Assessment of anorexia nervosa: an overview of universal issues and contextual challenges

Abstract

AimAnorexia Nervosa (AN) is a complex and clinically challenging syndrome. Intended for specialist audiences, this narrative review aims to summarise the available literature related to assessment in the adult patient context, synthesising both research evidence and clinical consensus guidelines.MethodWe provide a review of the available literature on specialist assessment of AN focusing on common trajectories into assessment, obstacles accessing assessment, common presenting issues and barriers to the assessment process, the necessary scope of assessment, and tools and techniques. It describes the further step of synthesising assessment information in ways that can inform resultant care plans.ResultsIn addition to assessment of core behaviours and diagnostic skills, considerations for the expert assessor include the functions of primary care, systemic and personal barriers, knowledge of current assessment tools and research pertaining to comorbid pathology in AN, assessing severity of illness, role of family at assessment, as well as medical, nutritional and compulsory elements of assessment.ConclusionComprehensive assessment of AN in the current healthcare context still remains largely the remit of the specialist ED clinician. Assessment should remain an on-going process, paying particular attention to available empirical evidence, thereby reducing the gap between research and practice.

Empirically Derived Subtypes of Full and Subthreshold Anorexia Nervosa in Adolescent Females: Understanding General Psychopathology and Treatment Implications

“…The scales on which the Low Pathology AN patients reported clinical elevations, including Interpersonal Problems, were typical of the scores expected in this clinical sample according to EDI-3 norms, and suggest that these patients experience some level of distress in social relationships, feelings of insecurity, and generally poor interpersonal relationships (Garner, 2004). The characteristics of the Low Pathology AN patients may support the potential effects of the AN symptoms, in that as the disorder progresses and weight drops individuals' fear of fatness may also decrease as they are not confronted with as much fat on their body (Sugenor & Maguire, 2013).…”

Practitioner eating disorder detection: The influence of health mindset, thin‐ideal internalization, orthorexia and gender role

“…As highlighted in our original study (Worsfold & Sheffield, 2018), various gaps still exist within ED‐MHL research (Linville et al, 2012; Mond, 2014; Surgenor & Maguire, 2013). First, research could extend past exploring beliefs and practices of medical professionals to a broader group of health practitioners that are regular providers of mood or weight management services, such as psychologists, naturopaths and fitness instructors.…”

Evaluating the effectiveness of an evidence-based online training program for health professionals in eating disorders

“…Early diagnosis and intervention has prognostic benefits in limiting the ED’s progression and improving physical and psychosocial outcomes [13, 14]. EDs are clinically challenging for mental health services due to the high medical risks brought on by the disorder [15]. It is commonly reported that health professionals from various clinical disciplines lack confidence and training in screening, diagnosing and treating people with EDs [16–18].…”

“…Lack of training, experience, and inadequate educational resources have also been associated with negative attitudes of health professionals towards people presenting with an ED [15]. These negative or dismissive perceptions are likely related to the nature of the symptoms and blame-based stigmatisation [26–28].…”