Date of Award

2001

Degree Type

Dissertation

First Advisor

Colleen A. Redding

Abstract

The purpose of this study was to advance understanding of the self-change process in recovery from anorexia nervosa (AN) and bulimia nervosa (BN) through: (a) development of a staging instrument for recovery from BN; (b) development of TTM-based measures, including decisional balance, self-efficacy, and processes of change; (c) invariance testing of these measures across AN and BN subsamples; and (d) characteristic description of individuals at each stage of change. The sample (N = 427) was composed of AN subgroup (n = 278) and BN subgroup (n = 149) who completed questionnaires measuring all constructs of the TTM, as well as the EAT-26, demographics, and other self-reported recovery measures. Three staging algorithms were evaluated for construct, discriminant, and concurrent validity; theoretical consistency; sensitivity; overall effect size; and predictive ability. The most meaningful algorithm measured stage progress through the stages by "readiness to stop bingeing/purging." Sequential measure development found all TTM constructs and their previously established relationships to be valid for eating disorders (EDs). Multiple sample modeling found tau equivalent models to be preferred for pros and cons, and self-efficacy; whereas, the congeneric model was preferred for processes of change. Stage of change profiles replicated change patterns across the stages were comparable to most other health behaviors utilizing the TTM framework. Incorporating the TTM into EDs research and treatment requires a new way of thinking about the recovery process. These research findings not only improve our understanding of the process of recovery from AN and BN, but can help to enhance our treatments as well.

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