Dimensions of Diversity in Sustained Eating Disorder Recovery in Females: A Study of the Predictive Power of Hope, Resilience, and Spirituality

Abstract

Eating disorders are historically believed to impact individuals of European-American descent (Talleyrand, 2010). However, recent literature provided support for similar prevalence rates across ethnic groups (e.g., Wade, Keski-Rahkonen, & Hudson, 2011) and sexual orientation groups (e.g., Maloch, Bieschke, McAleavey, & Locke, 2013). Up to 80% of affected individuals are estimated to attain some level of recovery (Treasure, Claudino, & Zucker, 2010), with several variables contributing to the recovery process. This dissertation quantitatively examined the effects of hope, resilience, and spirituality on recovery among a diverse group of females with a previous diagnosis of an eating disorder. Research questions examined the relationship between sustained eating disorder recovery and the Eating Disorder Examination-Questionnaire (EDE-Q) and assessed the degree to which hope, resilience, and spirituality predict EDE-Q scores and sustained time in recovery. The study also examined ethnic and sexual orientation group differences in EDE-Q scores, sustained time in recovery, hope, resilience, and spirituality. Major findings included that EDE-Q scores were predicted by hope, resilience, and spirituality. Additionally, there were differences found in hope between individuals who identified as heterosexual and as a sexual minority. Implications included the potential impact of targeted clinical interventions to increase hope, resilience, and spirituality among affected individuals seeking recovery. Limitations included accessing individuals in recovery, obtaining a diverse sample, conceptualizing and measuring recovery, and the use of self-report. Future research should address measurement and conceptualization issues of eating disorder recovery, as well as methods to increase hope, resilience, and spirituality among affected individuals holding minority identities. DIVERSITY IN EATING DISORDER RECOVERY iii DEDICATION This study is dedicated to the thousands of individuals who continue to seek recovery from an eating disorder. DIVERSITY IN EATING DISORDER RECOVERY iv ACKNOWLEDGEMENTS There are many people who have helped make this dissertation possible, and without whom, it may never have been completed. First, the John and Barbara Pisapia Doctoral Research Award had an important role in providing financial support toward the completion of this dissertation. The award provided funding for 100 gift cards for participants, and allowed me to access a much more substantial sample size than would have otherwise been possible. To the chairperson of my dissertation committee, Dr. Christine Schimmel, I am so grateful for your patience and guidance throughout this process. Your willingness to provide constructive, thoughtful feedback and reassurance was critical, and I feel so lucky to have had you as my dissertation chair. Dr. John Blake, thank you for your willingness to schedule teleconferences to review the statistical analyses and results with me; those meetings were both helpful and crucial to ensuring that the appropriate a...