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A Computer-Based Platform for Aiding Clinicians in Eating Disorder Analysis and Diagnosis
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Pride Before a Fall: Shame, Diagnostic Crossover, and Eating Disorders
1Department of Psychiatry, Warneford Hospital, University of Oxford, Warneford Lane, Oxford, OX3 7JX, England. rose.mortimer@stcatz.ox.ac.uk.
Journal of Bioethical Inquiry
|July 3, 2019
Summary
Individuals with eating disorders often perceive diagnostic labels as reflecting moral character, leading to shame during diagnosis changes. This impacts self-identity and highlights the need for clinical consideration of diagnostic crossover experiences.
Area of Science:
- Psychiatry
- Clinical Psychology
- Medical Ethics
Background:
- Eating disorders encompass a range of serious conditions.
- Diagnostic criteria for eating disorders can evolve, leading to diagnostic crossover.
- The psychological impact of shifting diagnoses is not fully understood.
Purpose of the Study:
- To explore the lived experiences of individuals who transitioned between eating disorder diagnoses.
- To understand the perceived meaning and impact of diagnostic labels and changes on self-identity.
Main Methods:
- Qualitative research methodology.
- In-depth interviews with five "mostly recovered" ex-patients.
- Thematic analysis of participant accounts regarding diagnostic transitions.
Main Results:
- Participants associated diagnostic labels with moral character traits.
- A perceived diagnostic hierarchy placed anorexia nervosa above bulimia nervosa and binge eating disorder.
- Diagnostic crossover was experienced as a shameful moral failing, impacting self-identity.
Conclusions:
- The perceived moral weight of eating disorder diagnoses significantly influences patient experience.
- Clinicians should be aware of the potential for shame and identity disruption during diagnostic shifts.
- Further research into the ethical and clinical implications of diagnostic shame is warranted.
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