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University Microfilms International 300 N INFORMATION TO USERS This reproduction was made from a copy of a document sent to us for microfilming. While the most advanced technology has been used to photograph and reproduce this document, the quality of the reproduction is heavily dependent upon the quality of the material submitted. The following explanation of techniques is provided to help clarify markings or notations which may appear on this reproduction. 1.The sign or “target” for pages apparently lacking from the document photographed is “Missing Page(s)”. If it was possible to obtain the missing page(s) or section, they are spliced into the film along with adjacent pages. This may have necessitated cutting through an image and duplicating adjacent pages to assure complete continuity. 2. 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These prints are available upon request from the Dissertations Customer Services Department. 5. Some pages in any document may have indistinct print. In all cases the best available copy has been filmed. University Microfilms International 300 N. Zeeb Road Ann Arbor, Ml 48106 8504052 Mateo, Magdalena Arceo TREATMENT IN ANOREXIA NERVOSA: ASSESSING OUTCOMES IN HOSPITALIZED FEMALES The Ohio State University Ph.D. 1984 University Microfilms International 300 N. Zeeb Road, Ann Arbor, Ml 48106 Copyright 1984 by Mateo, Magdalena Arceo All Rights Reserved PLEASE NOTE: In all cases this material has been filmed in the best possible way from the available copy. Problems encountered with this document have been identified here with a check mark V . 1. Glossy photographs or pages ______ 2. Colored illustrations, paper or print _____ 3. Photographs with dark background _____ 4. Illustrations are poor copy ______ 5. Pages with black marks, not original copy ______ 6. Print shows through as there is text on both sides of page ______ 7. Indistinct, broken or small print on several pages / 8. Print exceeds margin requirements _____ 9. Tightly bound copy with print lost in spine ______ 10. Computer printout pages with indistinct print ______ 11. Page(s)___________lacking when material received, and not available from school or author. 12. Page(s)___________seem to be missing in numbering only as text follows. 13. Two pages n u mbered ___________. Text fol lows. 14. Curling and wrinkled pages ______ 15. Other ___________________________________________________________ University Microfilms International TREATMENT IN ANOREXIA NERVOSA: ASSESSING OUTCOMES IN HOSPITALIZED FEMALES DISSERTATION Presented In Partial Fulfillm ent of the Requirements for the Degree Doctor of Philosophy In the Graduate School of The Ohio S ta te U n ive rs ity By Magdalena Arceo Mateo, B.S.N., M.N. ***** The Ohio State University 1984 Reading Committee: Approved by: James V. WIgt11 Joseph J. Quaranta F ran klIn R. Banks AdvIsor liege of Education Copyright by Magdalena Arceo Mateo 1984 ACKNOWLEDGMENTS For their assistance during my graduate study, I wish to express my appreciation to the following people: Domingo V. Mateo, my husband, who has given me encouragement throughout th Is endeavor; Cresencla C. Arceo, my mother, who taught me to value hard work and preseverance through her professional excellence and personal in te g r Ity ; James V. W igtil,. my advisor and mentor, who has provided Invaluable support throughout my graduate experience; Joseph J. Quaranta and F ra n k lin R. Banks fo r t h e ir understanding and cooperation; Judith L. Johnson who provided statistical assistance and support a t c ru c ia l moments; The staff at the Eating Disorders Program particularly Virginia Supplee and Elizabeth Landis for their cooperation in the conduct of the study; The patients with anorexia nervosa who made this study possible by their participation. i i VITA July 16, 1945 Born - Manila, Philippines 1969 B.S. Nursing Far Eastern University Man!la, Ph11ippines 1969-1970 Staff Nurse Family Clinic Manila, Ph iIippines 1970-1973 Faculty Institute of Nursing Far Eastern University Manila, Ph iIippi nes 1972 Masters in Nursing University of the Philippines Quezon C ity , P h ilip p in e s 1973-1974 Staff Nurse Metropol itan General Hospital Windsor, Ontario, Canada 1974-1976 Instructor School of Nursing University of Windsor O n tario , Canada 1976-1978 Staff Nurse Upham Hal I The Ohio State University Hospitals Columbus, Ohio 1978-1979 Clinical Nurse Specialist Upham Hal I The Ohio State University Hospitals Columbus, Ohio 1979-1983 Assistant Director, Nursing Upham Hal I The Ohio State University Hospitals Columbus, Ohio i i i Clinical Nurse Specialist Upham Hal I The Ohio State University Hospital Columbus, Ohio TABLE OF CONTENTS Page ACKNOWLEDGMENTS................................................. II VITA ........................................ I l l LIST OF TABLES . ................................................................................ v ll Chapter I. INTRODUCTION ................................................................................. 1 Background to the Problem ............................................. 1 Purpose of the Study ........................................................... 4 Research Questions .......................................................... 4 Need for Study ........................................................................ 5 Definition of Terms ........................................ 8 Limitations of the Study ................................................. 10 Summary and O v e rv ie w .......................................................... 11 I I . REVIEW OF THE LITER A TU R E...................................................... 13 Historical Perspective ...................................................... 13 Epidemiology of Anorexia Nervosa ................................ 17 Diagnosis of Anorexia Nervosa ........................................ 21 Factors Associated with the Development of Anorexia Nervosa .................................... 33 Treatm ent and Outcome ............................... ..... 39 Summary .......................................................................................... 47 I I I . METHODOLOGY..................................................................................... 49 Introduction ..... 49 Research Setting ................................................................... 49 The Treatment Program .......................................................... 51 S a m p le ......................................................................................... 55 Col le c tio n of D a t a ............................................................... 55 Instrumentation ........................................................................ 56 Eating Disorder Inventory ........................................ 56 Eating Attitudes T est ................................................. 60 Body CathexIs Se I f CathexIs Sea I e ....................... 63 v Chapter Page Beck Depression Inventory ........................................................ 65 Multidimensional Locus of Control Scale . 68 Statistical Analysis ............................................................ 71 Summary .......................................................................................... 74 IV. RESULTS............................................................................................................... 75 Demographic and Clinical Variables .............................. 75 Research Questions ............................................................... 80 Summary ........................................ 89 V. SUMMARY, CONCLUSIONS AND RECOMMENDATIONS. ..... 93 Summary .......................................................................................... 93 Conclusions................................................................................. 99 Recommendations ..................................................................................... 107 APPENDIXES A. Admission Orders Sample G uidelines fo r D la te tic Care P a tie n t Management Inform ation .................................. 112 B. A Behavioral Approach Sample ........................................................... 119 C. Eating Disorder Levels System ............................................................ 123 D. Human Subjects Review Committee Report ...................................... 126 E. Action Report of the Nursing Investigation Committee ...................................................................................................... 128 F. Instructions for Subjects ...................................................................
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