Critical Incidents in Anorexia Nervosa: Patients’ Perspective

Abstract

BackgroundAlthough social-emotional difficulties are believed play a key role in anorexia nervosa (AN), there is uncertainty regarding what these difficulties might look like. Previous research has largely focused on a “disease model” of social-emotional processing in AN with little attention paid to positive emotions and experiences. Therefore, the aim of the present study was to obtain a fuller picture of critical life events in AN. MethodsThirty-four participants aged 16-48 with current or past AN completed an online survey describing self-defined positive and difficult critical events.ResultsTwo major themes were identified in the descriptions of positive critical events: Moments of celebration, reflecting external focus, and Unexpected positive outcomes, revealing negative biases. Difficult events were broadly divided into included eating disorder (ED) related and Non-ED life events, involving discussion of relational conflict and feeling unsupported. DiscussionThe findings suggest that AN is largely characterised by negative emotionality and bias. However, people with AN can live rich lives with positive experiences, which reflect reduced self-focused attention and increased “big-picture” thinking. Moreover, people with AN may be open to have their negative expectations challenged through corrective experiences. Together these findings be useful targets for further clinical research.