"من احساس چاقی می کنم": القای تجربی جابجایی بدنی در تغذیه ای اختلال
|کد مقاله||سال انتشار||مقاله انگلیسی||ترجمه فارسی||تعداد کلمات|
|31456||2011||5 صفحه PDF||سفارش دهید||4096 کلمه|
Publisher : Elsevier - Science Direct (الزویر - ساینس دایرکت)
Journal : Behaviour Research and Therapy, Volume 49, Issue 4, April 2011, Pages 289–293
Body displacement, the theory that predicts that individuals with eating disorders will displace negative feelings about themselves onto their body, was tested experimentally in this study. Unrestrained eaters (n = 61), restrained eaters (n = 33), and individuals with eating disorders (n = 26) were randomly assigned to a control condition or an ineffectiveness induction. In the ineffectiveness condition participants were asked to recall and reflect on a past experience when they felt useless or incapable (i.e., ineffective). Results showed that individuals with eating disorders who were made to feel ineffective reported more implicit appearance/body concern than those in the control condition. Unrestrained and restrained eaters did not show this effect. This is the first experimental study to support body displacement theory. These data can be used clinically to educate and encourage patients with eating disorders to address thoughts and feelings related to ineffectiveness directly, instead of displacing this distress onto their body and potentially perpetuating their eating disorder.
Clinicians in the eating disorder field report that a common response reported by those struggling with eating disorders is, “I feel fat”. However, fat is not a traditional feeling, and clinicians working with individuals with eating disorders often help to connect the experience of “feeling fat” with underlying issues related to rejection, failure, and ineffectiveness. In clinical settings, it has been seen that those coping with an eating disorder often report intense feelings of fatness within minutes of an upsetting experience (despite the fact that their body and appearance have not changed). In 1978, Hilde Bruch, a pioneer in the conceptualization and treatment of anorexia nervosa, proposed that the body dissatisfaction seen in individuals with disordered eating may be a result of the displacement of negative affect. Specifically, negative feelings are displaced onto one’s body in an attempt to localize the distress thereby making the distress more controllable (e.g., through restriction, exercise, weight loss). Once the negative feeling has been displaced onto the body, the feeling becomes less threatening and individuals believe that they can assert control over the feeling by changing their body (Harper-Giuffre and Mackenzie, 1992 and Jasper, 1993). More recently, Fairburn (2008) has included education about body displacement theory (i.e., feeling fat) as part of his transdiagnostic cognitive behavioral therapy (CBT) for eating disorders. Additionally, the process of body displacement may play an important role in the development and maintenance of eating disorder pathology. Despite widespread clinical use, body displacement theory has not been extensively studied or supported in the literature. Forbush and Watson (2006) established some support for the body displacement hypothesis by showing that individuals with eating disorders demonstrated higher levels of emotional inhibition than did non-clinical controls. The authors suggested that emotional inhibition may lead to handling emotional distress by turning it inwards, and confusing real affect with body affect, thereby experiencing increased feelings of fatness when in emotional distress (Forbush & Watson, 2006). To our knowledge, only two experimental studies have been conducted to directly test the body displacement hypothesis. In the first, Eldredge, Wilson, and Whaley (1990) randomly assigned restrained and unrestrained eaters to either a success or a failure condition, and measured body dissatisfaction with the Eating Disorder Inventory (EDI: Garner, Olmsted, & Polivy, 1983) and the Body Shape Questionnaire (BSQ: Cooper, Taylor, Cooper, & Fairburn, 1987). It was predicted that restrained eaters would exhibit the body displacement predicted in eating disorders because restrained eaters possess a self-schema in which weight is a central component (similar to those with eating disorders). However, neither restrained nor unrestrained eaters felt worse about their bodies in the failure condition. It is possible that body displacement is unique to disordered eating or that the measures used (i.e., EDI, BSQ) are less sensitive to detecting body displacement which is likely a more labile and subtle effect. In another study, Coelho, Carter, McFarlane, and Polivy (2008) randomly assigned eating disordered participants, restrained eaters and unrestrained eaters to either a control condition or an anxiety condition1, and feelings of fatness were measured via the Thought-Shape Fusion Scale (Shafran, Teachman, Kerry, & Rachman, 1999). Results showed that only restrained eaters reported significantly more feelings of fatness in the anxiety condition than in the control condition. Surprisingly, eating disordered participants did not show this effect. One possibility is that the anxiety manipulation used in this study (i.e., imagine delivering a speech) did not trigger the ineffectiveness or lowered self-esteem that may be necessary to induce body displacement in participants with eating disorders. A more direct manipulation of ineffectiveness may be required. Given the paucity of research in this area an experiment was designed to test body displacement theory. This study used an ineffectiveness induction and a body dissatisfaction measure. We chose the Body Image States Scale (Cash, Fleming, Alindogan, Steadman, & Whitehead, 2002) because it is a psychometrically supported short state measure that we thought would be sensitive to the inductions. We were also interested in using a dependent measure that detected body/appearance concern implicitly, given that the more obvious measures may lead to demand characteristics and/or a ceiling effect [asking someone with an eating disorder about body (dis)satisfaction can in and of itself trigger body dissatisfaction across conditions].