{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T08:52:41Z","timestamp":1791449561597,"version":"4.3.3"},"reference-count":42,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"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":["Int J Mental Health Nurs"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Eating disorders (EDs) contribute substantially to morbidity and mortality in the United States, with anorexia nervosa (AN) having the second\u2010highest mortality rate among psychiatric disorders. Stigma towards individuals with AN remains a barrier to treatment and engagement. Public and clinician misperceptions that AN is self\u2010inflicted may contribute to blame, punitive treatment and poorer recovery outcomes. This study aimed to clarify the concept of stigma in the context of AN and develop a working definition by examining its use across disciplines. The Walker and Avant (2019) concept analysis method was employed. A literature review was conducted between March and May 2026 using CINAHL, PsycINFO and PubMed. Searches included English\u2010language articles published from 2016 to 2026 and applied predefined search terms and inclusion criteria. Ten articles met inclusion criteria. Although stigma has been defined in broader mental health contexts, the reviewed literature did not identify a concept analysis specific to AN. Defining attributes included structural, volitional and internal stigma. Antecedents and consequences were identified across societal, clinical and lived\u2010experience perspectives. Stigma in the context of AN was conceptualized as a multidimensional process involving perceptions of volition and misinterpretation of the illness's ego\u2010syntonic features, contributing to devaluation and minimization of the illness and its associated suffering. The resulting conceptual model and working definition integrate individual, clinical and societal perspectives to inform practice and advocacy.<\/jats:p>","DOI":"10.1111\/inm.70370","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T08:21:13Z","timestamp":1791447673000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Stigma as a Multidimensional Construct in Anorexia Nervosa"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2406-4127","authenticated-orcid":false,"given":"Alyssa","family":"Hamel","sequence":"first","affiliation":[{"name":"University at Buffalo School of Nursing  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3563-2749","authenticated-orcid":false,"given":"Matthew","family":"Murphy","sequence":"additional","affiliation":[{"name":"University at Buffalo School of Nursing  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3578-3389","authenticated-orcid":false,"given":"Emily Anne","family":"Barr","sequence":"additional","affiliation":[{"name":"University at Buffalo School of Nursing  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40337\u2010025\u201001198\u2010x"},{"key":"e_1_2_12_3_1","unstructured":"American Psychological Association. n.d.\u201cStigma.\u201dhttps:\/\/dictionary.apa.org\/stigma."},{"key":"e_1_2_12_4_1","unstructured":"Association of Anorexia Nervosa and Associated Disorders.2024.\u201cEating Disorder Statistics.\u201dhttps:\/\/anad.org."},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ap.12171"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2024.106412"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638237.2020.1793128"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1089\/aut.2023.0197"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.894178"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638237.2019.1581326"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/10640266.2026.2692540"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1037\/sah0000432"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.20317"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.3109\/09638237.2015.1101422"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0000000000000480"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22691"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40337\u2010024\u201001176\u20109"},{"key":"e_1_2_12_18_1","unstructured":"Edwards\u2010Gayfield P.2024.\u201cWeight Stigma.\u201dhttps:\/\/www.nationaleatingdisorders.org\/weight\u2010stigma\/."},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40337\u2010024\u201001078\u2010w"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/erv.2735"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40337\u2010025\u201001192\u20103"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916\u2010025\u201004326\u20101"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11920\u2010025\u201001629\u20101"},{"key":"e_1_2_12_24_1","volume-title":"Stigma: Notes on the Management of Spoiled Identity","author":"Goffman E.","year":"1963"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22932"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bodyim.2023.04.008"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/papt.12425"},{"issue":"1","key":"e_1_2_12_28_1","first-page":"23","article-title":"The Power of Stigma","volume":"1","author":"L\u00f3pez\u2010Ibor J. J.","year":"2002","journal-title":"World Psychiatry"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.23750\/abm.v91i12\u2010S.10797"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1037\/h0087196"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40337\u2010026\u201001621\u2010x"},{"key":"e_1_2_12_32_1","unstructured":"Merriam\u2010Webster. n.d.\u201cStigma. In Merriam\u2010Webster.com Dictionary.\u201dhttps:\/\/www.merriam\u2010webster.com\/dictionary\/stigma."},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.24374"},{"key":"e_1_2_12_34_1","unstructured":"National Centre of Excellence for Eating Disorders.2026.\u201cSBIRT\u2010ED Screener Tool.\u201dhttps:\/\/nceedus.org\/sbirt\u2010screening\/."},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003583"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.15353\/cfs\u2010rcea.v8i3.473"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/capr.12097"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215\u20100366(20)30423\u20105"},{"key":"e_1_2_12_39_1","unstructured":"Thompson S.2021.\u201cIn EBSCO Research Starters.\u201dhttps:\/\/www.ebsco.com\/research\u2010starters\/psychology\/attribution\u2010theory."},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1037\/sah0000355"},{"key":"e_1_2_12_41_1","volume-title":"Strategies for Theory Construction in Nursing","author":"Walker L. 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