Both affected and unaffected sisters had more set-shifting difficulties than unrelated healthy women. This finding, together with the replicated finding that set-shifting difficulties persist after recovery, suggests that set-shifting difficulties are trait characteristics and may inform the search for the endophenotype in anorexia nervosa.
Women with AN have strengths in tasks requiring local processing (EFT) and weaknesses on tasks benefited by global processing (RCFT and SCT). These results are consistent with the weak central coherence account. This trait might play a role in the maintenance of AN and can be addressed in specific clinical interventions.
The profile of illness perceptions expressed by the AN sample is associated with poor mental health and functioning and may inform the treatment approach. Lay perceptions of AN differed in the conceptualization of AN as a "slimming disease" amenable to change. This discrepancy may contribute to the stigmatization of AN.
Anorexia nervosa often begins in adolescence, and there is a growing body of quantitative literature looking at the efficacy of treatment for adolescents. However, qualitative research has a valuable contribution to make to the understanding of treatment and recovery. This paper aims to review qualitative studies on the experience of treatment and recovery for adolescents with anorexia nervosa. Key themes from the 11 studies identified the role of family, peers and professionals, family therapy, the inpatient setting, emphasis on physical versus psychological and conceptualisation of recovery. Future studies would benefit from relating their findings to adolescent theory and considering reflexivity. Implications for clinical practice are also discussed.
relationship: depression and stress may promote unhealthy dietary preference, 9 whereas in turn a healthy diet may lower the risk of incident depression over time. 10 The findings of our study provide empirical support to Kiecolt-Glaser's hypothesis 1 about the joint contribution of depression and diet to inflammation, and suggest that intervention aimed at improving the quality of diet may be especially effective in buffering the inflammatory process boosted by depression, which ultimately could result in various health benefits.
Anorexia nervosa (AN) appears to be associated with certain personality features. The degree to which personality pathology persists after the acute phase of illness is unclear. This study aimed to investigate personality pathology in a large sample (n = 153) of women with histories of AN using the Dimensional Assessment of Personality Pathology (DAPP) and to evaluate the persistence of pathological personality features by comparing women with acute (n = 83) and remitted AN (n = 55). Women with AN demonstrated high levels of emotional dysregulation, social inhibition and compulsivity relative to age-matched healthy women (n = 124). Identity problems, intimacy problems and schizotypal features were highlighted as important. The same 14 pathological personality dimensions were significantly elevated in both ill and remitted participants, though remitted individuals' scores were reduced on 4 of the subscales. These results indicate that pathological personality features in AN are persistent traits, although some features may become exaggerated in the acute phase.
The P-CED is a useful tool for identifying the positive and negative aspects of eating disorders that can be targeted in treatment or used as an outcome measure in research.
Home treatment (HT) is emerging as an alternative to admission for adolescents with anorexia nervosa. It relies heavily on parental (often maternal) input to be effective. Given the high levels of carer stress reported by mothers, the current study aimed to explore mothers' experience of HT. A qualitative study using purposeful sampling was conducted. Nine interviews were analyzed using interpretative phenomenological analysis. Two contextual themes described the mother-daughter relationship and maternal stress and distress prior to HT. The third theme, "experience of help," included sub-themes of when help is needed, the need for containment, gaining strength and skills, and how HT met families' philosophy and values. The results support previous research on the stress that mothers particularly are under when their adolescent daughters have anorexia nervosa, and provides rich data on their experiences. HT is perceived as having both helpful and unhelpful aspects. Further research on its effectiveness is needed.
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