'Pro-Ana' as negotiating (Dis)order in cyberspace : how women reproduce, restructure, and challenge 'Psy' discourse

Current literature on the topic of anorexia is dominated by the disciplines of psy, which has meant that the practice of self-starvation is viewed as originating from the pathological nature of the individual ; divorcing the experience of anorexia from the very social and cultural backdrop from within which it emerges. Contrastingly, socio-cultural approaches to anorexia have focused on the contextual features of the disorder that relate to the historical specificity of our contemporary condition. This has often meant that self-starving is conceptualized as the result of women either over-conforming to, or resisting, the cultural ideal of the slim body. The complexity of anorexic practice is neglected when it is discursively positioned in this way because there is a multiplicity of discourses which constitute the anorexic's subjectivity. Due to the fact that psy discourse has particular influence on the anorexic experience this thesis employs a critical discourse analytic approach to explore how women, in the pro-anorexia internet community, negotiate their subjectivity through reproducing, restructuring, and challenging the discursive constructions of psy which are produced by the DSM-IV. The transgressive nature of the pro-ana community has meant that its members have been framed as either oppressed or liberated, as cultural dupes or as active agents; demonstrating a pattern which mirrors the same binary logic that has surrounded discussions of the 'anorexic' for decades. Through transcending these limitations, the findings of this study are used to articulate an alternative viewpoint of the community which challenges the dominant discourses which surround it at present

Experiences of a commercial weight-loss programme after primary care referral: a qualitative study.

BACKGROUND: Referral to a commercial weight-loss programme is a cost-effective intervention that is already used within the NHS. Qualitative research suggests this community-based, non-medical intervention accords with participants' view of weight management as a lifestyle issue. AIM: To examine the ways in which participants' attitudes and beliefs about accessing a commercial weight management programme via their doctor relate to their weight-loss experience, and to understand how these contextual factors influence motivation and adherence to the intervention. DESIGN AND SETTING: A qualitative study embedded in a randomised controlled trial evaluating primary care referral to a commercial weight-loss programme in adults who are overweight or obese in England. The study took place from June-September 2013. METHOD: Twenty-nine participants (body mass index [BMI] ≥28 kg/m(2); age ≥18 years), who took part in the WRAP (Weight Loss Referrals for Adults in Primary Care) trial, were recruited at their 3-month assessment appointment to participate in a semi-structured interview about their experience of the intervention and weight management more generally. Interviews were audiorecorded, transcribed verbatim, and analysed inductively using a narrative approach. RESULTS: Although participants view the lifestyle-based, non-medical commercial programme as an appropriate intervention for weight management, the referral from the GP and subsequent clinical assessments frame their experience of the intervention as medically pertinent with clear health benefits. CONCLUSION: Referral by the GP and follow-up assessment appointments were integral to participant experiences of the intervention, and could be adapted for use in general practice potentially to augment treatment effects

Personality and Insomnia: A Systematic Review and Narrative Synthesis

The inherent nature of personality serves as a predisposing, and possible maintaining factor of insomnia. However, methodological differences limit the ability to draw causal conclusions regarding the specific traits involved in the aetiology of the disorder. This systematic review of the relationship between insomnia and personality provides a narrative synthesis of the literature to date. Here, we identified N=76 studies meeting the inclusion/exclusion criteria. The outcomes reliably evidenced the experience of insomnia to be associated with personality traits which are typically considered to be negative or maladaptive in nature. More specifically, insomnia was related to neuroticism, introversion, perfectionistic doubts and concerns, elevated personal standards, negative affect, social inhibition and avoidance, hysteria, hypochondriasis, psychasthenia, impulsive behaviour, anger, hostility and psychopathic tendencies, schizotypal and borderline traits, reduced conscientiousness and self-directedness, and negatively perceived perception of the self. Several studies examined the role of personality plays in predicting the treatment efficacy and adherence of CBTi. Moving forward, longitudinal research, methodological consistency, the mediating role of treatment outcomes and adherence, and clinical and population representative samples should be prioritised. Methodological strengths and limitations of the literature are discussed alongside the next steps which should be taken to advance our understanding of the literature

Diurnal Preference and Correlates of Multidimensional Perfectionism, Type-D Personality, and Big Five Personality Traits

