Object Relations and Relationships with Parents as Predictors of Motivation to Recover from Eating Disorders
Read full paper at:
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=50782#.VE8rmVfHRK0
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=50782#.VE8rmVfHRK0
Author(s)
The lack
of motivation to recover from eating disorders (ED) poses a big problem in
light of literature showing the critical role motivation plays in the outcome
of ED treatment. Literature exploring the factors contributing to motivation to
recover is scarce. The current study aims at exploring the associations between
aspects of object relations and quality of relationships with parents to the
motivation for recovery in light of research suggesting an influence of these
variables in the development of ED. 79 females, visitors of either “pro-anorexia”
websites (in which ED are glorified as an alternative life style rather than
being acknowledged as mental disorders) or “prorecovery” websites, completed a
set of questionnaires online including Eat-26, Anorexia Nervosa Stages of
Change Questionnaire, Quality of Relationship Inventory regarding parents and blatt’s
Object Relations Inventory. Results show that while the score on EAT-26 was
related to both mother and father variables, only the quality of relationship
with the father is a significant variable in predicting motivation to recover
from ED. Implications for treatment and further research are discussed.
Cite this paper
Warshawsky, D. & Handelzalts, J. (2014).
Object Relations and Relationships with Parents as Predictors of
Motivation to Recover from Eating Disorders. Psychology, 5, 1730-1742. doi: 10.4236/psych.2014.515180.
| [1] |
Ainsworth, M. D. (1969). Object
Relations, Dependency, and Attachment: A Theoretical Review of the
Infant-Mother Relationship. Child Development, 40, 969-1025. http://dx.doi.org/10.2307/1127008 |
| [2] |
Ametller, L., Castro, J.,
Serrano, E., Martinez, E., & Toro, J. (2005). Readiness to Recover
in Adolescent Anorexia Nervosa: Prediction of Hospital Admission.
Journal of Child Psychology and Psychiatry, and Allied Disciplines, 46,
394-400. http://dx.doi.org/10.1111/j.1469-7610.2004.00360.x |
| [3] |
Aronson, J. K. (1986). The Level
of Object Relations and Severity of Symptoms in the Normal Weight
Bulimic Patient. International Journal of Eating Disorders, 5, 669-681. http://dx.doi.org/10.1002/1098-108X(198605)5:4<669::AID-EAT2260050407>3.0.CO;2-P |
| [4] | Balint, M. (1968). The Basic Fault: Therapeutic Aspects of Regression. London: Tavistock. |
| [5] |
Bardone-Cone, A. M., & Cass.
K. M. (2007) What Does Viewing a Pro-Anorexia Website Do? An
Experimental Examination of Website Exposure and Moderating Effects.
International Journal of Eating Disorders, 40, 537-548.
http://dx.doi.org/10.1002/eat.20396 |
| [6] |
Becker, B., Bell, M., &
Billington, R. (1987). Object Relations Ego Deficits in Bulimic College
Women. Journal of Clinical Psychology, 43, 92-95. http://dx.doi.org/10.1002/1097-4679(198701)43:1<92::AID-JCLP2270430113>3.0.CO;2-Z |
| [7] |
Bewell, C. V., & Carter, J.
C. (2008). Readiness to Change Mediates the Impact of Eating Disorder
Symptomatology on Treatment Outcome in Anorexia Nervosa. The
International Journal of Eating Disorders, 41, 368-371. http://dx.doi.org/10.1002/eat.20513 |
| [8] |
Blake, W., Turnbull, S., &
Treasure, J. (1997). Stages and Processes of Change in Eating Disorders:
Implications for Therapy. Clinical Psychology & Psychotherapy, 4,
186-191. http://dx.doi.org/10.1002/(SICI)1099-0879(199709)4:3<186::AID-CPP128>3.0.CO;2-5 |
| [9] | Blatt, S. J., Chevron, E. S., Quinlan, D. M., Schaffer, C. E., & Wein, S. (1988). The Assessment of Qualitative and Structural Dimensions of Object Representations. Unpublished Manuscript, New Haven, CT: Yale University. |
| [10] |
Botta, R. A., & Dumlao, R.
