Auswahl der wissenschaftlichen Literatur zum Thema „Anorexia nervosa Social aspects Case studies“

Numerous studies have identified links between psychopathology and a history of traumatic life events and dysfunctional attachment relationships. Hence, given the possible traumatic origins of this pathology, it may be useful to provide a trauma-focused intervention such as the eye movement desensitization and reprocessing (EMDR) therapy. This article illustrates a clinical case by describing the positive results of the EMDR therapy in the recovery of unremitting anorexia nervosa in a 17-year-old inpatient. She had previously been hospitalized on 4 occasions in the previous 4 years and received both psychodynamic and cognitive-behavioral therapy. At pretreatment, the client weighed (28 kg, 62 lb) and had a body mass index of 14. She was designated with a dismissing attachment style on the Adult Attachment Interview. EMDR therapy was provided for 6 months in hospital, in twice weekly 50-minute sessions and consisted of standard procedures primarily focusing on her relational traumas, interspersed with psychoeducational talk therapy sessions, and integrated with ego state therapy. At the end of treatment, the client weighed (55 kg, 121 lb) and had a body mass index of 21.5. She no longer met diagnostic criteria for anorexia nervosa, and her attachment style had changed to an earned free-autonomous state of mind. She reported an increase in self-confidence and in her ability to manage various social challenges. Results were maintained at 12 and 24 months follow-up. The treatment implications of this case study are discussed.

SUMMARY INTRODUCTION: The interplay between eating disorders and psychosis is a challenging field to which little attention has been paid. Its study raises conceptual and methodological questions in both areas, making the diagnosis and management of patients difficult. Such questions are addressed and illustrated with a review and case report. METHODS: The authors present the case of a woman with Anorexia Nervosa and with comorbid Shared Psychotic Disorder, based on a literature review regarding the comorbidity between eating disorders and psychosis. The authors conducted a non-systematic review by searching the PubMed database, using the Mesh Terms “anorexia nervosa”, “bulimia nervosa”, “comorbidity” and “psychotic disorders”. RESULTS: The findings suggest that studies on the subject are limited by issues regarding data on the prevalence of comorbidities, phenomenological aspects of eating disorders, and the interface and integration with psychotic symptoms. CONCLUSIONS: The case presented illustrates the difficulties in managing a patient with a comorbid eating disorder and psychosis. In order to ensure a rigorous assessment of both psychotic and eating disorder symptoms, the focus should be on the pattern of appearance or emergence of symptoms, their phenomenology, clinical and family background of the patient, and clinical status on follow-up.

- Anorexia nervosa is a complex pathology that has been studied through different paradigma (Onnis, 2004; Treasure, Schimdt, van Furth, 2006). The different authors who studied anorexia nervosa seem to agree about the hypothesis of a multi-factors pathogenesis in which a very important role is played by the relational aspects and, specifically, by family relationships, in the beginning and in the going on of this pathology. Nevertheless, Reiss (1989) pointed out we have to consider both practising and represented family, that is the role of family relationships (i.e. observed interactions) and individual representations. The practising family has been studied by systems theory paradigm, which found very typical transactional patterns in anorexic families, such as enmeshment and triangulation (Minuchin et al., 1980; Selvini Palazzoli et al., 1988; 1998). On the other hand, attachment theory studied the represented family and the role of insecure attachment models in psychopathology onset (Bowlby, 1973; Main, 1996). Many studies have underlined the prevalence of insecure attachment models and unresolved attachment status in response to loss or to trauma in anorexic patients and their mothers, pointing out the role of transgenerational transmission (Cole-Detke, Kobak, 1996; Fonagy et al., 1996; Ward et al., 2001; Ammaniti, Mancone, Vismara, 2001; Ramaciotti, Sorbello, Pazzagli, Vismara, Mancone, Pallanti, 2001).Key-words: anorexia nervosa, adolescence, family, relationships, internal working models.Parole-chiave: anoressia nervosa, adolescenza, famiglia, relazioni, modelli operativi interni.

