标题：Psychological Meanings of Eating Disorders and Their Association With Symptoms, Motivation Toward Treatment, and Clinical Evolution Among Outpatients
摘要：Unlike patients suffering from egodystonic disorders, people with eating disorders sometimes attribute positive meanings to their
symptoms, and this attribution process contributes to the maintenance of the disorder. This study aims at exploring psychological meanings
of eating disorders and their associations with symptoms, motivation toward treatment, and clinical evolution. Eighty-one adults with an
eating disorder (anorexia nervosa, n = 46 and bulimia nervosa, n = 35) treated in a day-hospital program were asked, each week over an 8-
week period, to identify the psychological meanings they ascribed to their eating disorder. Avoidance was the most frequently identified
meaning, followed by mental strength, security, death, confidence, identity, care, and communication. Avoidance was more frequently
mentioned by participants with bulimia than in cases of anorexia. Security and mental strength were associated with less motivation toward
treatment. Death was associated with more depressive and anxious symptoms. An exploratory factor analysis showed that these meanings
formed three main dimensions: Avoidance, Intrapsychic, and Relational. Findings suggest that psychological meanings associated with
eating disorders can be assessed and used as a clinical tool to increase treatment acceptability and effectiveness.
