Eating disorders are difficult to treat which may partly be due to limited understanding of maintaining factors. Research has explored maintaining factors for eating disorders and this thesis focused on a number of these. A systematic literature review was conducted to explore the role of family functioning in eating disorders and an empirical paper considered the role of shame and pride.\ud The systematic literature review identified and evaluated quantitative research investigating family functioning in eating disorder families and its relationship with outcomes from the disorder. Fourteen studies were reviewed and findings indicated that eating disorder families reported poorer family functioning than control families, patients consistently rated their family more dysfunctional than their parents, but the notion of a typical pattern of family dysfunction was not supported. In relation to outcome, those with positive perceptions of family functioning had more positive outcomes, irrespective of eating disorder severity. Conclusions of the review were limited by conflicting, variable findings and methodological issues.\ud An empirical study was conducted with 73 adults with an eating disorder to explore the component structure and psychometric properties of the Shape, Weight and Eating Scale (SWES) and investigate differences in responses for participants who restrict or binge-purge. A three component structure was retained; 'Lack of Pride in Attractiveness', 'Pride in Control' and 'Shame around Eating'. The reliability and validity of the SWES were assessed and discussed. 'Pride in Control' significantly contributed to variance of restricting cognitions and behaviours whilst 'Shame around Eating' significantly contributed to variance of binge-purging cognitions and behaviours and restricting cognitions. The findings supported the notion of shame-shame and shame-pride cycles (Goss & Gilbert 2002) in eating disorders and highlighted the need for a measure of shame and pride specific to eating, body shape and weight. The study limitations, clinical implications and future research were discussed
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