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Motivation to change in adolescents with eating disorders

James, M. C. (2007). Motivation to change in adolescents with eating disorders. (Unpublished Doctoral thesis, City University London)


Motivation is a complex issue, thought to influence engagement as well as response to treatment in a number of mental health disorders. Little attention has been paid to the motivation of adolescents who are/have been treated for an eating disorder, in whom motivation to change is complicated by developmental factors and dependence on others.

The present study has been conducted in two parts. Part 1 investigates the validity of the stages of change model in adolescents through use of a questionnaire based on Prochaska and DiClemente's model. Part 2 is a qualitative study assessing motivation to change in young people with eating disorders within a systemic context. Index participants for both parts of the study were aged between 12-16 years and were recruited from three specialist eating disorder services. The aims of Part 1 were a) to explore the psychometric properties of an adapted version of the University of Rhode Island Change Assessment Questionnaire (URICA) with a sample of young people with eating disorders, and b) determine if this version of the URICA could be made more developmentally appropriate for use with this sample whilst retaining its psychometric properties. Part 2 aimed to develop a model to understand the contextual and relationship factors influencing motivation to change/recover in adolescents with eating disorders.

Results from Part 1 (n=39) indicate that the stages of change model has limited validity in adolescents with eating disorders, but can be used to distinguish those with no motivation to change from those with some degree of contemplation. Qualitative findings (n=11) identified three main groups of factors influencing motivation: illness factors, treatment factors and 'normal life'. Findings suggest that inpatient treatment makes it difficult for young people to think about their eating disorder because they are preoccupied by 'going home'. Issues around control and responsibility emerged as central themes influencing motivation; and young people and their families' value different components of treatment in the recovery process.

Publication Type: Thesis (Doctoral)
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Departments: Doctoral Theses
School of Health & Psychological Sciences > Psychology
Doctoral Theses > School of Arts and Social Sciences Doctoral Theses
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