IntroductionThe presence of an extra X-chromosome, also known as Klinefelter's Syndrome, occurs in approximately 1 in 500 live male births. Epidemiological studies have reported an increased vulnerability to psychiatric disturbances in this group of patients and suggest that the X chromosome may be involved in the aetiology.Material and MethodsComprehensive review of the scientific literature (Medline, Ovid) on Psychiatric pathology in Klinefelter's Syndrome published over the last 20 years.ResultsThis is a case report of a 27 year-old-male with Klinefelter's Syndrome confirmed by karyotyping (XXY), suffering from different neuropsychiatric disorders, such as mental retardation, dyslexia, ADHD and social dysfunctioning. Since the age of 16 he has required multiple psychiatric hospitalizations due to his impulse control difficulties and exaggerated mood swings.This case raises the question of whether Klinefelter's syndrome patients are predisposed to psychiatric pathology (including Schizophrenia, Bipolar Disorder, Anorexia Nervosa or social-emotional processing) at a genetic level.ConclusionsReviews of the neuropsychiatric problems associated with Klinefelter's Syndrome confirm an association between disorders in this area and the chromosomal abnormality. Further studies are needed to identify involvement of X-linked epigenetic influence and susceptibility to several psychiatric diseases.

Resume This paper offers a methodical review of the scientific literature of the last decade that concerns itself with online services offering supportive advocacy for anorexia nervosa and bulimia nervosa (‘pro-ana’ and ‘pro-mia’). The main question is whether these studies reproduce the traditional divide in the study of eating disorders, between clinical and social science perspectives, with limited mutual exchanges. Having first identified a specific body of literature, the authors investigate its content, methods and approaches, and analyse the network of cross-citations the components generate and share. On this basis, the authors argue that the scientific literature touching on pro-ana websites can be regarded as a single transdisciplinary body of knowledge. What’s more, they show that the literature on computer-mediated sociabilities centred on eating disorders displays different structural characteristics with respect to the traditional, non-Web-related research on eating disorders. In the latter, the social sciences have usually provided a critical counterpoint to the development of a health sciences mainstream. In the case of Web-related research, however, the social sciences have taken the lead role in defining the field, with the health sciences following suit.

IntroductionGender is crucial in many aspects of life, including attitude towards body image perception. Although the well-known female preponderance, recent studies demonstrate an increasing Eating Disorders (EDs) incidence in males but scant literature attention.AimsThis study aims to highlight the growing phenomenon of EDs in males and shed light on sex-related clinical features and psychiatric comorbidities.MethodOut of 280 persons aged 18–74, consecutively referred to Bologna's outpatients EDs clinic, 267 were included in this retrospective observational study.ResultsThe men/women ratio was one to five. The most frequent EDs in males was Binge Eating Disorder, whereas in females Anorexia Nervosa and Bulimia Nervosa prevailed. Excessive exercising and fasting were the most common dysfunctional behaviors in men, while self-induced vomiting and laxative-diuretic abuse were more typical in women. Mood and Somatoform Disorders were more common in women, whereas Anxiety and Psychosis Disorders in males. Within personality disorders, borderline and histrionic prevailed in female, while narcissistic and anti-social in males.ConclusionsMale compared to female EDs, show differences in clinical presentation, symptoms and comorbidities. The increased proportion of affected men should alert general practitioners, clinicians and psychologists working in non-specialized settings to be more aware of the possibilities of encountering an ED in men and of the need of exploring the eating habits in all male patients. The finding of a more pronounced physical hyperactivity in men in order to achieve an ideal body shape which is muscular and athletic suggests the need of a deeper attention to sex-different symptoms and behaviors declination.Disclosure of interestThe authors have not supplied their declaration of competing interest.

