title: Rumination and modes of processing around meal times in women with anorexia nervosa: qualitative and quantitative results from a pilot study.
abstract: OBJECTIVE
  The primary aim of this exploratory study was to examine qualitatively and quantitatively the effects of rumination, mindful breathing, and distraction on processing styles and the meal time experience in women with a history of anorexia nervosa (AN).
  
  
  METHODS
  A quasi-experimental within-participant design was employed. Thirty-seven women with history of AN and all experiencing current eating disorder psychopathology listened to a single rumination, mindful breathing and distraction exercise before a meal time. Qualitative and quantitative analyses were employed.
  
  
  RESULTS
  Specific themes were extracted for each exercise including avoidance, being in the moment and rumination. The rumination exercise led to significantly greater analytical self-focus. Mindful breathing led to significantly greater experiential self-focus compared with distraction in partially weight-restored AN participants.
  
  
  CONCLUSIONS
  In AN, self-material is processed in a ruminative way and avoidance is valued. It is difficult to shift individuals with AN out of a rumination around meal times using brief mindful breathing. Future research should investigate at what stage of AN illness mindful-based and acceptance-based strategies are useful and how these strategies could be incorporated in treatment.
authors.affiliation: University of Oxford Department of Psychiatry, Warneford Hospital, UK.
authors.forename: Felicity A
authors.initials: FA
authors.lastname: Cowdrey
authors.forename: Anne
authors.initials: A
authors.lastname: Stewart
authors.forename: Jill
authors.initials: J
authors.lastname: Roberts
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Park
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology*; D001288:Attention; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D006801:Humans; D010865:Pilot Projects; D012649:Self Concept; D013850:Thinking
keywords: anorexia nervosa; eating disorder; meal time; mindfulness; rumination; treatment