Pro-anorexics and recovering anorexics differ in their linguistic Internet self-presentation

Abstract

Objective

Pro-anorexia has emerged as a new and emotionally charged eating disorder phenomenon. This study explored the linguistic markers of differences in Internet self-presentation of self-identified pro-anorexics who defend anorexia as a lifestyle and self-identified anorexics in recovery.

Method

One hundred sixty-two Internet message board entries and 56 homepages originating from either pro-anorexics or recovering anorexics were analyzed for linguistic markers of emotional, cognitive, and social functioning, temporal focus, and anorexia-related psychological concerns.

Results

Across both text sources, pro-anorexics displayed more positive emotions, less anxiety, a lower degree of cognitive reflection, and lower levels of self-directed attention than did recovering anorexics. Pro-anorexics were also more focused on the present and less on the past. Finally, pro-anorexics were more preoccupied with eating and less with school-related issues and death.

Conclusion

Linguistically, pro-anorexics and recovering anorexics engage in distinct psychological self-presentation styles. More research is needed to understand the clinical implications of these different linguistic styles.

Introduction

Pro-anorexia has received widespread media attention as a new and emotionally charged eating disorder phenomenon [1]. Pro-anorexics are individuals who consider anorexia a legitimate alternative lifestyle that they choose to have, rather than an illness that they cannot control [2]. Their websites contain pictures of emaciated models, tips for dieting and how to hide weight loss from parents or doctors, and community manifestoes such as the “Ana Creed”, a list of beliefs that describe what it means to be pro-anorexic (e.g., “I believe in a wholly black and white world, the losing of weight, recrimination for sins, the abnegation of the body and a life ever fasting”; [2], [3]). Although the real prevalence of “pro-ana” sites is impossible to determine, their number has been estimated to exceed 500 [4]. A concern about these sites is their potential to trigger those on the brink of an eating disorder into full-fledged anorexia. Despite media efforts to combat pro-anorexic attitudes, these sites remain popular [2].

The purpose of this study was to explore differences in self-presentation styles of individuals who publicly defend anorexia as a lifestyle and individuals who identify themselves as recovering from anorexia. Methodologically, we attempted to complement traditional questionnaire-based assessments by sampling information directly and nonreactively from pro-anorexics' main communication platforms, personal homepages, and message boards [5], [6]. Two text sources, homepages and message boards, were selected to identify self-presentation styles that generalize across different online media. Pro-anorexics were contrasted against recovering anorexics as a comparison group to better understand how attitudinal factors can affect psychological processes that, in turn, may create barriers to successful anorexia treatment. Recovering anorexics were further considered an appropriate comparison group because they also extensively use homepages and message boards to share their experiences with others.

This study analyzed self-presentation from a linguistic perspective [7]. The psychological study of language use has recently received increasing scientific attention [8]. Word-count-based text analysis approaches have been shown to reliably capture diagnostic information about a wide range of psychological phenomena, including psychiatric disorders [9], suicidal ideations [10], coping with breast and prostate cancer [11], [12], psychological responses to a national upheaval [13], and even risk for coronary heart disease [14].

Because of their vehement anorexia-as-a-lifestyle ideology, we expected pro-anorexics, compared with recovering anorexics, to show a more pronounced hedonic focus (references to positive emotions and the present), a higher level of self-absorption (references to self), and a lower level of cognitive reflection (use of cognitive words).