<p><strong>List of abstracts and authors:</strong></p><p><strong>1. Bipolar disorder not otherwise specified -overdiagnosed or underdiagnosed?</strong></p><p>E Allers</p><p><strong>2. The prognosis of major depression untreated and treated: Does the data reflect the true picture of the prognosis of this very common disorder?</strong></p><p>E Allers</p><p><strong>3. Can we prolong our patients' life expectancy? Providing a better quality of life for patients with severe mental illness</strong></p><p>O A Betencourt</p><p><strong>4. The scope of ECT practice in South Africa</strong></p><p>J Benson-Martin, P Milligan</p><p><strong>5. Biomarkers for schizophrenia: Can we evolve like cancer therapeutics?</strong></p><p>P Buckley<strong></strong></p><p><strong>6. Relapse in schizophrenis: Major challenges in prediction and prevention</strong></p><p>P Buckley</p><p><strong>7. Informed consent in biological treatments: The right to know the duty to inform</strong></p><p><strong></strong>I Chetty</p><p><strong>8. Effectiveness of a long-acting injectable antipsychotic plus an assertive monitoring programme in first-episode schizophrenia</strong></p><p><strong></strong>B Chiliza, L Asmal, O Esan, A Ojagbemi, O Gureje, R Emsley</p><p><strong>9. Name, shame, fame</strong></p><p>P Cilliers</p><p><strong>10. Can we manage the increasing incidence of violent raging children? We have to!</strong></p><p>H Clark</p><p><strong>11. Serotonin, depression and antidepressant action</strong></p><p>P Cowen</p><p><strong>12. Prevalence and correlates of comorbid psychiatris illness in patients with heroin use disorder admitted to Stikland Opioid Detoxification Unit</strong></p><p>L Dannatt, K J Cloete, M Kidd, L Weich</p><p><strong>13. Investigating the association between diabetes mellitus, depression and psychological distress in a cohort of South African teachers</strong></p><p>A K Domingo, S Seedat, T M Esterhuizen, C Laurence, J Volmink, L Asmal</p><p><strong>14. Neuropeptide S -emerging evidence for a role in anxiety</strong></p><p>K Domschke</p><p><strong>15. Pathogenetics of anxiety</strong></p><p>K Domschke</p><p><strong>16. The effects of HIV on the fronto-striatal system</strong></p><p>S du Plessis, M Vink, J Joska, E Koutsilieri, C Scheller, B Spottiswoode, D Stein, R Emsley</p><p><strong>17. Effects of acute antipsychotic treatment on brain morphology in schizophrenia</strong></p><p>R Emsley, L Asmal, B Chiliza, S du Plessis, J Carr, A Goosen, M Kidd, M Vink, R Kahn</p><p><strong>18. Development of a genetic database resource for monitoring of breast cancer patients at risk of physical and psychological complications</strong></p><p>K Grant, F J Cronje, K Botha, J P Apffelstaedt, M J Kotze</p><p><strong>19. Unipolar mania reconsidered: Evidence from a South African study</strong></p><p><strong></strong>C Grobler</p><p><strong>20. Antipsychotic-induced movement disorders: Occurence and management</strong></p><p>P Haddad</p><p><strong>21. The place of observational studies in assessing the effectiveness of long-acting injectable antipsychotics</strong></p><p>P Haddad</p><p><strong>22. Molecular mechanisms of d-cycloserine in fear extinction: Insights from RNS sequencing</strong></p><p>S Hemmings, S Malan-Muller, L Fairbairn, M Jalali, E J Oakeley, J Gamieldien, M Kidd, S Seedat</p><p><strong>23. Schizophrenia: The role of inflammation</strong></p><p>DC Henderson</p><p><strong>24. Addictions: Emergent trends and innovations</strong></p><p>V Hitzeroth</p><p><strong>25. The socio-cultural-religious context of biological psychiatric practice</strong></p><p>B Janse van Rensburg</p><p><strong>26. Biochemical markers for identifying risk factors for disability progression in multiple sclerosis</strong></p><p><strong></strong>S Janse van Rensburg, M J Kotze, F J Cronje, W Davis, K Moremi, M Jalali Sefid Dashti, J Gamieldien, D Geiger, M Rensburg, R van Toorn, M J de Klerk, G M Hon, T Matsha, S Hassan, R T Erasmus</p><p><strong>27. Alcohol-induced psychotic disorder: Brain perfusion and psychopathology - before and after antipsychotic treatment</strong></p><p>G Jordaan, J M Warwick, D G Nel, R Hewlett, R Emsley</p><p><strong>28.'Pump and dump': Harm reduction strategies for breastfeeding while using substances</strong></p><p>L Kramer</p><p><strong>29. Adolescent neuropsychiatry - an emerging field in South African adolescent psychiatric services</strong></p><p>A Lachman</p><p><strong>30. Recovery versus remission, or what it means to be healthy for a psychiatric patient?