DClinPsy Portfolio Volume 1 of 3 - University of Hertfordshire ...

A further issue as regards the BMI was categorising the BMI values from this sample
using the USA as opposed to the UK percentile groups which were more stringent and
consequently fewer participants fitted the categories. The US categorisation enabled
better comparison of the groups but was used on a UK sample, which is not ideal.
Due to the focus of the study cultural and gender differences were not adequately
considered. The sample size was not adequate for further analysis of differences between
ethnic groups with an over representation of white Europeans. Another limitation is that
information regarding physical health such as diabetes or thyroid difficulties was not
ascertained and such factors may have had an important role to play. Finally, most of the
questionnaire data collected was self-reported and therefore liable to participant biases.
Suggestions for further research
It may be useful to study inflexibility in relation to disordered eating longitudinally. Such
a perspective can consider the prognosis of disordered eating and decipher whether
inflexibility causes and/or maintains eating disorders/obesity. Disordered eating has been
found to decrease over time along with a decrease in ‘putative risk factors’ (i.e. dieting
and body image dissatisfaction (Keel, Fulkerson & Leon, 1997). It might therefore be
useful to replicate such a study to explore whether inflexibility decreases alongside the
other risk factors.
Measuring inflexibility in the cultures that have a different body ideal to see whether they
have higher levels of flexibility and or body image acceptance may be useful in
considering the social factors implicated. Lastly, randomised control trials to compare
the ACT treatment for AN with other treatments should be undertaken to support the
utility of ACT.
280