Peculiarities of psychological rehabilitation of patients with eating disorders

- Левченко, Дарина Олександрівна (orcid.org/0000-0001-9080-5336) (2025) Peculiarities of psychological rehabilitation of patients with eating disorders Masters thesis, Інститут психології ім. Г. С. Костюка.

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Abstract

Levchenko D. O. Peculiarities of psychological rehabilitation of patients with eating disorders – Qualification scientific work in the form of a manuscript. Dissertation for the degree of Doctor of Philosophy in the specialty 053 “Psychology” (05 – Social and Behavioral Sciences). – G. S. Kostyuk Institute of Psychology of the National Academy of Sciences of Ukraine, Kyiv, 2025. The dissertation is devoted to the theoretical justification and experimental study of the problem of providing psychological assistance to patients with various types of eating disorders and to enhancing its effectiveness. The relevance of the study is determined by the annually increasing prevalence of eating disorders worldwide and the high mortality rate associated with them. The aim of the study is to investigate the individual psychological characteristics of patients with eating disorders and to develop a model of psychological rehabilitation using various psychotherapeutic approaches to improve the effectiveness of care provision. The dissertation represents an independent, comprehensive, and complete study presenting both theoretical and practical aspects of psychological rehabilitation for patients with eating disorders. The first chapter provides a theoretical analysis emphasizing that psychological rehabilitation is aimed at creating a high quality of life for patients in need of restoring specific functions. Special attention is given to patients’ impaired capabilities and the temporarily disrupted relationships between them and society, which require restoration. The features of psychological rehabilitation of patients with eating disorders lie in applying a comprehensive approach to selecting methods that take into account early experiences of relationships with significant adults. This allows influencing the deep components of personality, including self-perception, perception of others, self-regulation, mentalization, self-reflection, attachment type, and internal introjects. The personal dimension of the rehabilitation process is key to overcoming eating disorders of any type. It has been identified that individuals with diagnosed eating disorders exhibit certain typological characteristics, including difficulties in regulating self-esteem and affect, challenges with autonomy, impulse control, basic trust, and body perception. It is noted that working on addiction-related issues should consider the structural level of personality organization and the stages of psychosexual development. The psychotherapeutic process highlights several focal points: attachment disturbances, drive-related dysfunctions, self-regulation, emotional communication, goal setting, and identity disturbances. The patient’s personality plays a crucial role in the treatment process, and their individual psychological characteristics are a leading factor influencing all stages of the psychological support strategy. The second chapter examines the individual psychological characteristics of patients with eating disorders, comparing personality profiles and identifying differences among patients with anorexia, bulimia, and binge eating disorder. The study was conducted at Dr. Kadirov’s medical center, involving 90 female participants aged 18 to 56, divided into three diagnostic groups: Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Binge Eating Disorder (BED). Each group consisted of 30 participants. Subsequently, the participants were divided into experimental and control samples of 45 individuals each. Methods for studying individual psychological characteristics included: observation, analysis of medical records, the Eating Pattern Inventory (EPI) (D. Garner), the 16 Personality Factor Questionnaire (16PF) (R. B. Cattell), the Attachment Style Questionnaire (ASQ) (K. Bartholomew, L. Horowitz), and interviews based on the Operationalized Psychodynamic Diagnosis (OPD-2) for the structure and conflict axes (OPD Task Force). The individual psychological characteristics of patients with anorexia were identified, including high self-control, tendency to introversion, symbolic thinking, and determination, along with increased tension, anxiety, and a dominant avoidant attachment type. The effective rehabilitation strategy for this group focused on working with leading intrapsychic conflicts and attachment features to foster trust, interpersonal safety, and overcoming super-ego rigidity. Patients with bulimia were found to have softness, indecisiveness, emotional instability, and an anxious attachment type with borderline levels of structural integration. Effective rehabilitation strategies for this group focused on working with personality structure and attachment type to strengthen personal structure, reduce anxiety, regulate aggression, and develop resources to resolve intrapsychic conflicts. Patients with binge eating disorder demonstrated emotional variability, impulsivity, low organization, and an anxious attachment type at a lower borderline level of structural integration. Rehabilitation strategies for this group focused on