</strong></p><p>B Latecki</p><p><strong>31. Holistic methods utilised to normalise behaviours in youth diagnosed with neuro-biochemical disorders</strong></p><p>P Macqueen</p><p><strong>32. Candidate genes and novel polymorphisms for anxiety disorder in a South African cohort</strong></p><p>N McGregor, J Dimatelis, S M J Hemmings, C J Kinnear, D Stein, V Russel, C Lochner</p><p><strong>33. Higher visual functioning</strong></p><p>A Moodley</p><p><strong>34. The effects of prenatal methylmercury exposure on trace element and antioxidant levels in rat offspring following 6-hydroxydopamine-induced neuronal insult</strong></p><p>Z M Moosa, W M U Daniels, M V Mabandla</p><p><strong>35. Paediatric neuropsychiatric movement disorders</strong></p><p>L Mubaiwa</p><p><strong>36. The South African national female offenders study</strong></p><p>M Nagdee, L Artz, C de Clercq, P de Wet, H Erlacher, S Kaliski, C Kotze, L Kowalski, J Naidoo, S Naidoo, J Pretorius, M Roffey, F Sokudela, U Subramaney</p><p><strong>37. Neurobiological consequences of child abuse</strong></p><p>C Nemeroff</p><p><strong>38. What do Stellenbosch Unviversity medical students think about psychiatry - and why should we care?</strong></p><p>G Nortje, S Suliman, K Seed, G Lydall, S Seedat</p><p><strong>39. Neurological soft skins in Nigerian Africans with first episode schizophrenia: Factor structure and clinical correlates</strong></p><p><strong></strong>A Ojagbemi, O Esan, O Gureje, R Emsley</p><p><strong>40. Should psychiatric patients know their MTHFR status?</strong></p><p>E Peter</p><p><strong>41. Clinical and functional outcome of treatment refractory first-episode schizophrenia</strong></p><p>L Phahladira, R Emsley, L Asmal, B Chiliza</p><p><strong>42. Bioethics by case discussion</strong></p><p>W Pienaar</p><p><strong>43. Reviewing our social contract pertaining to psychiatric research in children, research in developing countries and distributive justice in pharmacy</strong></p><p>W Pienaar</p><p><strong>44. The performance of the MMSE in a heterogenous elderly South African population</strong></p><p>S Ramlall, J Chipps, A I Bhigjee, B J Pillay</p><p><strong>45. Biological basis addiction (alocohol and drug addiction)</strong></p><p>S Rataemane</p><p><strong>46. Volumetric brain changes in prenatal methamphetamine-exposed children compared with healthy unexposed controls</strong></p><p><strong></strong>A Roos, K Donald, G Jones, D J Stein</p><p><strong>47. Single voxel proton magnetic resonance spectroscopy of the amygdala in social anxiety disorder in the context of early developmental trauma</strong></p><p>D Rosenstein, A Hess, S Seedat, E Meintjies</p><p><strong>48. Discussion of HDAC inhibitors, with specific reference to supliride and its use during breastfeeding</strong></p><p>J Roux</p><p><strong>49. Prevalence and clinical correlates of police contact prior to a first diagnosis of schizophrenia</strong></p><p>C Schumann, L Asmal, K Cloete, B Chiliza, R Emsley</p><p><strong>50. Are dreams meaningless?</strong></p><p>M Solms</p><p><strong>51. The conscious id</strong></p><p>M Solms<strong></strong></p><p><strong>52. Depression and resilience in HIV-infected women with early life stress: Does trauma play a mediating role?</strong></p><p>G Spies, S Seedat</p><p><strong>53. State of affairs analysis for forensic psychiatry in SA</strong></p><p>U Subramaney</p><p><strong>54. Escitalopram in the prevention of post-traumatic stress disorder: A pilot randomised controlled trial</strong></p><p>S Suliman, S Seedat, J Pingo, T Sutherland, J Zohar, D J Stein</p><p><strong>55. Epigenetic consequences of adverse early social experiences in primates</strong></p><p>S Suomi</p><p><strong>56. Risk, resilience, and gene x environment interactions in primates</strong></p><p>S Suomi</p><p><strong>57. Biological aspects of anorexia nervosa</strong></p><p>C Szabo</p><p><strong>58. Agents used and profiles of non-fatal suicidal behaviour in East London</strong></p><p>H Uys</p><p><strong>59. The contributions of G-protein coupled receptor signalling to opioid dependence</strong></p><p>J van Tonder</p><p><strong>60. Emerging trend and innovation in PTSD and OCD</strong></p><p>J Zohar</p><p><strong>61. Making the SASOP treatment guidelines operational</strong></p><p>E Allers</p><p><strong>Poster Presentations</strong></p><p><strong>62. Neuropsychological deficits in social anxiety disorder in the context of early developmental trauma</strong></p><p><strong></strong>S Bakelaar, D Rosenstein, S Seedat</p><p><strong>63.Social anxiety disorder in patients with or without early childhood trauma: Relationship to behavioral inhibition and activation and quality of life</strong></p><p><strong></strong>S