The meaning of self-starvation: qualitative study of patients' perception of anorexia nervosa.
OBJECTIVE
Anorexia nervosa (AN) patients tend to place a positive value on their symptoms. Many clinicians believe that this plays a central role in maintaining the disorder. However, empirical research on how patients attribute meaning to their symptoms is lacking. This study aims at systematically exploring the meaning that the patients with AN attribute to their anorectic behavior.


METHODS
A qualitative, descriptive, phenomenological design was used. Eighteen women aged 20-34 with AN (DSM-IV) were interviewed with an informant-centered interview. The interviews were tape-recorded, verbatim transcribed, coded, and analyzed phenomenologically, using a QSR-N*Vivo software program.


RESULTS
The psychological meanings that the informants attributed to their anorectic behavior could be summarized in eight constructs: "Security" (feeling of stability and security), "Avoidance" (avoiding negative emotions), "Mental strength" (inner sense of mastery), "Self-confidence" (feeling acknowledged and worthy of compliments); "Identity" (achieving new identity), "Care" (eliciting care from others), "Communication" (communicating difficulties), and "Death" (wishing to starve oneself to death).


CONCLUSIONS
The eight constructs may have central functions in the maintenance of AN and should be regarded when patients' motivation and goals for treatment are assessed. Further study of the possible functions of the constructs in maintaining AN is warranted.
Nordbø
Ragnfrid H S
RH
Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway. ragnfrid.nordbo@fhi.no
Espeset
Ester M S
EM
Gulliksen
Kjersti S
KS
Skårderud
Finn
F
Holte
Arne
A
D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology*; D001293:Attitude to Death; D001294:Attitude to Health; D003142:Communication; D005260:Female; D006801:Humans; D010361:Patients / Q000523:psychology*; D012649:Self Concept; D013217:Starvation / Q000523:psychology*; D011795:Surveys and Questionnaires