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Though writing from divergent perspectives, researchers and clinicians view eating disorders as fundamentally disorders of the self, manifested, for instance, as problems in self-esteem, self-perception, and self-regulation. Other psychiatric patients also have such disorders. The aim of the study, therefore, was to explore a central psychological feature of eating disorders, the sense of self, and to identify aspects unique to hospitalized anorexia nervosa patients so as to distinguish them from other psychiatric patients, as well as from nonpatients.
The sense of self was assessed with open-ended self-descriptions. Seventy-seven females aged 14 to 24 were asked to describe themselves. They met criteria for one of three groups: Anorexia Nervosa Patients (n = 15),Control Patients (n = 15), and Control Nonpatients (n = 47). The self-descriptions were rated on eighteen scales, which fell into four factors and two affective scales. The self-descriptions of the three groups were compared statistically on the six variables.
The two patient groups shared characteristics that significantly differentiated them in two ways from women who were not patients:(1) lower levels of Agency (indicating less investment in chosen areas; a more negative, fragmented self-regard; a relatively unarticulated sense of self; and more despair over defining or becoming the person they wanted to be); and (2) lower levels of Relatedness (indicating more isolation from or dependency on others; feeling rejected or judged by others; and a low interest in issues of relatedness). There were no significant differences among the three groups in Differentiation.What significantly differentiated the anorexia nervosa patients from both the other psychiatric patients and the nonpatients was a heightened Self-reflectivity in their self-descriptions (indicating more self-reflection; a less concrete, more internal focus; more contradictions about the self; and harsher judgments of the self) and more expressions