Bakelaar, C Bruijnen, A Sambeth, S Seedat</p><p><strong>64. Exploring altered affective processing in obssessive compulsive disorder symptom subtypes</strong></p><p>E Breet, J Ipser, D Stein, C Lochner<strong><br /></strong></p><p><strong>65. To investigate the bias toward recognising the facial expression of disgust in obsessive compulsive disorder as well as the effect of escitalopram</strong></p><p>E Breet, J Ipser, D Stein, C Lochner</p><p><strong>66. A fatal-case of nevirapine-induced Stevens-Johnson's syndrome in HIV mania</strong></p><p>A Bronkhorst, Z Zingela, W M Qwesha, B P Magigaba<strong></strong></p><p><strong>67. Association of the COMT G472A (met/met) genotype with lower disability in people diagnosed with multiple sclerosis</strong></p><p>W Davis, S J van Rensburg, L Fisher, F J Cronje, D Geiger, M J Kotze</p><p><strong>68. Homocycsteine levels are associated with the fat mass and obesity associated gene FTO(intron 1 T&gt;A) polymorphism in MS patients</strong></p><p>W Davis, S J Van Rensburg, M J Kotze, L Fisher, M Jalali, F J Cronje, K Moremi, J Gamieldien, D Geiger, M Rensburg, R van Toorn, M J de Klerk, G M Hon, T Matsha, S Hassan, R T Erasmus</p><p><strong>69. Analysis of the COMT 472 G&gt;A (rs4680) polymorphism in relation to environmental influences as contributing factors in patients with schizophrenia</strong></p><p>D de Klerk, S J van Rensburg, R A Emsley, D Geiger, M Rensburg, R T Erasmus, M J Kotze</p><p><strong>70. Dietary folate intake, homocysteine levels and MTHFR mutation detection in South African patients with depression: Test development for clinical application </strong></p><p>D Delport, N vand der Merwe, R Schoeman, M J Kotze</p><p><strong>71. The use ofexome sequencing for antipsychotic pharmacogenomic applications in South African schizophrenia patients</strong></p><p>B Drogmoller, D Niehaus, G Wright, B Chiliza, L Asmal, R Emsley, L Warnich</p><p><strong>72. The effects of HIV on the ventral-striatal reward system</strong></p><p>S du Plessis, M Vink, J Joska, E Koutsilieri, C Scheller, B Spottiswoode, D Stein, R Emsley</p><p><strong>73. Xenomelia relates to asymmetrical insular activity: A case study of fMRI</strong></p><p>S du Plessis, M Vink, L Asmal</p><p><strong>74. Maternal mental helath: A prospective naturalistic study of the outcome of pregancy in women with major psychiatric disorders in an African country</strong></p><p>E du Toit, L Koen, D Niehaus, B Vythilingum, E Jordaan, J Leppanen</p><p><strong>75. Prefrontal cortical thinning and subcortical volume decrease in HIV-positive children with encephalopathy</strong></p><p>J P Fouche, B Spottiswoode, K Donald, D Stein, J Hoare</p><p><strong>76. H-magnetic resonance spectroscopy metabolites in schizophrenia</strong></p><p>F Howells, J Hsieh, H Temmingh, D J Stein</p><p><strong>77. Hypothesis for the development of persistent methamphetamine-induced psychosis</strong></p><p><strong></strong> J Hsieh, D J Stein, F M Howells</p><p><strong>78. Culture, religion, spirituality and psychiatric practice: The SASOP Spirituality and Psychiatry Special Interest Group Action Plan for 2012-2014</strong></p><p>B Janse van Rensburg</p><p><strong>79. Cocaine reduces the efficiency of dopamine uptake in a rodent model of attention-deficit/hyperactivity disorder: An <em>in vivo</em> electrochemical study</strong></p><p><strong></strong>L Kellaway, J S Womersley, D J Stein, G A Gerhardt, V A Russell</p><p><strong>80. Kleine-Levin syndrome: Case in an adolescent psychiatric unit</strong></p><p>A Lachman</p><p><strong>81. Increased inflammatory stress specific clinical, lifestyle and therapeutic variables in patients receiving treatment for stress, anxiety or depressive symptoms</strong></p><p>H Luckhoff, M Kotze, S Janse van Rensburg, D Geiger</p><p><strong>82. Catatonia: An eight-case series report</strong></p><p>M Mabenge, Z Zingela, S van Wyk</p><p><strong>83. Relationship between anxiety sensitivity and childhood trauma in a random sample of adolescents from secondary schools in Cape Town</strong></p><p>L Martin, M Viljoen, S Seedat</p><p><strong>84. 