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Cited by 28Eating Disorders and BehaviorsArt Therapy and Mental HealthMedia Influence and Health

Literary reading and eating disorders: survey evidence of therapeutic help and harm

Open access
Troscianko, Emily T.·2018·Journal of Eating Disorders
DOI 10.1186/s40337-018-0191-5PMC PMC5902994
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Abstract

BACKGROUND: There is growing evidence for the efficacy of self-help bibliotherapy as a treatment for eating disorders, although little understanding of how specific linguistic characteristics may enhance or constrain its effects. Meanwhile, 'creative bibliotherapy' (the therapeutic use of fiction, poetry, or sometimes film, rather than self-help books) is widely practised, but even more poorly understood than the self-help variety: although a range of theoretical models exist, claims of the healing power of literature are far more commonly made than tested. METHODS: An online survey including quantitative (forced-choice) and qualitative (free-response) items was designed and administered in collaboration with the charity Beat to investigate the connections between respondents' reading habits and their mental health, with a focus on eating disorders, and attracted 885 respondents. Responses to two sequences of questions, exploring the differential effects of fiction about eating disorders versus respondents' preferred genre of other fiction on the dimensions of mood, self-esteem, feelings about one's body, and diet and exercise habits, were analysed using a 2 × 2 repeat measures factorial ANOVA design for each of the four dependent variables. RESULTS: Surprisingly, fiction about eating disorders was perceived by respondents as broadly detrimental to mood, self-esteem, feelings about their bodies, and diet and exercise habits, while respondents' preferred genre of other fiction was experienced as beneficial to mood and broadly neutral on the other three dimensions. The free-response data added detail to these core findings, as well as suggesting numerous other possible effects and mechanisms, drawing attention to the roles of positive and negative feedback structures and of highly selective interpretive filtering, and highlighting the dangers of 'self-triggering': using books to deliberately exacerbate an eating disorder. CONCLUSIONS: The findings directly challenge existing theoretical models of creative-bibliotherapeutic mechanisms, which tend to insist on the importance of a close match between the reader's and the protagonist's situations. They point the way forward for a new programme of clinical research and practice by suggesting other ways to conceive of how embodied cognitive acts of textually cued interpretation may intervene in the psychopathology of an eating disorder - for good and for ill.

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  • Creative bibliotherapy has been sporadically subjected to empirical assessment, and the results do not yield a consistent picture; hypotheses have generally not been well formulated.

    “Though creative bibliotherapy has been sporadically subjected to empirical assessment, the results do not yield a consistent picture and hypotheses have, in general, not been well formulated (see Troscianko [17] for the best appraisal of the literature).”

    From Five studies evaluating the impact on mental health and mood of recalling, reading, and discussing fiction (2022) · cites this paper as Troscianko [17]

    The Background section, “Creative and self-help bibliotherapy” (page unavailable), describes empirical evidence as scarce and criticizes the theories’ limited support and lack of precision. It does not characterize the available results as inconsistent; it calls the evidence promising, while noting its quality limitations. The claim is therefore supported on sporadic assessment and weakly formulated models, but not on inconsistent results. (LLM, conf=0.82)

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  • In eating disorders, reading novels or memoirs unrelated to the illness generally had neutral or positive effects on readers' emotions, self-esteem, body perception, and behavior, whereas narratives centered on illness experiences were often reported to have a "significant negative impact".

    “Troscianko et al. found in the field of eating disorders that reading novels or memoirs unrelated to the illness generally had neutral or positive effects on readers’ emotions, self-esteem, body perception, and behavior, whereas narratives centered on illness experiences were often reported to have a “significant negative impact” (87).”

    From Recent developments in bibliotherapy for adolescent depression (2025) · cites this paper as [87]

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  • Troscianko presents evidence that readers with eating disorders recall having their symptoms exacerbated by fiction that thematises the experience of having an eating disorder.

    “evidence that readers with eating disorders recall having their symptoms exacerbated by fiction that thematises the experience of having an eating disorder.”

    From Five studies evaluating the impact on mental health and mood of recalling, reading, and discussing fiction (2022) · cites this paper as Troscianko [17]

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  1. [32]Billington J Is literature healthy?: the literary agenda 2016 Oxford Oxford University Press

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Authors
Troscianko, E. T.
Affiliations
University of Oxford (GB)
Corresponding author
Troscianko, Emily T.
ORCID
Troscianko, Emily T.
Venue
Journal of Eating Disorders
Publisher
Springer Science and Business Media LLC
Published
2018-04-16
Volume
6
Issue
1
Pages
8-8
ISSN
2050-2974 (ISSN-L)
DOI
10.1186/s40337-018-0191-5
PMC
PMC5902994
OpenAlex
W2801945696
Cited by
28
References
53
Citations by year
2026: 1 · 2025: 7 · 2024: 6 · 2023: 2 · 2022: 5 · 2021: 2 · 2020: 2 · 2019: 1 · 2018: 1
FWCI
1.76
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Eating Disorders (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Arts and Humanities Research Council (05/116952)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Social Sciences › Arts and Humanities › Conservation › Art Therapy and Mental Health
  • Social Sciences › Arts and Humanities › Literature and Literary Theory › Media Influence and Health
Keywords
eating disorders, bibliotherapy, reading habits, mood, self-esteem, body image, therapeutic mechanisms, self-triggering, feedback structure

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