{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T14:37:26Z","timestamp":1761489446009},"reference-count":52,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,9,12]],"date-time":"2014-09-12T00:00:00Z","timestamp":1410480000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychiatric Ment Health Nurs"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:sec><jats:title>Accessible summary<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Bulimia nervosa, if not treated or if treated unsuccessfully, can develop into a severe and enduring eating disorder.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Analysis of self\u2010management of Seed\u2010BN indicates that individuals frequently experience significant negative mental health issues and a complex relationship with medication management.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Two discrete patterns of coping strategies to prevent deterioration in distressing symptoms were in evidence, controlled vomiting, which was related to the management of anxiety, and uncontrolled vomiting due to more dominant self\u2010management of compulsive acts.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>The implications for nursing revolve around accurate assessment of vomiting and subsequent engagement by the individual with their coping strategies in relation to perceived deterioration in distressing symptoms.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p>This paper reports on the results of a study into the self\u2010reported coping strategies employed by a small sample (<jats:italic>n<\/jats:italic> = 12) of individuals diagnosed with bulimia nervosa purging sub\u2010type, severe and enduring eating disorder (Seed\u2010<jats:styled-content style=\"fixed-case\">BN<\/jats:styled-content>), referred to an outpatient clinic for psychotherapy. Data collection focused on the vomiting activities of participants through analysis of their self\u2010management from diary extracts, which recorded vomiting patterns. Participants all experienced significant mental health issues, had complex histories of <jats:styled-content style=\"fixed-case\">BN<\/jats:styled-content> over a prolonged period, difficulties maintaining relationships, and many had an additional history of substance misuse including dependence on prescription drugs. The study findings indicated two different self\u2010management strategies, anxiety containment and compulsion maintenance. There was a clear association between anxiety and controlled weekly vomiting patterns compared with compulsion and daily vomiting patterns. The implications for nursing practice relate to the potential for assessment of differences in vomiting patterns to indicate self\u2010management status and subsequent interventions focusing on either anxiety or compulsive patterns.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpm.12167","type":"journal-article","created":{"date-parts":[[2014,9,12]],"date-time":"2014-09-12T09:09:19Z","timestamp":1410512959000},"page":"20-29","source":"Crossref","is-referenced-by-count":5,"title":["Anxiety and compulsion patterns in the maintenance of bingeing\/purging behaviours by individuals with bulimia nervosa"],"prefix":"10.1111","volume":"22","author":[{"given":"M.","family":"Thomas","sequence":"first","affiliation":[{"name":"Department of Mental Health &amp; Learning Disabilities Faculty of Health &amp; Social Care University of Chester  Chester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Lovell","sequence":"additional","affiliation":[{"name":"Department of Mental Health &amp; Learning Disabilities Faculty of Health &amp; Social Care University of Chester  Chester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,9,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.57.5.459"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1352465806003511"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0b013e3280ba4989"},{"key":"e_1_2_9_7_1","volume-title":"Bulimia Nervosa \u2013 A Cognitive Therapy Programme for Clients","author":"Cooper M.","year":"2000"},{"key":"e_1_2_9_8_1","volume-title":"Treating Bulimia Nervosa and Binge Eating: An Integrated Metacognitive and Cognitive Therapy Manual","author":"Cooper M.","year":"2009"},{"key":"e_1_2_9_9_1","volume-title":"Bulimia Nervosa and Binge\u2010Eating: A Self\u2010help Guide Using Cognitive behavioural Techniques","author":"Cooper P.J.","year":"1998"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1017\/S135246580800458X"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1037\/10500-002"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/1098-108X(199204)11:3<205::AID-EAT2260110303>3.0.CO;2-A"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1352465806002864"},{"key":"e_1_2_9_14_1","unstructured":"EngelB. 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