'Making ethics real'. An overview of an ethics course presented by Fraser Health Ethics Services, BC, Canada</strong></p><p>JJ McCallaghan</p><p><strong>85. Clozapine discontinuation rates in a public healthcare setting</strong></p><p>M Moolman, W Esterhuysen, R Joubert, J C Lamprecht, M S Lubbe</p><p><strong>86. Retrospective review of clozapine monitoring in a publica sector psychiatric hospital and associated clinics</strong></p><p>M Moolman, W Esterhuysen, R Joubert, J C Lamprecht, M S Lubbe</p><p><strong>87. Association of an iron-related TMPRSS6 genetic variant c.2007 C&gt;7 (rs855791) with functional iron deficiency and its effect on multiple sclerosis risk in the South African population</strong></p><p>K Moremi, S J van Rensburg, L R Fisher, W Davis, F J Cronje, M Jalali Sefid Dashti, J Gamieldien, D Geiger, M Rensburg, R van Toorn, M J de Klerk, G M Hon, T Matsha, S Hassan, R T Erasmus, M Kidd, M J Kotze</p><p><strong>88. Identifying molecular mechanisms of apormophine-induced addictive behaviours</strong></p><p>Z Ndlazi, W Daniels, M Mabandla</p><p><strong>89. Effects of lifestyle factors and biochemistry on the major neck blood vessels in patients with mutiple sclerosis</strong></p><p>M Nelson, S J van Rensburg, M J Kotze, F Isaacs, S Hassan</p><p><strong>90. Nicotine protects against dopamine neurodegenration and improves motor deficits in a Parkinsonian rat model</strong></p><p>N Ngema, P Ngema, M Mabandla, W Daniels</p><p><strong>91. Cognition: Probing anatomical substrates</strong></p><p>H Nowbath</p><p><strong>92. Chronic exposure to light reverses the effects of maternal separation on the rat prefrontal cortex</strong></p><p>V Russel, J Dimatelis</p><p><strong>93. Evaluating a new drug to combat Alzheimer's disease</strong></p><p>S Sibiya, W M U Daniels, M V Mabandla</p><p><strong>94. Structural brain changes in HIV-infected women with and without childhood trauma</strong></p><p>G Spies, F Ahmed, C Fennema-Notestine, S Archibald, S Seedat</p><p><strong>95. Nicotine-stimulated release of hippocampal norepinephrine is reduced in an animal model of attention-deficit/ hyperactivity disorder: the spontaneously hypertensive rat</strong></p><p>T Sterley</p><p><strong>96. Brain-derive neurotrophic factor (BDNF) protein levels in anxiety disorders: Systematic review and meta-regression analysis</strong></p><p>S Suliman, S M J Hemmings, S Seedat</p><p><strong>97. A 12-month retrospective audit of the demographic and clinical profile of mental healthcare users admitted to a district level hospital in the Western Cape, South Africa</strong></p><p>E Thomas, K J Cloete, M Kidd, H Lategan</p><p><strong>98. Magnesium recurarization: A comparison between reversal of neuromuscular block with sugammadex v. neostigmine/ glycopyrrolate in an <em>in vivo</em> rat model</strong></p><p><strong></strong>M van den Berg, M F M James, L A Kellaway</p><p><strong>99. Identification of breast cancer patients at increased risk of 'chemobrain': Case study and review of the literature</strong></p><p>N van der Merwe, R Pienaar, S J van Rensburg, J Bezuidenhout, M J Kotze</p><p><strong>100. The protective role of HAART and NAZA in HIV Tat protein-induced hippocampal cell death</strong></p><p>S Zulu, W M U Daniels, M V Mabandla</p>

This article analyses two young adult (YA) novels about young men’s experience of anorexia nervosa (AN), within the dual contexts of medical humanities research into literary depictions of illness, and the broader field of YA literature about AN. While emphasising the importance of diverse literary narratives in order to raise awareness of the prevalence of AN in men and boys, and to contribute to the reduction of stigma, it also considers current research into the potentially harmful triggering effects of AN literature on vulnerable readers. It identifies Anne Percin’s Point de côté (Side Stitch) (2006) and Simon Boulerice’s Jeanne Moreau a le sourire à l’envers (Jeanne Moreau Has An Upside-Down Smile) (2013) as examples of good practice in AN literature, due to their thematic focus on male experience, and because they employ narrative strategies that disrupt reader identification with the anorexic character, and avoid focusing directly on potentially triggering descriptions of anorexic ideas and behaviour. They also contribute to diversifying the portrayal of AN via non-judgmental portrayal of lesbian, gay, bisexual, and transgender (LGBT) themes, a topic absent from equivalent YA novels currently available in English. The article further argues that literature—including fiction—contributes to the overall social and cultural discourse surrounding specific illnesses and is likely to affect patients’ real-world experiences, but that it is a specific kind of discourse in its own right, which demands to be read with the appropriate tools. Its detailed analysis of narrative voice alongside thematic content demonstrates how specific approaches from the field of literary studies may complement empirical research into literature and its place within mental health discourse.

