions of this disorder. The theoretical and clinical implications of this research are
reviewed and directions for future investigations are proposed.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:BVAU.2429/11195 |
| Date | 11 1900 |
| Creators | Cockell, Sarah Jane |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Relation | UBC Retrospective Theses Digitization Project [http://www.library.ubc.ca/archives/retro_theses/] |
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