Date of Submission



The purpose of this thesis was to investigate the process of change in relation to eating disorder symptomatology. Two models of the process of change, the Transtheoretical Model of Change (TTM; Prochaska & DiClemente, 1982) and the Adaptive Change Model (ACM; Bowles, 2000), provided the theoretical foundation for this investigation. The first study of this thesis provided a longitudinal investigation into the relationship between readiness to change and an improvement in eating disorder symptomatology over time in a non-clinical sample. A support factor comprising negative emotions, social support, and inner drive, theorised to influence the relationship between readiness to change and eating disorder symptomatology over time, was also investigated. A non-clinical sample of 140 female participants completed three baseline measures: the Eating Disorder Inventory-3 (EDI-3; Garner, 2004) assessing eating disorder symptomatology, the Anorexia Nervosa Stages of Change Questionnaire (Rieger et al., 2000) measuring readiness to change, and the Adaptive Change Questionnaire (Bowles,) measuring readiness to change and the support factor. The EDI-3 was administered again at three month and six months following the initial point of data collection. Contrary to expectations, neither readiness to change nor the support factor aided in the prediction of improvements over time in the participants' levels of eating disorder symptomatology. Participants' prior levels of eating disorder symptomatology and body mass index were found to predict their subsequent levels of eating disorder symptomatology. These findings indicated that the participants did not change in accordance with the principles of the TTM or the ACM, suggesting they did not know of or use the best theoretically defined means of engaging in the change process (i.e. in accordance with the TTM or the ACM). The second study of this thesis investigated this assertion via qualitative methods.;A sample of 179 participants who had experienced an eating disorder and 166 lay participants provided information regarding their views on the process of recovery from an eating disorder and the factors that could aid and hinder this recovery. Content analysis of the participants' responses regarding the process of recovery revealed three categories describing the steps involved in recovery. These categories comprised the initiation of the recovery process, seeking help and support, and dealing with thoughts, feelings, and behaviours related to the eating disorder. Two additional categories emerged describing the difficult and ongoing nature of recovery and communicating a lack of knowledge about the recovery process. Content analysis of the participants' responses regarding factors that aid recovery revealed five categories. These categories consisted of support, qualities of the environment, personal qualities of the individual experiencing an eating disorder, tasks of the individual, and professional treatment. Content analysis of the participants' responses regarding factors that hinder recovery revealed seven categories. These categories pertained to unhelpful relationships with others, daily living, treatment, difficult thoughts and emotions, compounding and maintaining factors, valued and habitual aspects of an eating disorder, and difficulties with food, weight, and shape. The participants' responses were also categorised into the factors of the TTM and the ACM to investigate whether the participants would explain the process of recovery using concepts similar to those found in these models. The largest proportion of the participants' responses corresponded with the action stage of change found in both of these models, the TTM helping relationships process factor, and the ACM social support factor. This finding indicated that the participants tended to be unaware of or undervalue the remaining factors of these models.;On the basis of the findings of this thesis it was suggested that, for individuals to engage in more effective change with respect to their eating disorder symptomatology, it may be beneficial to first gain a greater awareness of the TTM and the ACM in their totality and how these models can be used to more effectively engage in the change process. It was also suggested that individuals with an eating disorder, as well as their family and friends, may benefit from learning about the categories that naturally emerged from the participants' responses describing the process of recovery from an eating disorder and the factors that can aid or hinder recovery. It was anticipated that this information could not only be a useful point of discussion during treatment, but also during discussions about relapse prevention and discharge planning.


School of Psychology

Document Type


Access Rights

Open Access


321 pages

Degree Name

Doctor of Philosophy (PhD)


Faculty of Arts and Sciences