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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
Conclusion The hypotheses investigated in this project included looking at the relationship between inflexibility and body image acceptance (from an ACT perspective) and eating disorder risk (EDR), inflexibility was found to be significantly higher in the high eating disorder risk group. Body image acceptance was also associated with flexibility as was hypothesised. Depression and anxiety were found to be associated with inflexibility and higher EDR. These findings have provided evidence for both the ACT model and a transdiagnostic approach. The study suffered from various limitations primarily the cross–sectional design that disallows any firm conclusions about cause and effect and does not allow one to see the progression of a disorder. 281
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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
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Co-morbidity with other psychopatho
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After insertion, if the fingers pul
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This is consistent with the asserti
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The sample size was not adequate fo
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Conclusion This study found that in
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Catalano, R. F., Hawkins, J. D., Be
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Greco, L. A., Blomquist, K. K., Acr
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HADS, and the influence of age, gen
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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 and 262: Journal-Ready Copy Helen Eracleous
Page 263 and 264: Abstract Objective: The study inves
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: Clinical implications Due to the cr
Page 283 and 284: Greco, L. A., Lambert, W., & Baer,
Page 285: Smolak, L., Levine, M. P., and Stri
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