working with personality structure and attachment type to strengthen personal organization, improve self-regulation, and overcome resistance. It was determined that patients with bulimia and binge eating disorder predominantly exhibited an anxious attachment type, whereas patients with anorexia demonstrated an avoidant attachment type. Additionally, anorexia patients displayed an upper borderline level of structural integration, while bulimia and binge eating disorder patients varied between lower and upper borderline levels. The percentage expression of leading unconscious conflicts was clarified depending on the type of disorder. The third chapter presents a comprehensive psychological rehabilitation program for patients with eating disorders based on psychodynamic and cognitive-behavioral approaches, including individual, group, and family work, and evaluates its effectiveness. During the formative experiment, 52 individual Katathym-Imaginative Psychotherapy sessions were conducted over six months, with participants hospitalized for the first two months. Group work based on the cognitive-behavioral DBT approach included 26 weekly sessions over six months. Family work with codependent participants included eight outpatient sessions. The formative experiment confirmed the effectiveness of the developed comprehensive psychological rehabilitation program. Following its implementation, the experimental group showed statistically significant (p < 0.05) reductions in eating disorder symptoms and improvements in personality structural integration and attachment types, along with a decrease in certain unconscious conflicts. Statistical analysis confirmed the non-random nature of differences between the groups. This demonstrates that the proposed program promotes reductions in eating disorder symptoms, enhances self-regulation, strengthens identity, and the quality of interpersonal relationships. Most participants with initially high or medium symptom levels showed medium or low levels upon program completion. The results indicate that comparing individual psychological characteristics of patients with different types of eating disorders provides a foundation for building effective psychorehabilitation models that combine individual and group therapy strategies. The scientific novelty of the dissertation lies in the systematic study of individual psychological characteristics of patients with anorexia, bulimia, and binge eating disorder. For the first time, differences in eating disorder symptoms, attachment types, structural integration levels, and leading unconscious conflicts were clarified among patients with various eating disorder types. Psychodynamic characteristics, including the leading personality radical, attachment type, and central conflict, were also expanded based on disorder-specific features. A comprehensive psychological rehabilitation program was proposed and tested, integrating psychodynamic and cognitive psychotherapy approaches. For the first time, individual Katathym-Imaginative Psychotherapy techniques were combined with group Dialectical Behavior Therapy techniques to process early traumatic experiences influencing the formation of eating disorders. The study results supplement theoretical understanding and provide practical recommendations for psychotherapeutic work with patients with various eating disorders. The theoretical significance of the study lies in systematizing approaches to studying eating disorders, typologizing patients with eating disorders, identifying specific individual psychological differences for each disorder type, improving psychodiagnostic tools, and developing scientific foundations for a comprehensive psychological approach to overcoming eating disorders. The practical significance lies in the applicability of the developed psychological rehabilitation program in clinical practice to reduce eating disorder symptoms in patients, address personality structural deficits, destructive behavioral patterns, and negative emotional states. The program promotes harmonization of personal needs, development of affective self-regulation and emotional communication, and improves the effectiveness and quality of psychological care for patients with eating disorders. Future research perspectives include enhancing psychodiagnostic tools to study individual psychological characteristics of patients with eating disorders and developing expanded psychological rehabilitation programs considering other types of eating disorders.

Item Type:	Thesis (Masters)
Keywords:	psychological rehabilitation, deviant behavior, eating disorders, food addiction, anorexia, bulimia, binge eating disorder, typological features, individual psychological characteristics.
Subjects:	Science and knowledge. Organization. Computer science. Information. Documentation. Librarianship. Institutions. Publications > 1 Philosophy. Psychology Science and knowledge. Organization. Computer science. Information. Documentation. Librarianship. Institutions. Publications > 6 Applied Sciences. Medicine. Technology > 61 Medical sciences
Divisions:	Institute of Psychology after N.Kostiuk > Department of consulting psychology and psychotherapy
Depositing User:	Дарина Олександрівна Левченко
Date Deposited:	08 Oct 2025 13:00
Last Modified:	08 Oct 2025 13:00
URI:	https://lib.iitta.gov.ua/id/eprint/746727

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