The Social Construction of Defect Personal Stories of Emotions in Eating Disorders

This article explores episodes characterized by overwhelming emotions in Eating Disorders (ED). In ED, emotions and symptoms are connected. The mentalizing perspective understands eating disordered symptoms as a form of regulation of painful emotions and as indicative of a reduced ability to attend to mental states in oneself and others (impaired mentalizing). However, the interpersonal and emotional processes associated with impaired mentalizing are insufficiently attended to in research. Based on interviews with eating disordered patients, this article analyses stories of everyday episodes portrayed as emotionally overwhelming. The results of this analysis establish that a wide array of emotions or emotional experiences are activated, the most prominent being inadequacy, anger, discomfort, fear, and sadness. Episodes are typically “multi-emotional”, characterized by a variety of emotional constellations. The findings do not indicate that eating disordered patients generally have difficulty identifying emotions. Eating disordered symptoms are therefore discussed as a form of defense. The episodes described typically instigate the activation of eating disordered symptoms. Furthermore, the episodes are predominantly social, with other people present, whether physically or in mind. In conclusion, the article discusses the implications of the findings to the understanding of eating disorders and treatment.

Stuck in painful time: perception of time by individuals with eating disorders depending on their mood

Introduction: Eating disorders still pose a formidable challenge to health care professionals. The suffering of eating-disordered individuals may be profound, with the main contributing factors being low self-esteem, guilt and depression, a sense of hopelessness, and loneliness. The objective of the study was to determine how patients with eating disorders perceive time, and in particular whether their experience of time differs from that of healthy individuals. Another goal was to examine the relationship between the mood of the subjects and their time perspective. Materials and methods: The subjects were 30 women with eating disorders and 30 age-matched healthy female controls. The three measures applied were: the Time Metaphors Questionnaire by Małgorzata Sobol-Kwapińska, the Time Perspective Inventory by Philip Zimbardo, and the UWIST Mood Adjective Checklist (UMACL) by Gerald Matthews et al. Results: As expected, statistical analyses revealed that women with eating disorders were characterised by a more negative perception of time than healthy subjects. The study also confirmed the expected correlations between positive and negative time perceptions and mood. Conclusion: The results appear to have a considerable scholarly and practical value, and should be used in the psychotherapy of eating-disordered individuals focusing on existential aspects, including in particular topics regarding the experience of time by sufferers.

Psychometric Properties and Convergent and Divergent Validity of the Portuguese Yale Food Addiction Scale 2.0 (P-YFAS 2.0)

Purpose The construct of food addiction has been gaining increased attention as a research topic. Currently, the Yale Food Addiction Scale 2.0 is the only measure to operationalize the addictive-like eating behavior according to addiction criteria proposed by the Diagnostic and Statistical Manual of Mental Disorders. The present study aimed at examining the psychometric properties of the Portuguese version of the Yale Food Addiction Scale 2.0, as well as investigating the convergent and divergent validity between this scale and the following measures: Eating Disorders Examination Questionnaire, Body Investment Scale, and Difficulties in Emotion Regulation Scale. We also sought to explore the moderator role of difficulties in emotion regulation in the relationship between food addiction and binge eating. Methods: A sample of 302 female college students (Mage = 21.37, SD = 3.24) completed self-report measures.Results Sixteen (5.3%) participants were diagnosed as having food addiction. The confirmatory factor analysis suggested that the original one-dimensional structure is adequate to represent the Portuguese Yale Food Addiction Scale 2.0. The symptom count scores of the scale were correlated with body mass index, eating disordered behavior, body investment and difficulties in emotion regulation. The severity level of the scale also discriminated the severity of eating disordered behaviors, body investment and difficulties in emotion regulation. Finally, the relationship between food addiction and binge eating was moderated by difficulties engaging in goal-directed behavior when experiencing negative emotions.Conclusion The Portuguese version of the Yale Food Addiction Questionnaire 2.0 may be a useful tool to investigate food addiction.

Material Environments and the Shaping of Anorexic Embodiment: Towards A Materialist Account of Eating Disorders

Anorexia nervosa is a paradoxical disorder, regarded across disciplines as a body project and yet also an illness of disembodied subjectivity. This overlooks the role that material environments—including objects and spaces—play in producing embodied experiences of anorexia both within and outside treatment. To address this gap, this paper draws together two ethnographic studies of anorexia to explore the shared themes unearthed by research participants’ engagements with objects that move across boundaries between treatment spaces and everyday lives. Demonstrating how the anorexic body is at once both phenomenologically lived and socio-medically constituted, we argue that an attention to materiality is crucial to understanding lived experiences. A materialist account of anorexia extends the literature on treatment resistance in eating disorders and offers a reconceptualisation of ‘the body in treatment’, showing how objects and spaces shape, maintain, and even ‘trigger’ anorexia. Therefore, against the background of the high rates of relapse in eating disorders, this analysis calls for consideration of how interventions can better take account of eating disordered embodiment as shaped by material environments.

Effects of Cognitive-behavioral and Psychodynamic-interpersonal Treatments for Eating Disorders: a Meta-analytic Inquiry Into the Role of Patient Characteristics and Change in Eating Disorder-specific and General Psychopathology in Remission

Background: Cognitive behavior therapy (CBT) and psychodynamic-interpersonal therapies (PIT) are the most used outpatient treatments for eating disorders. Knowledge about the outcomes of these therapies in terms of remission is limited. Also, there is a lack of knowledge about how different therapeutic changes and patient characteristic affects outcomes. Method: Reports on the effects of CBT and PIT for eating disorders were searched. Rates of remission and changes in eating disorder specific and general psychopathology were computed and meta-analytically synthesized. Regression models were made to predict summary event rates by patient characteristics and changes in specific and general psychopathology. Results: Only CBT produced remission rates (34.2%) significantly different from waitlist conditions, and only CBT led to significantly greater change in specific psychopathology than waitlist/nutritional counseling conditions. However, CBT and PIT were equally effective in changing general psychopathology. For CBT, change in specific psychopathology predicted remission only when controlling for differences between diagnostic categories. Change in general psychopathology predicted remission only for PIT. The presence of comorbid personality disorder decreased the effect of CBT. Conclusions: A group of patients with eating disorders may require therapy aimed at strengthening deficits in self functions not easily ameliorable by cognitive behavioral techniques alone. However, although effective in changing specific and general psychopathology, PIT is not effective in producing behavioral change. Further research should be aimed at identifying treatment interventions that effectuate both behavioral change and strengthening self-functions to substitute eating-disordered behavior to meet psychological needs in the long-term.