The meaning of self-starvation: qualitative study of patients’ perception of anorexia nervosa

Objective: Anorexia nervosa (AN) patients tend to place a positive value on their symptoms. Many clinicians believe that this plays a central role in maintaining the disorder. However, empirical research on how patients attribute meaning to their symptoms is lacking. This study aims at sys-tematically exploring the meaning that the patients with AN attribute to their anorec-tic behavior. Method: A qualitative, descriptive, phe-nomenological design was used. Eighteen women aged 20–34 with AN (DSM-IV) were interviewed with an informant-centered interview. The interviews were tape-recorded, verbatim transcribed, coded, and analyzed phenomenologically, using a QSR-N*Vivo software program. Results: The psychological meanings that the informants attributed to their anorectic behavior could be summarized in eight constructs: ‘‘Security’ ’ (feeling of stability and security), ‘‘Avoidance’ ’ (avoid-ing negative emotions), ‘‘Mental strength’’ (inner sense of mastery), ‘‘Self-confidence’’ (feeling acknowledged and worthy of compliments); ‘‘Identity’ ’ (achieving new identity), ‘‘Care’ ’ (eliciting care from others), ‘‘Communication’ ’ (communicating difficul-ties), and ‘‘Death’ ’ (wishing to starve oneself to death). Conclusion: The eight constructs may have central functions in the mainte-nance of AN and should be regarded when patients ’ motivation and goals for treatment are assessed. Further study of the possible functions of the constructs in maintaining AN is warranted. VC 200