Fluctuations of Body Images in Anorexia Nervosa: Patients' Perception of Contextual Triggers

Clinical Psychology and Psychotherapy - Tập 19 Số 6 - Trang 518-530 - 2012
Ester M. S. Espeset1,2, Kjersti S. Gulliksen1, Ragnfrid H. S. Nordbø1, Finn Skårderud3,4, Arne Holte5,1,6
1Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
2Ester M. S. Espeset, Division of Mental Health, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, No-0403 Oslo, Norway.
3Lillehammer University College, Lillehammer, Norway
4Oslo University Hospital, Oslo, Norway
5Department of Psychology, University of Oslo, Oslo, Norway
6Modum Bad Research Institute, Vikersund, Norway

Tóm tắt

Body image disturbance is a central diagnostic criterion of anorexia nervosa (AN). To a great extent, previous studies have conceptualized body image disturbance as a relatively stable and trait‐like characteristic of the patient. There is, however, growing evidence that body images fluctuate in different situations and contexts. The aim of the present study was to explore which everyday contexts that patients with AN themselves associate with fluctuations in body image. Thirty‐two women (20–35 years) who had been diagnosed with AN (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) within the last year participated. Semi‐open and focused qualitative interviews were conducted, transcribed and analyzed using Grounded Theory techniques. The results suggest that body image is a dynamic phenomenon that may fluctuate in different situations and contexts. The participants linked such fluctuations to their own uncertainty about their real appearance. In lack of a stable and integrated experience of their own body, they were extremely sensitive towards body image threats and challenges in their daily life and reacted to these situations by fluctuations in their body image. Four contextual cues were found to trigger such changes in body image: these were eating food, being reminded of one's body appearance, relating to one's own emotional signals and interpreting other people's expressed and unexpressed opinions about oneself and one's appearance. Clinical and theoretical implications are discussed. Copyright © 2011 John Wiley & Sons, Ltd.Key Practitioner Message Individuals with anorexia nervosa may have quite varied body image experiences in different contexts. The contexts identified in this study may be a point of departure for clinicians in helping their patients to explore their subjective body image experiences and to connect these with emotional, cognitive and relational contexts in a psychologically meaningfully way.

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Tài liệu tham khảo

10.1176/appi.books.9780890423349

10.1016/S0005-7894(05)80043-7

10.1097/00006842-196203000-00009

10.1016/S0033-3182(78)70990-4

10.1002/eat.20132

Cash T.F., 2002, Body image: A handbook of theory, research and clinical practice, 163

10.1002/eat.10100

10.1002/(SICI)1098-108X(199709)22:2<107::AID-EAT1>3.0.CO;2-J

10.1080/10640260290081678

10.1016/j.brat.2007.11.004

10.1016/j.jbtep.2010.04.004

10.1348/014466504772812931

10.4135/9781452230153

10.1002/erv.747

10.1080/10640266.2011.551635

10.1002/erv.622

10.1016/j.bodyim.2008.08.005

10.1002/cpp.626

10.1002/1098-108X(198321)2:2<15::AID-EAT2260020203>3.0.CO;2-6

Garner D.M., 1991, Eating Disorder Inventory‐2 professional manual

10.1002/(SICI)1098-108X(199811)24:3<285::AID-EAT6>3.0.CO;2-I

10.1002/1098-108X(200007)28:1<8::AID-EAT2>3.0.CO;2-U

10.1016/j.appet.2008.05.057

10.1002/eat.20103

10.1002/eat.20105

10.1002/1098-108X(199301)13:1<77::AID-EAT2260130110>3.0.CO;2-N

10.1002/eat.1111

10.1007/s007870050130

10.1016/j.bodyim.2006.09.001

10.1016/j.eatbeh.2009.06.001

10.1002/eat.20228

10.1177/1359105309340977

10.1016/j.cpr.2003.10.004

10.1016/j.bodyim.2004.03.003

10.1016/j.bodyim.2007.07.003

10.1002/eat.20276

10.1002/eat.20547

Nordbø R.H., Reluctance to recover in anorexia nervosa, European Eating Disorders Review

10.1097/PSY.0b013e3181c6c7ca

10.1016/j.neubiorev.2010.11.001

10.1016/j.jpsychires.2004.10.006

10.1080/08870449208520024

10.1016/j.eatbeh.2008.02.001

10.1016/j.bodyim.2006.11.004

10.1348/014466505X53902

10.1007/s10964-005-9003-8

10.1002/erv.923

Skårderud F., Mentalizing in mental health practice

10.1007/s007870170010

10.1016/j.brat.2007.12.003

10.1016/j.actpsy.2009.03.011

10.1016/j.bodyim.2010.07.001

10.1002/eat.20776

10.1002/eat.20291

Taylor G.J., 1994, The alexithymia construct: Conceptualization, validation, and relationship with basic dimensions of personality, New Trends in Experimental and Clinical Psychiatry, 10, 61

10.1016/0005-7967(92)90096-Y

10.1017/CBO9780511526831

10.1002/1098-108X(199312)14:4<445::AID-EAT2260140408>3.0.CO;2-4

Thompson J.K. Heinberg L.J. Altabe M. &Tantleff‐Dunn S.(1999).Exacting beauty: Theory assessment and treatment of body image disturbance. (vols.1999).

10.1002/1098-108X(200101)29:1<65::AID-EAT10>3.0.CO;2-Y

10.1016/j.appet.2007.03.006

10.1016/j.jpsychores.2006.08.007

10.1016/S0022-3999(02)00492-0

10.1002/erv.418

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Clinical Psychology and Psychotherapy

Tập 19 Số 6

518-530

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