{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T09:03:47Z","timestamp":1780563827531,"version":"3.54.1"},"reference-count":64,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Eating Disorders"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Harmful consequences of having an eating disorder can be exacerbated by engagement in digital groups that promote eating disorder\u2010related content, particularly related to anorexia nervosa, and are often called pro\u2010Ana. This study aims to synthesize qualitative research regarding individuals' experiences of participating in these digital groups to elucidate the underlying personal drivers of the engagement and how it can affect eating problems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic database search for first\u2010person experiences yielded 27 relevant studies. We used an ethnographic approach and a thematic analysis for the meta\u2010synthesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified three meta\u2010themes across the studies: (1) \u201cPro\u2010Ana feels like a safe space where I can be myself\u201d, (2) \u201cPro\u2010Ana is a dangerous path\u201d, and (3) \u201cPro\u2010Ana becomes a joint project for living with an eating disorder\u201d.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Participants' experiences in pro\u2010Ana communities relate to concepts on offline stigmatization, fundamental needs for belonging, and the inherent ambivalence toward the online community\u2014balancing the pursuit of emotional support with the risks of indirect digital self\u2010harming. Helpers and clinicians are recommended to directly engage with clients regarding their digital activities and associated risks, including engagement in pro\u2010Ana, with openness and respect to mitigate feelings of shame and guilt.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/eat.70067","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:01:55Z","timestamp":1772989315000},"page":"1225-1245","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pro\u2010Ana\u2014Balancing a Digital Safe Space and Indirect Self\u2010Harming. Findings From a Meta\u2010Synthesis"],"prefix":"10.1002","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7522-8307","authenticated-orcid":false,"given":"Line Indrevoll","family":"St\u00e4nicke","sequence":"first","affiliation":[{"name":"Department of Psychology University of Oslo  Oslo Norway"},{"name":"Lovisenberg Hospital Nic Waals Institute  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9870-9796","authenticated-orcid":false,"given":"Liselotte Carlsen","family":"Rymoen","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2776-5887","authenticated-orcid":false,"given":"Tora Sandra Ausland","family":"Omdal","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2391-7594","authenticated-orcid":false,"given":"Margrethe Seeger","family":"Halvorsen","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,2]]},"reference":[{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.2196\/19008"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu17203288"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/hsc.12557"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033\u20102909.117.3.497"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1258\/135581902320432732"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/10640260701190600"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0277\u20109536(02)00064\u20103"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/02673843.2013.856802"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40337\u2010024\u201000992\u20103"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1207\/S15327965PLI1104_01"},{"issue":"2","key":"e_1_2_12_13_1","first-page":"31","article-title":"The Ana Sanctuary: Women's Pro\u2010Anorexia Narratives in Cyberspace","volume":"4","author":"Dias K.","year":"2003","journal-title":"Journal of International Women's Studies"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/10410236.2020.1868076"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1145\/3392845"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732319830425"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/erv.2735"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467\u20109566.2005.00465.x"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40519\u2010015\u20100242\u20108"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732307311640"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1348\/014466605X53596"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1590\/1413\u2010812320212611.3.34522019"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1207\/s15327019eb0904_5"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/1461444810363910"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpp.2365"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/17459435.2017.1294617"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022\u20100167.52.2.196"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1080\/01612840.2018.1493625"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.24495"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2017.00269"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chb.2021.106922"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1080\/10503307.2018.1447708"},{"key":"e_1_2_12_33_1","unstructured":"Livingstone S. 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