(2002). How Do Conflict and Communication Patterns between Fathers and
Daughters Contribute to or Offset Eating Disorders? Health
Communication, 14, 199-219. http://dx.doi.org/10.1207/S15327027HC1402_3 |
| [11] |
Broberg, A. G., Hjalmers, I.,
& Nevonen, L. (2001). Eating Disorders, Attachment and Interpersonal
Difficulties: A Comparison between 18- to 24-Year-Old Patients and
Normal Controls. European Eating Disorders Review, 9, 381-396. http://dx.doi.org/10.1002/erv.421 |
| [12] |
Cassin, S. E., Von Ranson, K.
M., Heng, K., Brar, J., & Wojtowicz, A. E. (2008). Adapted
Motivational Interviewing for Women with Binge Eating Disorder: A
Randomized Controlled Trial. Psychology of Addictive Behaviors, 22,
417-425. http://dx.doi.org/10.1037/0893-164X.22.3.417 |
| [13] |
Castro-Fornieles, J., Bigorra,
A., Martinez-Mallen, E., Gonzalez, L., Moreno, E., Font, E., & Toro,
J. (2011). Motivation to Change in Adolescents with Bulimia Nervosa
Mediates Clinical Change after Treatment. European Eating Disorders
Review: The Journal of the Eating Disorders Association, 19, 46-54. http://dx.doi.org/10.1002/erv.1045 |
| [14] |
Custers, K., & Van den
Bulck, J. (2009). Viewership of Pro-Anorexia Websites in Seventh, Ninth
and Eleventh Graders. European Eating Disorders Review: The Journal of
the Eating Disorders Association, 17, 214-219. http://dx.doi.org/10.1002/erv.910 |
| [15] | Drungaite, A. (2009). Anorexia Nervosa: What Makes Patients Feel Better during the Illness and the Process of Recovery? Thesis, Skovde: University of Skovde. |
| [16] |
Dunn, E. C., Neighbors, C.,
& Larimer, M. E. (2006). Motivational Enhancement Therapy and
Self-Help Treatment for Binge Eaters. Psychology of Addictive Behaviors,
20, 44-52. http://dx.doi.org/10.1037/0893-164X.20.1.44 |
| [17] |
Federici, A., & Kaplan, A.
S. (2008). The Patient’s Account of Relapse and Recovery in Anorexia
Nervosa: A Qualitative Study. European Eating Disorders Review: The
Journal of the Eating Disorders Association, 16, 1-10. http://dx.doi.org/10.1002/erv.813 |
| [18] |
Feld, R., Woodside, D. B.,
Kaplan, A. S., Olmsted, M. P., & Carter, J. C. (2001). Pretreatment
Motivational Enhancement Therapy for Eating Disorders: A Pilot Study.
The International Journal of Eating Disorders, 29, 393-400. http://dx.doi.org/10.1002/eat.1035 |
| [19] |
Franko, D. L. (1997). Ready or
Not? Stages of Change as Predictors of Brief Group Therapy Outcome in
Bulimia Nervosa. Group, 21, 39-45. http://dx.doi.org/10.1007/BF02872753 |
| [20] |
Garner, D. M., Olmsted, M. P.,
Bohr, Y., & Garfinkel, P. E. (1982). The Eating Attitudes Test:
Psychometric Features and Clinical Correlates. Psychological Medicine,
12, 871-878. http://dx.doi.org/10.1017/S0033291700049163 |
| [21] |
Geller, J., Brown, K. E.,
Zaitsoff, S. L., Goodrich, S., & Hastings, F. (2003). Collaborative
versus Directive Interventions in the Treatment of Eating Disorders:
Implications for Care Providers. Professional Psychology: Research and
Practice, 34, 406-413. http://dx.doi.org/10.1037/0735-7028.34.4.406 |
| [22] |
Geller, J., Drab-Hudson, D. L.,
Whisenhunt, B. L., & Srikameswaran, S. (2004). Readiness to Change
Dietary Restriction Predicts Outcomes in the Eating Disorders. Eating
Disorders, 12, 209-224. dhttp://dx.doi.org/10.1080/10640260490490438 |
| [23] |
Gilbert, A. A., Shaw, S. M.,
& Notar, M. K. (2000). The Impact of Eating Disorders on Family
Relationships. Eating Disorders, 8, 331-345. http://dx.doi.org/10.1080/10640260008251240 |
| [24] | Greenberg , J. R., & Mitchell, S. A. (1983). Object Relations in Psychoanalytic Theory. Cambridge, MA: Harvard University Press, 11-12. |
| [25] |
Grissett, N. I., & Norvell,
N. K. (1992). Perceived Social Support, Social Skills and Quality of
Relationships in Bulimic Women. Journal of Consulting and Clinical
Psychology, 60, 293-299. http://dx.doi.org/10.1037/0022-006X.60.2.293 |
| [26] |
Harper, K., Sperry, S., &
Thompson, J. K. (2008). Viewership of Pro-Eating Disorder Websites:
Association with Body Image and Eating Disturbances. International
Journal of Eating Disorders, 41, 92-95. http://dx.doi.org/10.1002/eat.20408 |
| [27] |
Huprich, S. K., & Greenberg,
R. P. (2003). Advances in the Assessment of Object Relations in the
1990s. Clinical Psychology Review, 23, 665-698. http://dx.doi.org/10.1016/S0272-7358(03)00072-2 |
| [28] |
Jenkins, J., & Ogden, J.