Includes bibliographical references (leaves [287]-309). Concerned with a group of people's everyday experiences of anorexia. The fieldwork on which the thesis is based was conducted in multiple sites (Vancouver, Edinburgh, and Adelaide) over 15 months (August 1998-October 1999) and deals with 44 women and 3 men ranging in ages from 14-55. Primarily concerned with the processes that propelled them towards and away from this phenomenon: the desires, connections, disconnections, practice, contested performances and struggles of becoming and unbecoming 'anorexic'.

Includes bibliographical references (leaves [287]-309).
vii, 309 leaves : col. ill. ; 30 cm.
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
Concerned with a group of people's everyday experiences of anorexia. The fieldwork on which the thesis is based was conducted in multiple sites (Vancouver, Edinburgh, and Adelaide) over 15 months (August 1998-October 1999) and deals with 44 women and 3 men ranging in ages from 14-55. Primarily concerned with the processes that propelled them towards and away from this phenomenon: the desires, connections, disconnections, practice, contested performances and struggles of becoming and unbecoming 'anorexic'.
Thesis (Ph.D.)--University of Adelaide, Dept. of Anthropology and Social Inquiry, 2002

Chow Yuet-ming.
Thesis (M.Phil.)--Chinese University of Hong Kong, 2000.
Includes bibliographical references (leaves 254-262).
Abstracts in English and Chinese, appendix in Chinese.
Abstract --- p.i
Acknowledgement --- p.iv
Chapter Chapter 1: --- Introduction --- p.1
Chapter 1.1 --- Rationale for Selecting this Research Topic --- p.1
Chapter 1.2 --- Research Objectives --- p.4
Chapter 1.3 --- Research Questions --- p.5
Chapter 1.4 --- Overview of the Present Thesis --- p.5
Chapter Chapter 2: --- Literature review --- p.7
Chapter 2.1 --- Anorexia Nervosa in Western Countries --- p.7
Chapter 2.1.1 --- Historical Perspective --- p.8
Chapter 2.1.2 --- Biomedical Perspective --- p.10
Chapter 2.1.2.1 --- Physiological manifestation of anorexia nervosa patients --- p.10
Chapter 2.1.2.2 --- Behavioral manifestation of anorexia nervosa patients --- p.12
Chapter 2.1.3 --- Psychological Models --- p.14
Chapter 2.1.3.1 --- Bruch ´ةs view --- p.14
Chapter 2.1.3.2 --- Minuchin´ةs view --- p.16
Chapter 2.1.3.3 --- Palazzoli 's view --- p.17
Chapter 2.1.4 --- Sociological Perspective --- p.24
Chapter 2.1.5 --- Summary of Part I (2.1) --- p.30
Chapter 2.2 --- Psychology of Self-development --- p.33
Chapter 2.2.1 --- "Erikson ,s identity formation" --- p.33
Chapter 2.2.2 --- Women self-development --- p.38
Chapter 2.2.3 --- Bowen's differentiation of self --- p.42
Chapter 2.2.4 --- Summary of Part II (2.2) --- p.46
Chapter 2.3 --- Anorexia Nervosa in Hong Kong Context --- p.48
Chapter 2.3.1 --- The notion of self in traditional Chinese family --- p.49
Chapter 2.3.2 --- Women position in Hong Kong --- p.55
Chapter 2.3.3 --- Related research in Hong Kong --- p.62
Chapter 2.3.4 --- Summary of Part III (2.3) --- p.69
Chapter Chapter 3: --- Theoretical framework --- p.71
Chapter 3.1 --- Theoretical Framework as Summarized from the Literature Review --- p.71
Chapter 3.2 --- Definition of Terms --- p.77
Chapter 3.2.1 --- Anorexia nervosa --- p.77
Chapter 3.2.2 --- Family --- p.78
Chapter 3.2.3 --- Family interaction --- p.79
Chapter 3.2.4 --- Family rule --- p.79
Chapter 3.2.5 --- Family myths --- p.80
Chapter 3.2.6 --- Family myths as quest for meaning --- p.80
Chapter 3.2.7 --- Meaning --- p.80
Chapter 3.2.8 --- Power --- p.81
Chapter 3.2.9 --- Power struggle --- p.81
Chapter 3.2.10 --- Differentiation of self --- p.81
Chapter Chapter 4: --- Research Methodology --- p.83
Chapter 4.1 --- General Overview --- p.83
Chapter 4.2 --- Research Methodology of this Study --- p.88
Chapter 4.2.1 --- Rationale in Selecting Qualitative Method --- p.88
Chapter 4.2.2 --- Research Design --- p.89
Chapter 4.2.3 --- Unit of Analysis --- p.90
Chapter 4.2.4 --- Sampling --- p.90
Chapter 4.2.5 --- Methods of Data Collection --- p.92
Chapter 4.2.5.1 --- Direct Observation of the Family Interviews of AN families --- p.92
Chapter 4.2.5.2 --- Participant Observation in an AN Mutual Support Group --- p.94
Chapter 4.2.5.3 --- Summary of the Case Study Protocol of this Study --- p.96
Chapter 4.2.6 --- Time Frame for Data Collection --- p.96
Chapter 4.2.7 --- Method of Analysis --- p.97
