Watkins, EL; (2013) The Development of Restricting Anorexia Nervosa: Does Personality Predict Individuals' Responses to Short-Term Fasting? Doctoral thesis , UCL (University College London).

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Abstract

Literature Review: Abstract Aims. There is concern that childhood weight-reduction programs may lead to eating disorder (ED) pathology. The aim was to provide a recent review of the impact of weight-reduction interventions on ED psychopathology or risks. Method. Reference lists and five electronic databases were searched to identify articles on overweight interventions for children aged five to 18, from 2008 to present. Papers were required to report on ED psychopathology. Results. The search yielded 267 articles on obesity interventions, of which 54 reported on psychosocial variables. Twenty-five articles, covering 24 studies, reported specifically on ED pathology or risks, and met inclusion criteria. Conclusions. Higher quality studies indicated that interventions had a beneficial or neutral influence on ED pathology. The ED pathology most likely to be adversely affected included weight concern, body dissatisfaction, and weight-related teasing. Studies used varying methodologies and assessment tools, and often did not report effect sizes, limiting the conclusions that could be drawn. Empirical Paper: Aims. The study aimed to investigate affective responses to fasting, in particular whether personality traits of high persistence and constraint, and low novelty-seeking, which have been linked to restricting anorexia nervosa (ANR), affect these experiences. Method. A non-clinical sample of 52 women with a mean age of 25 completed personality scales at baseline. A repeated-measures design was used, whereby participants provided diary measures of psychological variables throughout both 18-hour fasting and non-fasting periods. Results. Fasting led to increased irritability, and also to positive affective experiences of increased sense of achievement, reward, pride, and control. Self-reported persistence, constraint, and novelty-seeking did not affect experiences of fasting, and personality variables were not significant predictors of fasting responses. Conclusion. Even short-term fasting in healthy controls can lead to positive psychological experiences. This lends support to cognitive-behavioural and cognitive-interpersonal models of ANR, which suggest that dietary restriction is maintained through positive reinforcement. Levels of persistence, constraint, and novelty-seeking did not affect responses to fasting, suggesting that personality variables do not affect eating disorder pathology via responses to fasting.

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