Descriptive Expierence Sampling of Individuals with Bulimia Nervosa

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Descriptive Expierence Sampling of Individuals with Bulimia Nervosa UNLV Theses, Dissertations, Professional Papers, and Capstones 12-2009 Descriptive Expierence Sampling Of Individuals With Bulimia Nervosa Sharon Jones-Forrester University of Nevada, Las Vegas Follow this and additional works at: https://digitalscholarship.unlv.edu/thesesdissertations Part of the Health Psychology Commons Repository Citation Jones-Forrester, Sharon, "Descriptive Expierence Sampling Of Individuals With Bulimia Nervosa" (2009). UNLV Theses, Dissertations, Professional Papers, and Capstones. 1212. http://dx.doi.org/10.34917/2797381 This Dissertation is protected by copyright and/or related rights. It has been brought to you by Digital Scholarship@UNLV with permission from the rights-holder(s). You are free to use this Dissertation in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s) directly, unless additional rights are indicated by a Creative Commons license in the record and/or on the work itself. This Dissertation has been accepted for inclusion in UNLV Theses, Dissertations, Professional Papers, and Capstones by an authorized administrator of Digital Scholarship@UNLV. For more information, please contact [email protected]. DESCRIPTIVE EXPERIENCE SAMPLING OF INDIVIDUALS WITH BULIMIA NERVOSA by Sharon Jones-Forrester Bachelor of Arts York University, Toronto 1990 Master of Arts University of Nevada Las Vegas 2006 A dissertation submitted in partial fulfillment of the requirements for the Doctor of Philosophy Degree in Psychology Department of Psychology College of Liberal Arts Graduate College University of Nevada, Las Vegas December 2009 UMI Number: 3372129 Copyright 2009 by Jones-Forrester, Sharon All rights reserved INFORMATION TO USERS The quality of this reproduction is dependent upon the quality of the copy submitted. Broken or indistinct print, colored or poor quality illustrations and photographs, print bleed-through, substandard margins, and improper alignment can adversely affect reproduction. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if unauthorized copyright material had to be removed, a note will indicate the deletion. ______________________________________________________________ UMI Microform 3372129 Copyright 2009 by ProQuest LLC All rights reserved. This microform edition is protected against unauthorized copying under Title 17, United States Code. _______________________________________________________________ ProQuest LLC 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, MI 48106-1346 Copyright by Sharon Jones-Forrester 2009 All Rights Reserved THE GRADUATE COLLEGE We recommend that the dissertation prepared under our supervision by Sharon Jones-Forrester entitled Descriptive Experience Sampling of Individuals with Bulimia Nervosa be accepted in partial fulfillment of the requirements for the degree of Doctor of Philosophy Psychology Russell T. Hurlburt, Committee Chair Christopher Heavey, Committee Member Marta Meana, Committee Member Mark J. Lutz, Graduate Faculty Representative Ronald Smith, Ph. D., Vice President for Research and Graduate Studies and Dean of the Graduate College August 2009 ABSTRACT Descriptive Experience Sampling of Individuals with Bulimia Nervosa By Sharon Jones-Forrester Dr. Russell T. Hurlburt, Examination Committee Chair Professor of Psychology University of Nevada Las Vegas Despite 30 years of research, much remains unknown about inner experience in individuals with bulimia nervosa (BN); yet attaining a clearer understanding of inner experience in BN may prove to be crucial in uncovering the nature of this profoundly disruptive disorder. The present study used Descriptive Experience Sampling (DES) to examine inner experience in 13 participants with BN, replicating to some degree Doucette (1992) and Jones-Forrester (2006). Results in the present study were largely consistent with Doucette (1992) and Jones-Forrester (2006) but substantially different from beliefs about inner experience from the extant non-exploratory DES BN literature. Specifically, the present study found (as did previous DES studies of BN) that inner experience in BN is most saliently characterized by fragmented multiplicity, in which there is a pronounced division of attention and a striking inability to maintain a clear and single focus of attention. The present study found that individuals with BN frequently had an intense focus on the sensory aspects of ongoing phenomena, which often included a pronounced awareness or hypersensitivity to bodily sensations. Inner experience among iii individuals with BN in the present study was also characterized by unsymbolized thinking, inner speech, inner seeing, affect that is poorly differentiated and often confused with cognition, and interfering phenomena, in which participants were consciously attempting to interfere with or disconnect from ongoing process related to food, weight, shape, appearance, or BN-related behaviors. These results suggest that DES has utility for the direct examination of inner experience in BN, and that this examination may challenge currently held beliefs about the experiential nature of BN. Exploration of inner experience in individuals with BN allows for the expansion of our understanding of BN. The present study largely replicated previous DES BN studies and yielded previously unexamined phenomena that may prove important in the design of new, more effective intervention and prevention strategies. iv TABLE OF CONTENTS ABSTRACT ...................................................................................................................... iii LIST OF TABLES ............................................................................................................. xi ACKNOWLEDGMENTS .............................................................................................. xiii CHAPTER 1 INTRODUCTION TO BULIMIA NERVOSA .......................................... 1 Inner Experience in Individuals with Bulimia Nervosa .............................................. 1 Overview of Eating Disorders ..................................................................................... 5 Anorexia Nervosa ........................................................................................................ 5 Bulimia Nervosa .......................................................................................................... 9 Eating Disorders Not Otherwise Specified ................................................................ 23 Alternative Views of Eating Disorder Classification ................................................ 26 Bulimia Nervosa Literature Review ......................................................................... 28 CHAPTER 2 INTRODUCTION TO INNER EXPERIENCE METHODS ................... 74 Understanding Inner Experience ............................................................................... 74 Retrospective Assessment Methods .......................................................................... 75 Self-Report Questionnaires ....................................................................................... 75 Clinical Interviews..................................................................................................... 79 Concurrent Assessment Methods .............................................................................. 82 Diary Methods ........................................................................................................... 83 Cognitive Methods .................................................................................................... 87 Think Aloud............................................................................................................... 87 Thought Listing ......................................................................................................... 90 Thought Sampling ..................................................................................................... 91 Phenomenological Methods ...................................................................................... 92 Electronically Cued Checklists.................................................................................. 97 Experience Sampling Method ................................................................................... 97 Ecological Momentary Assessment ........................................................................ 101 Descriptive Experience Sampling ........................................................................... 106 Descriptive Experience Sampling Method ......................................................... 106 Critique ............................................................................................................... 108 Commonly Found Features of Inner Experience ................................................ 115 Descriptive Experience Sampling of Bulimia Nervosa ...................................... 118 CHAPTER 3 METHOD ................................................................................................ 132 Screening Phase ....................................................................................................... 132 Overview ............................................................................................................ 132 Participants ........................................................................................................
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