Anorexia nervosa, depression and medicalisation: a corpus-based study of patients and professionals

Hunt, Daniel (2013) Anorexia nervosa, depression and medicalisation: a corpus-based study of patients and professionals. PhD thesis, University of Nottingham.

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This study reports on the analysis of the Mental Health Discourse Corpus. This dataset is comprised of four sub-corpora that contain patients' online discussions of anorexia nervosa, patients' online discussions of depression, general practitioners' discussions of anorexia, and general practitioners' discussions of depression, respectively. The methodology integrates quantitative corpus linguistic approaches with qualitative analysis drawing on Hallidayan functional grammar, discourse analysis and discursive psychology. By interrogating corpora of health communication across communicative modes and participants, the study offers novel insights into the verbal presentation of anorexia and depression by patients and professionals, and examines their respective uptake of medical explanations of mental illness.

Common patterns in the online patient interactions are linguistic choices which realise the externalisation and personification of anorexia and depression, the discursive construction of individual helplessness, and the representation of psychological distress in terms of medical pathology. The uptake and proliferation of biomedical explanatory models of anorexia and depression serves to reduce illness stigma for individuals and, notably, is also used to perform local interactional tasks.

In the practitioners' talk, participants draw on medical and social explanations of depression and anorexia. Doctors construct depression as a categorical medical diagnosis while also expressing doubt towards its medical treatment and advocating non-medical interventions. When discussing anorexia, clinicians emphasise the bureaucratic role which body mass index scores occupy in managing anorexia and repeatedly highlight the difficulty of overcoming patients' resistance. In both cases, participants highlight the bureaucratic and communicative challenges of working with anorexic and depressed patients and construct a range of unfavourable moral identities for the chronically ill.

The practical implications of the research for users of online support groups and general practitioners working with depressed and anorexic patients are identified. In particular, I emphasise the centrality of communication to primary mental health care and the utility of studying online support groups to illuminate the experiences and beliefs of patients. A critical evaluation of the study's methodology is offered, along with recommendations for future research.

Item Type: Thesis (University of Nottingham only) (PhD)
Supervisors: Carter, R.A.
Harvey, K.
Keywords: health communication, anorexia nervosa, discourse analysis
Subjects: P Language and literature > P Philology. Linguistics
R Medicine > R Medicine (General)
Faculties/Schools: UK Campuses > Faculty of Arts > School of English
Item ID: 28065
Depositing User: Hatton, Mrs Kirsty
Date Deposited: 12 Jan 2015 13:18
Last Modified: 13 Oct 2017 21:40

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