(2012). Becoming “Whole” Again: A Qualitative Study of Women’s Views of
Recovering from Anorexia Nervosa. European Eating Disorders Review, 20,
e23-e31. http://dx.doi.org/10.1002/erv.1085 |
| [29] |
Jett, S., La Porte, D. J., &
Wanchisn, J. (2010). Impact of Exposure to Pro-Eating Disorder Websites
on Eating Behavior in College Women. European Eating Disorders Review:
The Journal of the Eating Disorders Association, 18, 410-416. http://dx.doi.org/10.1002/erv.1009 |
| [30] |
Jones, C. J., Leung, N., &
Harris, G. (2006). Father-Daughter Relationship and Eating
Psychopathology: The Mediating Role of Core Beliefs. British Journal of
Clinical Psychology, 45, 319-330. http://dx.doi.org/10.1348/014466505X53489 |
| [31] |
Kenny, M. E., & Gallagher,
L. A. (2002). Instrumental and Social/Relational Correlates of Perceived
Maternal and Paternal Attachment in Adolescence. Journal of
Adolescence, 25, 203-219. http://dx.doi.org/10.1006/jado.2002.0461 |
| [32] |
Kenny, M. E., & Hart, K.
(1992). Relationship between Parental Attachment and Eating Disorders in
an Inpatient and a College Sample. Journal of Counseling Psychology,
39, 521-526. http://dx.doi.org/10.1037/0022-0167.39.4.521 |
| [33] |
McHugh, M. D. (2007). Readiness
for Change and Short-Term Outcomes of Female Adolescents in Residential
Treatment for Anorexia Nervosa. The International Journal of Eating
Disorders, 40, 602-612. http://dx.doi.org/10.1002/eat.20425 |
| [34] | Miller, W. R., & Rollnick, S. (2002). Motivational Interviewing: Preparing People for Change (2nd ed.). New York: Guilford Press. |
| [35] |
Mintz, L. B., & O’Halloran,
M. S. (2000). The Eating Attitudes Test: Validation with DSM-IV Eating
Disorder Criteria. Journal of Personality Assessment, 74, 489-503. http://dx.doi.org/10.1207/S15327752JPA7403_11 |
| [36] |
Nordbø, R. H. S., Gulliksen, K.
S., Espeset, E. M. S., Skarderud, F., Geller, J., & Holte, A.
(2008). Expanding the Concept of Motivation to Change: The Content of
Patients’ Wish to Recover from Anorexia Nervosa. The International
Journal of Eating Disorders, 41, 635-642. http://dx.doi.org/10.1002/eat.20547 |
| [37] |
Norris, M. L., Boydell, K. M.,
Pinhas, L., & Katzman, D. K. (2006). Ana and the Internet: A Review
of Pro-Anorexia Websites. International Journal of Eating Disorders, 39,
443-447. http://dx.doi.org/10.1002/eat.20305 |
| [38] |
Pettersen, G., & Rosenvinge,
J. H. (2002). Improvement and Recovery from Eating Disorders: A Patient
Perspective. Eating Disorders, 10, 61-71. http://dx.doi.org/10.1002/erv.425 |
| [39] | Pierce, G. R. (1994). The Quality of Relationships Inventory: Assessing the Interpersonal Context of Social Support. In B. R. Burleson, & T. L. Albrecht (Eds.), Communication of Social Support: Messages, Interactions, Relationships, and Community (pp. 247-266). Newbury Park, CA: Sage. |
| [40] |
Pierce, G. R., Sarason, I. G.,
Sarason, B. R., Solky-Butzel, J. A., & Nagle, L. C. (1997).
