1 Royal National Hospital for Rheumatic Diseases, Bath, United Kingdom.
2 Tavistock and Portman National Health Service Foundation Trust, London, United Kingdom.
Qual Health Res. 2019 Aug;29(10):1461-1473. doi: 10.1177/1049732319830425. Epub 2019 Feb 27.
Websites advocating the benefits of eating disorders ("Pro-Ana") tend to reinforce and maintain restrictive eating and purging behaviors. Yet remarkably, no study has explored individual accounts of disengagement from these sites and the associated meanings. Using narrative inquiry, this study sought to address this gap. From the interviews of six women, two overarching storylines emerged. The first closely tied disengagement to recovery with varying positions of personal agency claimed: this ranged from enforced and unwelcomed breaks that ignited change, to a personal choice that became viable through the development of alternative social and personal identities. A strong counternarrative to "disengagement as recovery" also emerged. Here, disengagement from Pro-Ana was storied alongside a need to retain an ED lifestyle. With "recovery" being just one reason for withdrawal from Pro-Ana sites, clinicians must remain curious about the meanings individuals ascribe to this act, without assuming it represents a step toward recovery.
倡导饮食失调益处的网站(“Pro-Ana”)往往会强化和维持限制饮食和催吐行为。然而,令人惊讶的是,没有研究探讨过人们主动退出这些网站的个人经历以及相关的意义。本研究采用叙事探究方法来解决这一空白。通过对六名女性的访谈,出现了两个总体故事情节。第一个情节将退出与康复紧密联系起来,声称个人代理的立场各不相同:这从强制和不受欢迎的休息开始,这些休息引发了变化,到通过发展替代的社会和个人身份成为可行的个人选择。也出现了一个强烈的反驳“退出即康复”的叙事。在这里,Pro-Ana 的退出与保留 ED 生活方式的需求联系在一起。“康复”只是退出 Pro-Ana 网站的原因之一,因此临床医生必须对个人赋予这一行为的意义保持好奇,而不是假设它代表着朝着康复迈出的一步。