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Body Image, Disordered Eating and Emotional Processing in Adolescent Females Helen Eracleous, Saskia Keville (for the first part), Madeleine Tatham (the last part) and Joerg Shultz University of Hertfordshire, Hertfordshire, UK This research was conducted by the first author, under supervision of the above named authors, in fulfilment of the Doctorate in Clinical Psychology at the University of Hertfordshire. This paper is suggested for publication in Eating Disorders: The Journal of Prevention and Treatment. Corresponding author: Helen Eracleous, Doctor of Clinical Psychology Training Course, University of Hertfordshire, Hatfield, Herts, AL10 9AB, Tel: 01707 286 322, Email: h.eracleous@herts.ac.uk 262
Abstract Objective: The study investigated the relationship between ‘inflexibility’ in emotional processing (from an Acceptance and Commitment, ACT, perspective) and eating disorder risk. Body image dissatisfaction, depression and anxiety were also considered in relation to inflexibility and eating disorder risk. Method: The sample consisted of a non-clinical group of 96 12-15 year old females from secondary schools. The measures included Eating Disorder Inventory-3 (from which eating disorder risk was calculated), inflexibility and body image acceptance (using ACT measures), Body Mass Index (BMI) as well as depression and anxiety. Results: It was found that those with a higher eating disorder risk had higher levels of inflexibility and a lower body image acceptance as was predicted. Inflexibility was also associated with higher rates of anxiety and depression and acceptance of body image was negatively associated with depression and anxiety. Discussion: The relevance of inflexibility as a transdiagonstic process appears to be important in the understanding and potentially the prevention of eating pathology across the spectrum and associated problems of anxiety and depression. Clinical implications of these findings are discussed. Keywords: ACT, inflexibility, disordered eating, body image dissatisfaction 263
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DClinPsy Portfolio Volume 1 of 3 A
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Discuss the importance of the thera
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Psychoanalytically, the focus has b
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Type 2 refers to joint working and
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It appears that what links the conc
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It was concluded that the direct as
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Importance of Therapeutic Relations
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The therapist must also be aware of
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Understanding what constitutes a po
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References Alexander, L. B. & Lubor
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Gutfreund, M. J. (1992). A close-up
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Lambert, M. J. & Bergin, A. E. (199
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Shin, Sung-Man; Chow, Clifton; Cama
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Introduction Historically there has
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Furthermore connections’ in relat
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A triangular pattern of protection
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Another issue related to empowering
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There are many issues that the psyc
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Furthermore a common tendency in pe
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Conclusion Although systemic and ps
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References Banks, R. (2003). Psycho
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Linington, M. (2002). ‘Whose hand
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Small Scale Service Related Project
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• 36% stated that voluntary atten
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CONTENTS Pages Introduction 50-58 M
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Individual authors from different p
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Aim of current project This study w
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- appointment times given to all at
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RESULTS Forty professionals took pa
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The highest rated factor is about t
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Figure 2 Ratings of importance of e
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Figure 4 Ratings of importance of e
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Nursing rated the following five po
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Question Graph showing views of pro
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Other comments from Nursing stated
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However, the comments section invol
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e audited. Furthermore, it may be u
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Hodgson, R., Jamal, A., Gayathri, B
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APPENDICES 77
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How Multi-disciplinary Staff View W
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28 Are the patients attending given
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There should be a named person resp
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Literature Review Body Image, Disor
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Prevalence studies across Europe, t
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For example, the use of appetite su
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The next part of this review will e
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Similarly, negative characteristics
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When body image distress is very lo
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The role of emotion regulation in t
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Experiential avoidance is the unwil
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Ineffective avoidance coping strate
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References Alexander, L. C., Gratz,
