Anorexia nervosa: Friend or foe?

Abstract

Objective:The aim of this study was to examine anorexics' attitudes towards anorexia nervosa. Method: Anorexic patients were asked to write two letters to their anorexia nervosa, one addressing it as a friend and the other addressing it as an enemy. A coding scheme was developed using a ''Grounded Theory'' methodology to group recurrent themes. The scheme was used independently by three raters: the first author, a rater with extensive experience in eating disorders, and a novice in the field. Use of the coding scheme showed high interrater reliability and comprehensiveness. Results: Commonly expressed benefits of anorexia nervosa included feeling looked after or protected, gaining a sense of control, and feeling special. Perceived costs of the disorder included constant thoughts about food, feeling taken over, and the damage done to personal relationships. Discussion: The positive themes found in the letters are important indicators of factors which may maintain anorexia nervosa. The use of the letters to examine these factors has important clinical implications which are outlined.

Clarifying criteria for cognitive signs and symptoms for eating disorders in DSM‐V

“…In fact, if it were directly assessed, individuals with AN may not endorse the ''refusal'' criterion-or related cognitive criteria B or C-for a range of reasons (for a review of relevant literature on denial in AN, see Vandereycken, 2006a,b;Vitousek et al, 1991). 46,48,49 Some patients may recognize their symptoms yet choose either not to disclose or to conceal them due to an investment in maintaining their symptoms, 38,40,41 perceived stigma attached to AN, [51][52][53][54] or their concerns about social desirability. Alternatively, other individuals may not recognize or acknowledge the symptoms because of limited insight, developmental capacity, or cognitive impairment related to their nutritional compromise.…”

How perfectionism and ineffectiveness influence growth of eating disorder risk in young adolescent girls

“…Several other theoretical models also implicate both high levels of perfectionism and ineffectiveness (low selfefficacy or difficulties with managing life and strong emotion), as being critical to the development of eating disorders (Bardone-Cone, et al, 2006;Schmidt & Treasure, 2009;Fairburn, Cooper, & Shafran, 2003). Qualitative research (Serpell, Treasure, Teasdale, & Sullivan, 1999) suggests AN plays a powerful role in tackling a sense of ineffectiveness, making the person feel safe, helping them to communicate distress, and stifling emotions. The most endorsed worries of women with AN do not relate to aspects of eating or weight, but to issues that increase a sense of ineffectiveness: rejection and abandonment, negative perceptions of self, and experience of negative emotions (Sternheim et al, 2012).…”

Anorexia nervosa and autism spectrum disorders: Guided investigation of social cognitive endophenotypes.

“…There are several compelling reasons. First, improvement in social acceptance and interpersonal proficiency are arenas in which individuals with AN are motivated to improve (Serpell, Teasdale, Troop, & Treasure, 2004;Serpell, Treasure, Teasdale, & Sullivan, 1999). While limited motivation for treatment is commonly reported (Strober, 2004), a desire for interpersonal acceptance and concern for the opinion of others are factors that may actually serve to sustain symptom severity (Bizeul, Sadowsky, & Rigaud, 2001).…”