Life orientation and preferences of meta values in women with anorexia and bulimia nervosa

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УДК 159-055.2:17.022.1:616.33-008.4

DOI: 10.24919/2313-2094.4/36.98541

Life orientation and preferences of meta values in women with anorexia and bulimia nervosa

Anna Wiatrowska

Анотація

value vital woman anorexia

Анна Вятровська

У статті представлено результати досліджень з питань взаємодії між життєвою орієнтацією і переваги мета-цінностей у жінок з ано- рексією і булімією. Проведено анкетування життєвої орієнтації (SOC- 29) Антоновського і анкету цінностей Шварца (PVQ-R2). У дослідженні взяли участь 80 жінок з розладами харчової поведінки, у тому числі 40 жінок з анорексію і 40 - з булімією, відповідно до критеріїв досліджень ICD-10. Визначення імунних ресурсів та адаптивності і переваги мета- цінностей є особливо важливим з точки зору профілактики і лікування людей з розладами харчової поведінки.

Ключові слова: почуття когерентності, мета-цінності, психічна анорексія, психічна булімія, жінки.

Аннотация

Анна Вятровская

В статье представлены результаты исследований по вопросам взаимодействия между жизненной ориентацией и преимущества метаценностей у женщин с анорексией и булимией. Проведено анкетирование жизненной ориентации (SOC-29) Антоновского и анкету ценностей Шварца (PVQ-R2). В исследовании приняли участие 80 женщин с расстройствами пищевого поведения, в том числе 40 женщин с анорексией и 40 - с булимией, в соответствии с критериями исследований ICD-10. Определение иммунных ресурсов и адаптивности и преимущества метаценностей особенно важно с точки зрения профилактики и лечения людей с расстройствами пищевого поведения.

Ключевые слова: чувство когерентности, мета-ценности, психическая анорексия, психическая булимия, женщины.

Introduction

According to Antonovsky [1, 34], the sense of coherence (SOC) plays the foremost role in the group of health conditioning factors. It is a person's general orientation expressing the degree in which this person has a keen, permanent - though dynamic - sense of certainty that (1) stimuli arriving in the course of life from the inner and outer environments have a structured, predictable and explainable character; (2) they have access to the means which will enable them to cope with the requirements laid down by those stimuli; (3) these requirements are for that person a challenge worth the effort and involvement. A strong sense of coherence consists of three inter-correlated dimensions: the sense of comprehensibility, the sense of manageability and the sense of meaningfulness. The sense of comprehensibility refers to the degree of perceiving the surrounding world as ordered, predictable and coherent, independently of whether it really is so. The sense of manageability boils down to the belief that people have sufficient personal and other resources to cope with unfavourable circumstances or requirements of the environment. The sense of meaningfulness determines the degree in which man feels that life has sense from the emotional point of view and the efforts undertaken - though not easy - are worth the involvement and devotion [1, 32 - 34]. Although particular components of the sense of coherence are independent of each other, they remain in a mutual dynamic relation, thus creating a complex and ordered whole.

The value concept by Schwartz [8, 2 - 13], cf. [3, 26 - 28], [2, 53 - 63], which dominates in contemporary psychology, views them as emotion related beliefs concerning the desired objectives (going beyond specific activities and situations), at the same time constituting the criterion of one's own and others' behaviours. The Author proposes 10 types of universal basis values: (1) conformity (restraining from actions harming others, observing the norms, self-discipline, obedience, politeness); (2) tradition (accepting cultural and religious commands and prohibitions, modesty, devotion), (3) benevolence (caring about the welfare of those near and dear, faithfulness, responsibility, friendship, love), (4) universalism (caring about the welfare of all people and the environment, justice, equality, peace, wisdom), (5) self-direction (independence in thinking and acting, freedom and creativity), (6) stimulation (seeking novelty and variety, audacity, exciting life), (7) hedonism (aiming at pleasures, the joy of life), (8) achievement (aiming at personal success, ambition, efficiency), (9) power (aiming at control, domination and prestige, authority, wealth), (10) security (safety for oneself and the loved ones, social order, harmony, cleanliness, health, sense of belonging), and 4 meta types structured by two dimensions, namely self-transcendence versus self-enhancement and openness to change versus conservation. The first dimension describes the conflict between the values associated with others' good and interests (benevolence, universalism) and the values directed at the realization of one's own needs and goals (power, achievement). The second dimension presents the conflict between the values associated with independence in thinking and acting as well as the need for variety and stimulation (self-direction, stimulation) on the one hand and the values connected with the preservation of the existing order, a dislike to changes and self-limitation (conformity, security, tradition) on the other. In this classification, values associated with satisfying one's own needs, especially organic needs (hedonism) belong to both dimensions.