Chapter 4.2.8 --- Validity and Reliability of this Study --- p.97
Chapter 4.2.9 --- Summary of Chapter --- p.98
Chapter Chapter 5: --- Results of the Study :Data Gathered from Family Interview Sessions --- p.100
Chapter 5.1 --- Case History --- p.100
Chapter 5.2 --- Results Gathered from Family Interview Sessions --- p.104
Chapter 5.2.1 --- Having difficulties in differentiating from the family and self- starvation as a means of asserting the personal boundariesin the families --- p.104
Chapter 5.2.2 --- Being triangulated in the parents' marital discords and self- starvation as a means of diluting their conflicts --- p.122
Chapter 5.2.3 --- Self-sacrificing for the family interest --- p.131
Chapter 5.2.4 --- "Being helpless and powerless in the families, self-starvation as a means of empowering the mothers in the families " --- p.134
Chapter Chapter 6: --- Results of the Study:Data Gathered from Mutual Support Group Sessions --- p.138
Chapter 6.1 --- Case History --- p.138
Chapter 6.2 --- Results Gathered from Mutual Support Group sessions --- p.140
Chapter 6.2.1 --- Having difficulties in handling peer relationship --- p.140
Chapter 6.2.2 --- Having difficulties in resisting their mothers intrusiveness to their personal boundaries and self-starvation as a means of exerting their personal boundaries --- p.143
Chapter 6.2.3 --- Being triangulated in their parents marital discords and self- starvation as a means of diluting the marital conflicts --- p.149
Chapter 6.2.4 --- Acting for their mothers in the families --- p.149
Chapter 6.3 --- Cross-checking of findings with group members and worker --- p.161
Chapter Chapter 7: --- Discussions and Conclusion --- p.163
Chapter 7.1 --- Research Findings of this Study --- p.163
Chapter 7.2 --- Contributions of this Study --- p.173
Chapter 7.3 --- Limitations of this Study --- p.174
Chapter 7.4 --- Recommendation --- p.175
Chapter 7.4.1 --- Future Research --- p.175
Chapter 7.4.1.1 --- Proposed Theoretical Framework for Future Study --- p.175
Chapter 7.4.1.2 --- Proposed Methodology --- p.179
Chapter 7.4.2 --- Management of AN patients --- p.179
Chapter 7.4.3 --- Prevention of AN --- p.181
Appendix I: The Chinese verbatim of family interview sessions --- p.183
Appendix II: The Chinese verbatim of mutual support group sessions --- p.234
List of Figures:
Figure 1: Summary of the framework from western literature --- p.75
"Figure 2: Interplay among individual, family and society " --- p.76
Figure 3: Socio-demographic characteristics of the AN patients and their families of the family interview sessions --- p.91
Figure 4: Socio-demographic characteristics of the AN patients and their families of the mutual support group --- p.92
Figure 5: Summary of the proposed theoretical framework of Understanding self-starvation in Hong Kong --- p.178
Bibliography --- p.254

This chapter provides an overview of the use of IPT for patients with eating disorders. The most common eating disorders are anorexia nervosa, bulimia nervosa, and binge eating disorder. The chapter discusses the adaptations of IPT that have been used for the treatment of eating disorders and evaluates their performance in research studies. The assumption for testing IPT with eating disorders is that they occur in response to distress at poor social and interpersonal functioning and consequent negative mood, to which the patient responds with maladaptive eating behaviors. For anorexia nervosa, few data provide evidence for the benefit of IPT. For bulimia and binge eating disorder, however, IPT is considered a viable option for treatment and is recommended in numerous guidelines. A case example of a woman with bulimia nervosa is provided.

This chapter's first goal is to present the concept of Positive Play as an expression of play focused on social, psychological, and physical well-being and human potential. It presents some of its foundations in the form of eight maxims that emerged from an analysis on various games developed in the industry and in research settings. Afterwards, it demonstrates of how Positive Play can be integrated in different contexts of action, from diagnosis and intervention to contexts focused on prevention and promotion of awareness and knowledge in the scope of mental health, regarding treatment for Anorexia Nervosa, through a series of in-progress case studies in the form of game prototypes.