Assessing the Quality of Personal Relationships. Journal of Social and
Personal Relationships, 14, 339-356. http://dx.doi.org/10.1177/0265407597143004 |
| [41] |
Pollack, D. L., & Keaschuk,
R. A. (2008). The Object Relations of Bulimic Women in Context: An
Integration of Two Studies. Eating Disorders, 16, 14-29. http://dx.doi.org/10.1080/10640260701667920 |
| [42] | Prochaska, J. O., & Di Clemente, C. C. (1992). The Transtheoretical Approach. In Handbook of Psychotherapy Integration (pp. 147-171). Oxford: Oxford University Press. |
| [43] |
Prochaska, J. O., &
DiClemente, C. C. (1982). Transtheoretical Therapy: Toward a More
Integrative Model of Change. Psychotherapy: Theory, Research &
Practice, 19, 276-288. http://dx.doi.org/10.1037/h0088437 |
| [44] |
Richards, M. H., Gitelson, I.
B., Petersen, A. C., & Hurtig, A. L. (1991). The Role of Mothers and
Fathers. Psychology of Women Quarterly, 15, 65-81. http://dx.doi.org/10.1111/j.1471-6402.1991.tb00478.x |
| [45] |
Rieger, E., & Touyz, S.
(2006). An Investigation of the Factorial Structure of Motivation to
Recover in Anorexia Nervosa Using the Anorexia Nervosa Stages of Change
Questionnaire. European Eating Disorders Review, 14, 269-275. http://dx.doi.org/10.1002/erv.684 |
| [46] |
Rieger, E., Touyz, S. W., &
Beumont, P. J. V. (2002). The Anorexia Nervosa Stages of Change
Questionnaire (ANSOCQ): Information Regarding Its Psychometric
Properties. The International Journal of Eating Disorders, 32, 24-38. http://dx.doi.org/10.1002/eat.10056 |
| [47] |
Rieger, E., Touyz, S., Schotte,
D., Beumont, P., Russell, J., Clarke, S., Kohn, M. et al. (2000).
Development of an Instrument to Assess Readiness to Recover in Anorexia
Nervosa. The International Journal of Eating Disorders, 28, 387-396. http://dx.doi.org/10.1002/1098-108X(200012)28:4<387::AID-EAT6>3.0.CO;2-Y |
| [48] |
Rothschild-Yakar, L.,
Levy-Shiff, R., Fridman-Balaban, R., Gur, E., & Stein, D. (2010).
Mentalization and Relationships with Parents as Predictors of Eating
Disordered Behavior. The Journal of Nervous and Mental Disease, 198,
501-507. http://dx.doi.org/10.1097/NMD.0b013e3181e526c8 |
| [49] | Rubin, L. H., Witkiewitz, K., Andre, J. S., & Reilly, S. (2007). Methods for Handling Missing Data in the Behavioral Neurosciences: Don’t Throw the Baby Rat out with the Bath Water. The Journal of Undergraduate Neuroscience Education, 5, A71-A77. |
| [50] |
Rushford, N. (2006). Readiness
to Recover in Anorexia Nervosa: What Does It Depend on in Female
Inpatients? European Eating Disorders Review, 14, 388-396. http://dx.doi.org/10.1002/erv.732 |
| [51] |
Sanderson, S., Raab, S., &
Moch, P. (2012). BMI and EAT-26, Predictors for Low BMD? SAGE Open, 2. http://dx.doi.org/10.1177/2158244012441604 |
| [52] |
Sights, J. R., & Richards,
H. C. (1984). Parents of Bulimic Women. International Journal of Eating
Disorders, 3, 3-13. http://dx.doi.org/10.1002/1098-108X(198422)3:4<3::AID-EAT2260030402>3.0.CO;2-3 |
| [53] |
Starrels, M. E. (1994). Gender
Differences in Parent-Child Relations. Journal of Family Issues, 15,
148-165. http://dx.doi.org/10.1177/019251394015001007 |
| [54] |
Steiger, H., & Houle, L.
(1991). Defense Styles and Object-Relations Disturbances among
University Women Displaying Varying Degrees of “Symptomatic” Eating.