This study examined the extent to which the dimensions of the five-factor model, Type-D personality, and multidimensional perfectionism were associated with a diurnal preference in the general population. A sample of (N = 864) individuals completed the measures of diurnal preference, multidimensional perfectionism, Type-D personality, and the Big Five traits. A correlational analysis determined that agreeableness, conscientiousness, emotional stability, organization, and personal standards were independently related to morningness. In contrast, negative affect, social inhibition, Type-D personality, and perfectionistic doubts and concerns, as well as an increased perception of critical parental evaluation, were independently related to eveningness. After accounting for the shared variance amongst the personality traits, only negative affect, conscientiousness, organization, personal standards, and parental perception were significantly associated with diurnal preference. The current outcomes offer further insight into the relationship between personality and diurnal preference. Here, we observed greater reports of adaptive personality traits in relation to morningness, whereas negative affect and perceived parental evaluation and criticism were related to eveningness. As the first study to examine the relationship between Type-D personality, multidimensional perfectionism, and diurnal preference, the current outcomes should be considered preliminary

Queues, Crowds, and Angry Mobs: Face Identification Under Distraction in a Virtual Airport

In visual environments, selective attention must be employed to focus on task-relevant stimuli. A key question here concerns the extent to which other stimuli within the visual field influence target processing. In this study we ask whether face identity matching is subject to similar effects from irrelevant stimuli in the visual field, specifically task-irrelevant people. While most previous studies rely on highly controlled face and body stimuli presented in isolation, here we use a more realistic environment. Participants take the role of passport officers and must match a person’s face to their photo-ID while other people appear in the background, waiting to be processed. Presenting an interactive virtual environment on screen (Experiment 1 and 2) or in immersive VR (Experiment 3), we generally found no evidence for distraction from background people on face-matching accuracy. However, when immersed in VR, an angry crowd in the background increased matching speed, while not affecting accuracy. We discuss the theoretical implications of these results and their potential importance in practical settings

Homogeneity of cognitive and behavioural processes underlying the relationship between insomnia and body image disturbance

Specific cognitive behavioural mechanisms related to selective attention, situational avoidance and physical appearance are implicated in the development and maintenance of insomnia and negative reinforcement of body image disturbances. Therefore, we examined whether these processes potentially mediate the relationship between insomnia and body image perception. N = 728 participants completed self-reported measures of sleep-associated monitoring, insomnia symptoms, body image disturbance and coping with body image challenges. Symptoms of insomnia and sleep-associated monitoring behaviour were independently related to increased reports of body image disturbance, cognitive distortions of body image, appearance fixing (i.e. altering appearance by covering, camouflaging or correcting the perceived defect), avoidance (i.e. attempt to escape or avert stressful body image situations) and reduced levels of positive rationale acceptance (i.e. acceptance of the challenging event and positive self-care or rationale self-talk about one’s appearance). More crucially, sleep-related monitoring on awakening, cognitive distortion of body image and negative coping strategies related to body image (i.e. appearance fixing, avoidance, rationale acceptance) mediated the relationship between reports of body image disturbance and insomnia symptoms. The current findings expand upon previous research demonstrating consistent relationships between poor sleep and increased dissatisfaction with cutaneous features, by providing novel evidence that body image disturbances are associated with symptoms of insomnia. More crucially, we highlight the role of particular cognitive and behavioural mechanisms pertaining to sleep (i.e. selective attention for physical signs of poor sleep) and body image (i.e. avoidance and rationale acceptance) which may be targeted as part of cognitive behavioural treatments

The relationship between psychotic experiences, nightmares and emotion dysregulation: results from a student population

Sleep-disruption is commonly associated with psychotic experiences. Whilst sparse, the literature to date highlights nightmares and related distress as prominent risk factors for psychosis in students. We aimed to further explore the relationship between specific nightmare symptoms and psychotic experiences in university students whilst examining the mediating role of emotion dysregulation. Method: A sample(N=1273) of students respondents from UK Universities completed measures of psychotic experiences, nightmare disorder symptomology, and emotion dysregulation. Findings: Hierarchical linear regression analysis showed that psychotic experiences were significantly associated (Adjusted R 2 = 32.4%) with perceived nightmare intensity, consequences and resulting awakenings, and with emotion regulation difficulties. Furthermore, multiple mediation analysis showed that the association between psychotic experiences and nightmare factors was mediated by emotion regulation difficulties. Interpretation: Adaptive regulation of dream content during rapid eye-movement sleep has previously been demonstrated to attenuate surges in affective arousal by controlling the intensity and variability of emotional content. Deficits in emotion regulation may partially explain the experience of more intense and disruptive nightmares amongst individuals with psychotic experiences. Emotion regulation may represent an important control mechanism that safeguards dream content and sleep quality