The Assessment of the Family of People with Eating Disorders

Psychological Medicine Department, King's College London, Institute of Psychiatry, London, UK.
European Eating Disorders Review (Impact Factor: 2.46). 07/2008; 16(4):247-55. DOI: 10.1002/erv.859
Source: PubMed


The National Institute for Clinical Excellence (NICE) guidelines for eating disorders recommend that carers should be provided with information and support and that their needs should be considered if relevant. The aim of this paper is to describe how to structure an assessment of carers needs so that the family factors that can contribute to the maintenance of eating disorder symptoms are examined. We describe in detail the pattern of interpersonal reactions that can result when a family member has an eating disorder. Shared traits such as anxiety, compulsivity and abnormal eating behaviours contribute to some of the misperceptions, misunderstandings and confusion about the meaning of the eating disorder for family members. Unhelpful attributions can fuel a variety of emotional reactions (criticism, hostility, overprotection, guilt and shame). Gradually these forces cause family members to accommodate to the illness or be drawn in to enable some of the core symptoms.

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Available from: Ana R Sepulveda
    • "Research consistently shows that families perceive the ED behaviours as challenging, leading them to experience intense emotional reactions including anxiety, guilt and burden (Coomber & King, 2013a; Kyriacou, Treasure & Schmidt, 2008a; Kyriacou, Treasure & Schmidt, 2008b; Zabala, MacDonald & Treasure, 2009). Furthermore, it has been postulated that familial responses to AN may inadvertently maintain illness behaviours (Treasure et al., 2008). However, no research has been conducted to gauge the affected individual's perceptions of how their families respond to their illness behaviours, which leaves a crucial gap in our understanding of how families can either support or undermine their loved ones in their struggle with AN. "
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    ABSTRACT: The current study explores how affected individuals understand their family's perceptions of anorexia nervosa (AN). Perceptions of individuals with AN regarding their family's understanding of the illness may influence their ability to accept family support. Thematic analysis was used on qualitative data of 19 individuals with AN undergoing inpatient treatment. Participants perceived that families: (a) considered AN a problem with food rather than a mental illness; and (b) viewed treatment as time limited, and complete recovery as achievable. Family-based interventions are needed to facilitate understanding about AN, as well as the behavioral and psychological adjustments required during treatment and recovery.
    No preview · Article · Oct 2015 · Eating disorders
    • "This recognition facilitates acceptance of the diagnosis, treatment, referral, interventions, and minimizes undue stigma associated with having the illness. Our findings also fit well into a model of interpersonal maintaining factors described byTreasure et al. (2008). This model describes how unhelpful attributions can fuel a variety of emotional reactions that cause family members to become less helpful to the sick person. "
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    ABSTRACT: This qualitative study from northern Sweden investigated experiences of multi-family therapy (MFT) in 12 parents of children with anorexia nervosa (AN). The main reported benefit was the opportunity to talk to others in a similar situation, thereby sharing experiences and struggles. MFT resulted in new perspectives and insights that improved family dynamics and enabled new constructive behaviors. In conclusion, MFT seems to be a useful therapeutic modality in the treatment of AN in a northern European setting.
    No preview · Article · Apr 2015 · Eating disorders
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    • " missing. In fact, the family environment of patients with EDs has been explored mostly by qualitative studies, which have analyzed the personal experiences of relatives living with ED patients. 17–19 Moreover, the few available quantitative studies have adopted instruments not tailored for EDs, such as the experience of caregiving inventory (ECI). 20,21 This questionnaire , developed for the assessment of families of patients with schizophrenia, includes 66 items grouped into eight negative scales (difficult behaviours , negative symptoms, stigma, problems with services, effects on family, need to backup, dependency, loss) and in two positive scales (positive personal experiences and"

    Full-text · Article · Mar 2015 · European Psychiatry
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