The knowledge of preferences referring to the basic values and meta values can help to better understand an individual's attitudes and behaviours, both in health and in illness.

Anorexia nervosa is a disorder consisting in aiming to limit the consumed food (especially that rich in fats), which is frequently connected with different forms of behaviours (physical exercise, vomiting, abusing laxatives or duretics and others), which serve to lose weight or avoid the weight gain [10, 13]. The prevalence of anorexia nervosa, which is the disorder occurring mainly in women, is 4 - 8 per 100,000 people in the population per year, while the death rate is 5 - 2 % [6, 421].

The characteristic features of bulimia nervosa include recurrent episodes of binge eating, when huge amounts of food are consumed at short time intervals, followed by compensatory behaviours aimed to free the body from the consequences of the consumed energy and not to gain weight [10, 15 - 16]. To speak of bulimia, episodes of binge eating together with compensatory behviours must occur at least twice a week for the period of at least three months. The prevalence of bulimia among women is 1 - 1.5 % yearly, while the death rate in the case of bulimia (resulting from natural deaths, somatic complications or suicides) is significantly lower as compared to anorexia and is about 0.7 % [6, 438].

The Author's own studies

The purpose of the studies was to search for the relations between life orientation and preferences of meta values in women with eating disorders. The form of eating disorders was adopted as the differentiating criterion. The major research problem was contained in the following question: Does any relation exist between the sense of coherence in women with anorexia and bulimia on the one hand and preferences of meta values according to Shalom Schwartz's theory and if so, what is its character? Specific questions were formulated as follows: 1) Are there any significant differences in the sense of coherence in women with anorexia and in women with bulimia and if so, what are they? 2) Are there any significant differences in preferences of meta values in women with anorexia and in women with bulimia and if so, what are they?

The following hypothetical assumptions were formulated in reference to the main research problem: There exists a relation between life orientation and preferences of meta values in women with eating disorders. It is assumed that the dimensions of the sense of coherence (comprehensibility, manageability, meaningfulness) modify the preferences of meta values in the studied women. The relation between the sense of coherence and the preferences of meta values is shaped differently in the groups of women with anorexia and bulimia. The formulation of hypothetical assumptions was based on theoretical findings and the analysis of the existing, scarce studies [cf. 3, 34 - 38] concerning the relations between the analyzed variables. It was a pilot study.

The study comprised 40 women with diagnosed anorexia nervosa (AN) and 40 women with diagnosed bulimia nervosa (BN), according to the research criteria ICD-10. Women with diagnosed anorexia (M=20.1) were younger (M=23.6) and their illness started considerably earlier (M=16.4) as compared to women with bulimia (M=18.6). Moreover, they were hospitalized more seldom (M=1.8) than bulimic women (M=2.6).

The studies made use of the Portrait Value Questionnaire (PVQ-R2) by Schwartz [9, 941 - 943] and the Life Orientation Questionnaire (SOC-29) by Antonovsky [1, 174 - 178]. The Portrait Value Questionnaire consists of 57 statements, where 52 correspond to 10 types of universal basic values (selfdirection, stimulation, hedonism, achievement, power, universalism, benevolence, conformity, tradition and safety) and 5 spiritual values (not included in the study). Besides the preferences of the basic values, the tool measures - in accordance with Schwartz's theory - four meta values constituted by two dimensions, namely self-transcendence - self-enhancement, conformity - openness to changes. The studied person's task is to estimate the degree of similarity between a given description of values and themselves. This is done using a 9-point rating scale (the range of the score from - 1 to 7), where, for example - 1 means that a given value is opposite to the life guiding principles; 7 means that it is the most import life guiding principle. The Life Orientation Questionnaire is composed of 29 items expressed in the form of interrogative sentences equipped with a 7-point rating scale (the range of the score from 1 to 7), including described extremes. Besides establishing the general sense of coherence determined on the basis of calculating the points from all test items, the tool enables to find out the level of its three dimensions (the sense of comprehensibility with 11 test items, the sense of manageability with 10 items and the sense of meaningfulness with 8 test items).

Results

The first stage of analyses consisted in calculating the means and standard deviations of the sense of coherence and meta values in the group of women with anorexia and bulimia. The positive rates obtained in the procedure of ipsatization recommended by Schwartz indicate the placement of this meta

value above the means in the system of the group's values, while negative rates of preferences point out that the meta value is placed below the means.

The means and standard deviations of the sense of coherence and preferences of meta values The data concerning the preferences of meta values in women with eating disorders are discussed in detail in the article «The analysis of metavalues of women with anorexia and bulimia nervosa» [12, 64 - 73]. together with the levels of the significance of differences are presented in Tables 1 and 2.

Table 1. Means and standard deviations of the sense of coherence and its components in both studied groups