International Journal of Eating Disorders, 10, 145-153. http://dx.doi.org/10.1002/1098-108X(199103)10:2<145::AID-EAT2260100203>3.0.CO;2-D |
| [55] |
Stockford, K., Turner, H., &
Cooper, M. (2007). Illness Perception and Its Relationship to Readiness
to Change in the Eating Disorders: A Preliminary Investigation. British
Journal of Clinical Psychology, 46, 139-154. http://dx.doi.org/10.1348/014466506X115786 |
| [56] |
Stuart, G. W., Laraia, M. T.,
Ballenger, J. C., & Lydiard, R. B. (1990). Early Family Experiences
of Women with Bulimia and Depression. Archives of Psychiatric Nursing,
4, 43-52. http://dx.doi.org/10.1016/S0883-9417(05)80010-X |
| [57] |
Swanson, H., Power, K., Collin,
P., Deas, S., Paterson, G., Grierson, D., Yellowlees, A. et al. (2010).
The Relationship between Parental Bonding, Social Problem Solving and
Eating Pathology in an Anorexic Inpatient Sample. European Eating
Disorders Review: The Journal of the Eating Disorders Association, 18,
22-32. http://dx.doi.org/10.1002/erv.967 |
| [58] |
Tantillo, M., & Sanftner, J.
(2003). The Relationship between Perceived Mutuality and Bulimic
Symptoms, Depression and Therapeutic Change in Group. Eating Behaviors,
3, 349-364. http://dx.doi.org/10.1016/S1471-0153(02)00077-6 |
| [59] |
Treasure, J. L., Katzman, M.,
Schmidt, U., Troop, N., Todd, G., & De Silva, P. (1999). Engagement
and Outcome in the Treatment of Bulimia Nervosa: First Phase of a
Sequential Design Comparing Motivation Enhancement Therapy and Cognitive
Behavioral Therapy. Behavior Research and Therapy, 37, 405-418. http://dx.doi.org/10.1016/S0005-7967(98)00149-1 |
| [60] |
Wade, T. D., Frayne, A.,
Edwards, S.-A., Robertson, T., & Gilchrist, P. (2009). Motivational
Change in an Inpatient Anorexia Nervosa Population and Implications for
Treatment. The Australian and New Zealand Journal of Psychiatry, 43,
235-243. http://dx.doi.org/10.1080/00048670802653356 |
| [61] | Walters, E. E., & Kendler, K. S. (1995). Anorexia Nervosa and Anorexic-Like Syndromes in a Population-Based Female Twin Sample. The American Journal of Psychiatry, 152, 64-71. |
| [62] |
Ward, A., Troop, N., Todd, G.,
& Treasure, J. (1996). To Change or not to Change: “How” Is the
Question? British Journal of Medical Psychology, 69, 139-146. http://dx.doi.org/10.1111/j.2044-8341.1996.tb01858.x |
| [63] |
Whitney, J., Murray, J., Gavan,
K., Todd, G., Whitaker, W., & Treasure, J. (2005). Experience of
Caring for Someone with Anorexia Nervosa: Qualitative Study. The British
Journal of Psychiatry: The Journal of Mental Science, 187, 444-449. http://dx.doi.org/10.1192/bjp.187.5.444 |
| [64] |
Wilson, J. L., Peebles, R.,
Hardy, K. K., & Litt, I. F. (2006). Surfing for Thinness: A Pilot
Study of Pro-Eating Disorder Web Site Usage in Adolescents with Eating
Disorders. Pediatrics, 118, e1635-e1643. http://dx.doi.org/10.1542/peds.2006-1133 |
| [65] | Winnicott, D. W. (1974). Fear of Breakdown. International Review of Psycho-Analysis, 1, 103-107. |
| [66] |
Wolk, S. L., & Devlin, M. J.
(2001). Stage of Change as a Predictor of Response to Psychotherapy for
Bulimia Nervosa. The International Journal of Eating Disorders, 30,
96-100. http://dx.doi.org/10.1002/eat.1058 |
| [67] |
Wonderlich, S., Ukestad, L.,
& Perzacki, R. (1994). Perceptions of Nonshared Childhood
Environment in Bulimia Nervosa. Journal of the American Academy of Child
and Adolescent Psychiatry, 33, 740-747. http://dx.doi.org/10.1097/00004583-199406000-00015 eww141028lx |
评论
发表评论