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Cited by 152Eating Disorders and BehaviorsHealthcare Decision-Making and RestraintsNutrition, Health and Food Behavior

Perceived Coercion and Change in Perceived Need for Admission in Patients Hospitalized for Eating Disorders

Guarda, Angela S., Pinto, Angela Marinilli, Coughlin, Janelle W., Hussain, Shahana, Haug, Nancy A., Heinberg, Leslie J.·2007·American Journal of Psychiatry
DOI 10.1176/ajp.2007.164.1.108
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Abstract

OBJECTIVE: Ambivalence toward treatment is characteristic of eating disorders, and patients are often admitted to inpatient programs under pressure from clinicians, family, friends, educators, or employers. This study evaluated patient perceptions of the admissions process and perceived need for hospitalization and assessed whether these perceptions remain stable in the short term. METHOD: A total of 139 patients with eating disorders completed a 13-item self-report scale on the admission experience when they were admitted to a behavioral inpatient specialty program and again 2 weeks into their hospitalization. RESULTS: Patients with anorexia nervosa reported higher levels of perceived coercion and pressure and a lower sense of procedural justice than did those with bulimia. Patients under 18 (N=35) reported more perceived coercion than did adult patients (N=104), and a trend was noted for them to disagree that they needed hospitalization. Perceptions of coercion, of pressure by others toward hospitalization, and of procedural justice were stable in the short term. However, of the 46 patients (30 of them adults) who initially did not endorse needing admission, 20 patients (17 of them adults) changed their minds by 2 weeks into hospitalization and agreed that they needed hospital admission. CONCLUSIONS: Nearly half of patients with eating disorders who denied a need for treatment on admission converted to acknowledging that they needed to be admitted within 2 weeks of hospitalization. Since treatment avoidance is associated with poor outcome, these findings suggest a need for studies assessing the long-term outcome and ethics of pressuring patients with eating disorders into treatment.

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Authors
Guarda, A. S., Pinto, A. M., Coughlin, J. W., Hussain, S., Haug, N. A., & Heinberg, L. J.
Affiliations
Johns Hopkins University (US)
ORCID
Venue
American Journal of Psychiatry
Publisher
American Psychiatric Association Publishing
Published
2007-01
Volume
164
Issue
1
Pages
108-114
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
DOI
10.1176/ajp.2007.164.1.108
OpenAlex
W2073096420
Cited by
152
References
31
Citations by year
2026: 9 · 2025: 7 · 2024: 17 · 2023: 9 · 2022: 11 · 2021: 9 · 2020: 9 · 2019: 4 · 2018: 6 · 2017: 5 · 2016: 5 · 2015: 10 · 2014: 11 · 2013: 13 · 2012: 2
FWCI
8.34
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Keywords
eating disorders, anorexia nervosa, bulimia nervosa, perceived coercion, hospitalization, procedural justice, treatment pressure, adolescents, treatment avoidance
MeSH terms
Adolescent, Adult, Age Factors, Anorexia Nervosa, Feeding and Eating Disorders, Attitude to Health, Coercion, Female, Health Status, Hospitalization, Humans, Male, Patient Admission, Personality Inventory, Surveys and Questionnaires, Referral and Consultation, Bulimia Nervosa

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