Term Paper on "Haven't Decided"

Term Paper 5 pages (1620 words) Sources: 2

[EXCERPT] . . . .

Anorexia: A Comparison of Two Studies

Eating disorders like anorexia have been researched at length, but with varying results. I have chosen to examine how research on anorexia compares between an experimental study and a case study. The two articles I have chosen to examine are: 1) "Emotional Responses to Food in Adults With an Eating Disorder: A Qualitative Investigation" by McNamara, Chur-Hansen and Hay (experimental study); and 2) "Case Study: Eating Disorder in a 10-year-old Girl" by Scharer (case study).

In a qualitative, experimental study, McNamara, Chur-Hansen and Hay (2008) sought to determine a common theme in adult women with eating disorders. They interviewed ten women clinically diagnosed with anorexia nervosa, bulimia or an eating disorder not otherwise specified (EDNOS) while showing them slides of different foods. They were asked to express their emotions while looking at each slide. The authors assert that this research is unique and valuable because it focuses on the expression of emotions in an open interview situation, rather than having the respondents merely chose from a short list of emotions. The central theme the researchers uncovered was 'control.'

While the experimental study's primary goal was to determine patterns among a group of women, the case study focused on one subject: a ten-year-old girl ("Lisa") who had been diagnosed with anorexia and possibly bulimia. Another major difference was that in the McNamara study, the researchers were more concerned with determining causes of eating disorders, while in the Scharer study, the primary concerns were diagnosis, treatment and monitoring.

There is no clear statement of purpose in the Scharer study, however the goal appears to be to report on the case of Lisa and compare her case with the findings of other studies. The purpose statement in the McNamara article is, however, clearly articulated in the following sentence "The objective of this qualitative study is to explore the emotions of eating disordered adults" (p. 116). In addition, other sub-objectives are implied throughout the article, such as the objective of filling a gap in the present literature about eating disorders, and uncovering a single theme that (which turned out to be control) that is common to all of the respondents. An overarching objective is also discussed in terms of the study helping clinicians use the findings to help their patients with eating disorders by knowing the right questions to ask. McNamara et al. continually emphasize the need for a qualitative approach to research on eating disorders. This is a valid point considering that they are probing the emotional connection to food, which is difficult to quantify. The respondents did, however, participate in a quantitative study just prior to the qualitative interviews, which the authors refer to as "another, separate study" (p. 117). No other information is provided about the quantitative study.

In regard to the qualitative study, which is the main focus of the McNamara article, the use of in-depth interviews while showing the 16 slides of food items was an appropriate choice, since direct observations would have been very difficult and quantitative questionnaires would not provide the depth of information needed to understand the different layers of the women's emotional connection to food. Having the respondents comment after being shown the slides rather than being asked to respond to each slide as it was being shown was also a wise choice because it did not allow for a time delay which could taint the results. The authors do admit however that the study would have more valuable meaning if the food items were shown to the women in person rather than artificially on film.

The primary goal of the McNamara study was to explore the emotions of women with eating disorders in an attempt to derive a common theme. The research design was created to elicit in-depth responses from these women as they described their emotions while viewing certain foods (some fatty, some healthy). The primary goal of the Scharer case study is much less clear, however it does provide an etiological framework of the three dimensions the authors are exploring in the case study, which are: individual (including biological and psychological) familial, and cultural factors.

After providing a brief overview of how each of these factors is perceived in the scholarly literature, Scharer describes the subject of the case study, a 10-year-old girl named "Lisa," and how each of these factors relates to her situation. The author describes how Lisa's problem was first brought to the attention of her mother by a concerned teacher. A Clinical Nurse Specialist (CNS) was included in a meeting that was held with Lisa and her mother, encouraging them to seek treatment for what they assumed to be an eating disorder. It was later diagnosed as anorexia, with the possibility of other, contributing disorders. Minimal attention is paid by the author to the causes of Lisa's disorder, despite going into significant length about the causes of anorexia and bulimia in general in the literature review section of the article. The chief focus is on identifying the disorder in Lisa and getting her into a treatment program.

In the McNamara article, a framework is also used, but it seems to be more functional to the goals of the study than the framework in Scharer is. In McNamara, the researchers used the five step framework approach developed by Pope, Ziebland and Mays (2000) as a guideline for constructing meaning from the data in a systemized fashion. By following the five steps, including color coding the themes and responses, the researchers were able to achieve their goal of identifying a common thread from the transcripts, i.e. control.

One advantage that the Scherer study has over the McNamara study is that the researcher was not previously acquainted with the subject, so there was no bias introduced into the study, at least within this context. In the McNamara study, however, the recruitment strategy brought with it certain biases into the study due to the fact that one of the authors was the one who diagnosed all ten women with their eating disorders. Additionally, all of the women were recruited from the same facility. There is also no real mention of what the eating disorder not otherwise specified (EDNOS) entailed, prompting the authors to acknowledge toward the end of the article that "Future qualitative research should concentrate on a larger, more homogenous sample of adults with an eating disorder, who are acutely unwell" (p. 123).

It could be easily argued that inadequate consideration was given to the existing relationship between the third author and the participants. The fact that he, although a licensed psychiatrist, was the one who diagnosed these women with their eating disorders, seems to indicate a conflict of interest may exist. At the very least, this previous relationship could significantly bias the results.

In essence, other than the issue with the third author discussed above, ethical issues were given proper attention. Firstly, the researchers report that "The Integrated Mental Health Services Scientific Evaluation Committee and the Townsville Health Service District Institutional Ethics Committee approved this research" (p. 116). Secondly, the researchers had the participants sign consent forms both to participate in the study and to have their discussions recorded.

The primary finding was that the issue of control was directly related to every participant's response. The authors also clearly state that additional themes revealed included embarrassment, emptiness and disgust. They do however call for future research that compares and contrasts male participants with female participants, for more substantial results.

Technically, the research by McNamara et al. is valuable because as the authors continually emphasize throughout the article, this study has several unique qualities. At least to the best of their knowledge, they state that there is no other study that measures emotional responses of adult women with eating disorders in qualitative interviews while viewing… READ MORE

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