Pride in eating disorders: a scoping systematic Review

Purpose: Pride might play an important role in eating disorders (EDs) and eating disorder symptomatology. The present scoping PRISMA systematic review explores the emotion of pride in EDs and general populations specifically its association with ED-related symptomatology and aspects. Methods: Four databases (PubMed, PsycInfo, Web of Science, Scopus) were searched for studies assessing pride in ED patients or in association with ED-related symptoms. The systematic scoping review followed PRISMA guidelines and PICOS procedure. Results: Fifteen studies were selected including ten quantitative (mostly cross-sectional) and five qualitative studies. Most studies (n=9) were on general population samples assessed for pride in association with ED-related symptoms and behaviors, six were on clinical samples mostly focused on AN (n=5) and one a mixed EDs. Pride was evaluated in various forms including ED-related pride, appearance-related pride, body pride, pro-anorectic pride, and cultural pride. In general populations, high levels of maladaptive pride and low levels of adaptive body pride were related to greater ED-associated behaviors and symptomatology. In qualitative studies on AN patients, pride was associated with themes of control and with illness identification and as one factor that contributed to illness onset, maintenance and recovery. Conclusion: The review supports that integrating assessment of pride experiences in AN patients may be clinically useful for initial assessment, treatment planning and definitions of remission. Gaps in the literature and methodological limitations of studies are discussed. In particular, a lack of quantitative and longitudinal data and inconsistency in pride constructs emerged.