Reconceptualising Anorexia Nervosa: Co-designed psychometric network models generating a novel theory of illness

Abstract

Anorexia Nervosa (AN) has the highest mortality rate of the mental disorders and poor treatment efficacy, with a recovery rate of less than 50%. Despite this, presumed constructs of illness on which current treatments are developed are seldom explored and little innovation in phenomenological theory has occurred since the 1990s. The overarching aim of this thesis is to return to the foundations of taxonomy by interrogating constructs of illness in AN with those who live it, those who treat it, and those who have studied it, in order to identify more accurate conceptualisations of illness and ultimately, more effective therapeutic targets. The thesis consists of six chapters, including a general introduction, literature review, phenomenological metasynthesis, qualitative study, network modelling study and general discussion. Findings from this thesis have improved our understanding of the lived experience and phenomenology of AN and provided empirical evidence for the illness’ core psychopathology centring around self, affective regulation and embodiment. Results suggest AN is a complex disorder requiring a personalised, systems-based approach informed by neurobiology, physiology, metabolomics, and philosophy.