The role of pride in women with anorexia nervosa: A grounded theory study

ObjectiveTheory and clinical literature suggest that pride may play an important role in the maintenance of restrictive eating disorders. A grounded theory study explored experiences of, and reflections on, pride among women with a current or past diagnosis of anorexia nervosa. DesignThis is a qualitative study using grounded theory. MethodSemistructured interviews were conducted with 21 women recruited from an eating disorder unit in England, and from a UK self-help organization. Grounded theory from a constructivist lens was used. Analysis involved coding, constant comparison, and memo-writing. ResultsPride evolves over the course of anorexia nervosa. Two overarching conceptual categories were identified: pride becoming intertwined with anorexia' and pride during the journey towards recovery'. These categories encompassed different forms of pride: alluring pride', toxic pride', pathological pride', anorexia pride', shameful pride', recovery pride', and resilient pride'. Initially, pride contributed to self-enhancement and buffered negative emotions. As the condition progressed, pride became a challenge to health and interfered with motivation to change. During recovery, perceptions of pride altered as a healthy approach to living ensued. ConclusionsThe evolving nature of pride plays a central role in development, maintenance, and treatment of anorexia nervosa. Understanding of pride and its role in psychotherapeutic work with this client group may increase motivation to change and promote recovery. Future work should investigate whether tackling pride in eating disorders increases treatment efficacy and reduces the risk of relapsing.