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Croll, J. Neumark-Stainer, D., stor
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Hayes, S. C., Masuda, A., Bissett,
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Keel, P. K., Fulkerson, J. A., and
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McVey, G.L., Pepler, D., Davis, R.,
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Piran, N and Cormier, H.C. (2005) t
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Stice, E., Presnell, K., Shaw, H. a
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APPENDIX I: Search strategy Consult
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Body Image, Disordered Eating and E
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ACT and weight control 139 ACT and
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Demographics of sample and epidemio
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Acknowledgements I would like to th
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Introduction This study reports on
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Consequences of disordered eating P
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Transdiagnostic approach in underst
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Factors implicated in the developme
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Feelings of depression/ high levels
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ACT and processing unpleasant emoti
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Applying ACT theory to weight contr
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Heffner et al, (2002) assert that t
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This phenomenon has encouraged furt
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This project will therefore seek to
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Method Design: A non experimental,
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The researcher remained in the room
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The psychological scales will be de
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The comparison group (n = 770) cons
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4) Hospital Anxiety and Depression
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The BMI-for-age weight status categ
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Results Section I will provide desc
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The majority were in the middle set
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Table 5: Frequency counts and perce
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As regards experience of an illness
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Min-Max Skewness (Std error) 1-23 0
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The lower boundary of the box repre
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3. Moderate EDR compared to High ED
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Comparison of Body Image Acceptance
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Table 12 - Descriptive statistics f
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The boxplot above shows that there
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Hospital Anxiety & Deperssion Scale
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3. Anxiety-Underweight compared to
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As can be seen from the above scatt
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Hospital Anxiety & Deperssion Scale
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Comparison Mean difference (SE) Z p
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Section III - Further contributing
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Due to the small sample size in the
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Eating Disorder risk categories Tot
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25 (28%) out of the 88 participants
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% within Body mass index USA 35.7%
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Table 33: Results of the logistic r
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Moreover, 13% of those aged 12-14 y
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The clinical variables of anxiety a
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Summary of additional findings The
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Low self esteem involves an uncondi
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This study has supported the relati
Page 211 and 212: Co-morbidity with other psychopatho
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Page 215 and 216: This is consistent with the asserti
Page 217 and 218: The sample size was not adequate fo
Page 219 and 220: Conclusion This study found that in
Page 221 and 222: Catalano, R. F., Hawkins, J. D., Be
Page 223 and 224: Greco, L. A., Blomquist, K. K., Acr
Page 225 and 226: HADS, and the influence of age, gen
Page 227 and 228: Mykletun, A., Stordal, E. & Dahl, A
Page 229 and 230: Smolak, L., Levine, M. P., & Strieg
Page 231: Willcox, M. & Sattler, D. N. (1996)
Page 237 and 238: Appendix 3 Body Image Acceptance an
Page 239 and 240: Appendix 4 Hospital Anxiety and Dep
Page 241 and 242: Appendix 5 Background information D
Page 243 and 244: Appendix 6 Information sheet for pa
Page 245 and 246: If after reading this information s
Page 247 and 248: Dear Sir/Madam, U H Doctor of Clini
Page 249 and 250: U H CONSENT FORM Title of Project:
Page 251 and 252: CERTIFICATE OF ACHEIVEMENT This is
Page 253 and 254: Debriefing sheet Title of project:
Page 255 and 256: Appendix 10 Ethics approval Form SC
Page 257 and 258: Appendix 12 Boxplots and Descriptiv
Page 259 and 260: Appendix 13 Box plot and Descriptiv
Page 261: Journal-Ready Copy Helen Eracleous
Page 265 and 266: Taking such a perspective may also
Page 267 and 268: ACT suggests that inflexibility (i.
Page 269 and 270: The EDI has been the measure of cho
Page 271 and 272: Additional research questions were
Page 273 and 274: Hypotheses III Inflexibility was po
Page 275 and 276: A potential explanation may be that
Page 277 and 278: The last two are choosing life dire
Page 279 and 280: Clinical implications Due to the cr
Page 281 and 282: Conclusion The hypotheses investiga
Page 283 and 284: Greco, L. A., Lambert, W., & Baer,
Page 285: Smolak, L., Levine, M. P., and Stri
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