Eating disorder patient experiences of volitional stigma within the healthcare system and views on biogenetic framing: A Qualitative Perspective: A Qualitative Perspective

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Abstract

Objective: Research has consistently indicated that fear of stigma is a pertinent factor when understanding the poor prevalence of treatment seeking among individuals with mental illness, particularly eating disorders (EDs). The purpose of this study was to investigate the treatment experiences of ED sufferers within an Australian context, in addition to exploring patient views on framing EDs as biogenetic conditions, given the increased understanding and presentation of EDs as biologically based conditions. 

Methods: Semi-structured online data collection was conducted with 35 Australian women with a history of an ED (54.3% in treatment, 45.7% in "recovery" or "recovered"). The data were evaluated using a three-phased coding system, allowing findings to emerge from significant themes inherent within the raw data (thematic analysis). 

Results: Treatment was perceived as traumatic, punitive, blaming, lacking in understanding/education, and overemphasised the physical dimensions of the illness. The experience of volitional stigma in the health "care" system was frequent and expected, and for many sufferers had adverse effects. Biogenetic framing was perceived to be more likely to reduce (rather than exacerbate) stigma, particularly perceptions of volition and personal responsibility. Although reductions in blame and responsibility were welcomed, there was concern that biogenetic explanations could negatively impact recovery by endorsing genetic fatalism and encouraging self-fulfilling prophecies via genetic essentialism. 

Conclusions: Overall, findings highlight that attention to volitional stigma within the health system is required (particularly education) and that aetiological framing (with caution and sensitivity) is perceived to be a feasible stigma reduction method by ED sufferers.

LanguageEnglish
Pages325-338
Number of pages14
JournalAustralian Psychologist
Volume53
Issue number4
Early online date16 Jun 2016
DOIs
Publication statusPublished - 1 Aug 2018

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Delivery of Health Care
Physical Education and Training
Therapeutics
Fear
Feeding and Eating Disorders
Patient Experience
Stigma
Health Care System
Eating Disorders
Education
Health
Research
Responsibility
Recovery

Cite this

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abstract = "Objective: Research has consistently indicated that fear of stigma is a pertinent factor when understanding the poor prevalence of treatment seeking among individuals with mental illness, particularly eating disorders (EDs). The purpose of this study was to investigate the treatment experiences of ED sufferers within an Australian context, in addition to exploring patient views on framing EDs as biogenetic conditions, given the increased understanding and presentation of EDs as biologically based conditions. Methods: Semi-structured online data collection was conducted with 35 Australian women with a history of an ED (54.3{\%} in treatment, 45.7{\%} in {"}recovery{"} or {"}recovered{"}). The data were evaluated using a three-phased coding system, allowing findings to emerge from significant themes inherent within the raw data (thematic analysis). Results: Treatment was perceived as traumatic, punitive, blaming, lacking in understanding/education, and overemphasised the physical dimensions of the illness. The experience of volitional stigma in the health {"}care{"} system was frequent and expected, and for many sufferers had adverse effects. Biogenetic framing was perceived to be more likely to reduce (rather than exacerbate) stigma, particularly perceptions of volition and personal responsibility. Although reductions in blame and responsibility were welcomed, there was concern that biogenetic explanations could negatively impact recovery by endorsing genetic fatalism and encouraging self-fulfilling prophecies via genetic essentialism. Conclusions: Overall, findings highlight that attention to volitional stigma within the health system is required (particularly education) and that aetiological framing (with caution and sensitivity) is perceived to be a feasible stigma reduction method by ED sufferers.",
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