Accommodation of symptoms in anorexia nervosa: a qualitative study

Fox, John R. E. ORCID: https://orcid.org/0000-0003-3039-8024 and Whittlesea, Anna 2017. Accommodation of symptoms in anorexia nervosa: a qualitative study. Clinical Psychology and Psychotherapy 24 (2) , pp. 488-500. 10.1002/cpp.2020

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Abstract

Anorexia nervosa (AN) continues to remain poorly understood within eating disorders. Recent research and theory have moved away from understanding its aetiological causes, addressing instead potential maintaining factors. This study is focused on interpersonal maintenance factors: the response of close others. Relatives of those with AN typically carry the main burden of care, and research has found high levels of carer distress and unmet needs. Recent theories have proposed this emotional impact to contribute to expressed emotion and other unhelpful caregiver interactions which inadvertently maintain AN. One such understudied response is accommodation, described as a ‘process’ whereby caregivers ‘assist or participate’ in symptomatic behaviours of the cared for individual. There is a dearth of research relating to accommodation within eating disorders, particularly qualitative accounts. This study utilized a grounded theory methodology to explore caregivers' responses to managing AN, focusing particularly on carers' experience of accommodation. Eight participants with experience of caring for an individual diagnosed with AN were interviewed. Participants were recruited from a national eating disorder charity and regional eating disorder service. A number of themes emerged, including the importance of caregivers' emotional resources in mediating accommodation responses. Low‐perceived efficacy over AN contributed to caregiver burnout. Decreased emotional resources influenced a shift in caregiving aims conducive with accommodation. Nevertheless, carers perceived accommodation as counterproductive to recovery and consequently experienced internal conflict (cognitive dissonance). Dissonance was reduced using a number of cognitive and behavioural strategies. The implications of these findings are discussed with reference to existing literature.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Psychology
Publisher:	Wiley: 12 months
ISSN:	1063-3995
Date of Acceptance:	15 April 2016
Last Modified:	23 Oct 2022 13:20
URI:	https://orca.cardiff.ac.uk/id/eprint/110349

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