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

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Obesity can present an increased risk of high blood pressure, adverse lipoprotein profiles, diabetes mellitus, coronary heart disease, atherosclerotic cardio/cerebrovascular disease, colorectal cancer as well as completion of fewer years of education, higher rates of poverty, lower marriage rates (Dietz, 1998) and lower self esteem (Miller and Downey, 1999). As well as the potential risk of becoming overweight or obese, the converse has also been found. Adolescents who diet even when they have a normal body weight can threaten their nutritional status leading to large amounts of fat being lost, amenorrhea, ketosis, reduced body mass, reduced lean muscle tissue, reduced basal metabolic rate, fatigue, irritability, insomnia, lack of concentration, and growth failure (Mallick, 1983). Patton Selzer, Coffey, Carlin, and Wolfe, (1999) in their large longitudinal study, found that adolescent females who dieted at a severe level were 18 times more likely to develop an eating disorder than those who did not diet. Those who dieted at a moderate level were five times more likely to develop an eating disorder. Kotler, Cohen, Davies, Pine and Walsh (2001) followed 800 children and their mothers over a 17 year interval and found that early adolescent bulimic symptoms were associated with a 9-fold increase in risk for late adolescent bulimia and a 20-fold increase in risk for adult bulimia. Late adolescent bulimia was associated with a 35-fold increase in risk for adult bulimia. The risk factors this study identified for the later development of eating disorders included eating conflicts, struggles with food and unpleasant meals in early childhood. Kotler et al’s (2001) study adds to the literature that demonstrates that those with disordered eating or sub-clinical levels of eating disorders in adolescence are more likely to develop an eating disorder. The above studies demonstrate that disordered eating may increase one’s risk of developing an eating disorder or becoming overweight/obese. Both these extremes involve biological, psychological and social complications. This literature suggests that understanding disordered eating and the psychological mechanisms involved is vital in the prevention of obesity and eating disorders. 90
The next part of this review will explore the relevance of body image to the understanding of disordered eating before linking this with emotional processing. Body image Body image will be defined and the problems with negative body image/body image dissatisfaction, and its relation to disordered eating and emotional processing, will be considered. Body image dissatisfaction is defined as subjective dissatisfaction (negative thoughts and feelings) with one’s physical appearance and is associated with disordered eating (Littleton and Ollendick, 2003). Of the correlates, protective factors and risk factors identified in disordered eating research, body dissatisfaction is recognised as the single strongest predictor of eating disorder symptomatology among women (Polivy and Herman, 2002). Adolescent females reporting disordered eating had a significantly higher concern for appearance, (Croll et al, 2002). In Croll et al’s (2002) study, 73% reported having strong appearance concerns, compared with 39% of females not reporting disordered eating. High levels of body dissatisfaction have been found to be common among western females. To illustrate, Williams and Currie (2000) sampled over 1,800 Scottish schoolgirls and found 45% of the 11-year-old girls and 54% of 13-year-old girls were dissatisfied with their body size. A UK study of 609 schoolgirls aged 15-16 revealed that 56% of girls ‘felt too fat’ and had used some form of weight control strategy. Interviews confirmed that those showing unhealthy eating behaviour in the questionnaires did indeed show greater eating pathology as well as lower self-esteem and greater levels of global self-dissatisfaction and dissatisfaction with their physical appearance and family relationships, (Button, 1998). 91
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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
Page 39 and 40: Conclusion Although systemic and ps
Page 41 and 42: References Banks, R. (2003). Psycho
Page 43 and 44: Linington, M. (2002). ‘Whose hand
Page 45 and 46: Small Scale Service Related Project
Page 47 and 48: • 36% stated that voluntary atten
Page 49 and 50: CONTENTS Pages Introduction 50-58 M
Page 51 and 52: Individual authors from different p
Page 53 and 54: Aim of current project This study w
Page 55 and 56: - appointment times given to all at
Page 57 and 58: RESULTS Forty professionals took pa
Page 59 and 60: The highest rated factor is about t
Page 61 and 62: Figure 2 Ratings of importance of e
Page 63 and 64: Figure 4 Ratings of importance of e
Page 65 and 66: Nursing rated the following five po
Page 67 and 68: Question Graph showing views of pro
Page 69 and 70: Other comments from Nursing stated
Page 71 and 72: However, the comments section invol
Page 73 and 74: e audited. Furthermore, it may be u
Page 75 and 76: Hodgson, R., Jamal, A., Gayathri, B
Page 77 and 78: APPENDICES 77
Page 79 and 80: How Multi-disciplinary Staff View W
Page 81 and 82: 28 Are the patients attending given
Page 83 and 84: There should be a named person resp
Page 85 and 86: Literature Review Body Image, Disor
Page 87 and 88: Prevalence studies across Europe, t
Page 89: For example, the use of appetite su
Page 93 and 94: Similarly, negative characteristics
Page 95 and 96: When body image distress is very lo
Page 97 and 98: The role of emotion regulation in t
Page 99 and 100: Experiential avoidance is the unwil
Page 101 and 102: Ineffective avoidance coping strate
Page 103 and 104: References Alexander, L. C., Gratz,
Page 105 and 106: Croll, J. Neumark-Stainer, D., stor
Page 107 and 108: Hayes, S. C., Masuda, A., Bissett,
Page 109 and 110: Keel, P. K., Fulkerson, J. A., and
Page 111 and 112: McVey, G.L., Pepler, D., Davis, R.,
Page 113 and 114: Piran, N and Cormier, H.C. (2005) t
Page 115 and 116: Stice, E., Presnell, K., Shaw, H. a
Page 117 and 118: APPENDIX I: Search strategy Consult
Page 119 and 120: Body Image, Disordered Eating and E
Page 121 and 122: ACT and weight control 139 ACT and
Page 123 and 124: Demographics of sample and epidemio
Page 125 and 126: Acknowledgements I would like to th
Page 127 and 128: Introduction This study reports on
Page 129 and 130: Consequences of disordered eating P
Page 131 and 132: Transdiagnostic approach in underst
Page 133 and 134: Factors implicated in the developme
Page 135 and 136: Feelings of depression/ high levels
Page 137 and 138: ACT and processing unpleasant emoti
Page 139 and 140: 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
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Smolak, L., Levine, M. P., & Strieg
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Willcox, M. & Sattler, D. N. (1996)
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Appendix 3 Body Image Acceptance an
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Appendix 4 Hospital Anxiety and Dep
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Appendix 5 Background information D
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Appendix 6 Information sheet for pa
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If after reading this information s
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Dear Sir/Madam, U H Doctor of Clini
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U H CONSENT FORM Title of Project:
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CERTIFICATE OF ACHEIVEMENT This is
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Debriefing sheet Title of project:
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Appendix 10 Ethics approval Form SC
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Appendix 12 Boxplots and Descriptiv
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Appendix 13 Box plot and Descriptiv
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Journal-Ready Copy Helen Eracleous
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Abstract Objective: The study inves
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Taking such a perspective may also
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ACT suggests that inflexibility (i.
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The EDI has been the measure of cho
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Additional research questions were
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Hypotheses III Inflexibility was po
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A potential explanation may be that
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The last two are choosing life dire
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Clinical implications Due to the cr
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Conclusion The hypotheses investiga
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Greco, L. A., Lambert, W., & Baer,
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Smolak, L., Levine, M. P., and Stri
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