Discordant conceptualisations of eating disorder recovery and their influence on the construct of terminality

Journal of Eating Disorders, Год журнала: 2024, Номер 12(1)

Опубликована: Июнь 3, 2024

Abstract Eating disorders (EDs) are complex, multifaceted conditions that significantly impact quality-of-life, often co-occur with multiple medical and psychiatric diagnoses, associated a high risk of sequelae mortality. Fortunately, many people recover even after decades illness, although there different conceptualisations recovery understandings how is experienced. Differences in these influence categorisations ED experiences (e.g., longstanding vs. short-duration EDs), prognoses, recommended treatment pathways, research into outcomes. Within recent years, the proposal ‘terminal’ illness stage for subset individuals anorexia nervosa arguments prescription end-of-life pathways such has ignited debate. Semantic choices influential care, it critical to consider power dynamics outcomes ‘staging’ discourse. Conceptually, ‘terminality’ interrelates recovery, efficacy available treatments, iatrogenic harm, complex co-occurring as well functions an individual’s eating disorder, personal symbolic meanings individual may hold regarding suffering, self-starvation, death, health life. Our authorship represents wide range lived living EDs, treatment, ranging from severe EDs meet descriptors variety definitions ‘recovery’. have given rise shared motivation analyse existing discourses terminality found literature policy, shape conceptualisations, beliefs, actions healthcare systems seek serve them.

Язык: Английский

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Compassion-focused group therapy as a transdiagnostic treatment for comorbid eating disorders and posttraumatic stress disorder: a pilot feasibility and acceptability study

Clinical Psychologist, Год журнала: 2025, Номер unknown, С. 1 - 16

Опубликована: Янв. 30, 2025

Язык: Английский

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Concurrent delivery of written exposure therapy for posttraumatic stress disorder treatment in an intensive eating disorder program: a case series

Eating Disorders, Год журнала: 2025, Номер unknown, С. 1 - 8

Опубликована: Янв. 18, 2025

Posttraumatic stress disorder (PTSD) and eating disorders (EDs) frequently co-occur, with PTSD potentially worsening ED treatment outcomes. Integrated concurrent interventions that treat both conditions together have been recommended, but no best practices exist. This case series of nine patients provides preliminary data on Written Exposure Therapy (WET), a brief, low-resource intervention, delivered concurrently inpatient or day hospital treatment. Results showed reductions in symptoms, most experiencing clinically significant improvements. Changes symptoms varied, experienced deterioration. These findings suggest WET is promising, efficient method for treating alongside treatment, supporting the need clinical trials to assess its acceptability efficacy ED-PTSD.

Язык: Английский

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Level of family involvement as a predictor of outcome in eating disorder patients with and without provisional PTSD during residential treatment

Eating Disorders, Год журнала: 2025, Номер unknown, С. 1 - 15

Опубликована: Фев. 4, 2025

Objective Family involvement (FI) in the treatment of eating disorders (EDs) is critical for children/adolescents, yet its role during residential (RT) adults uncharted. PTSD may play a influencing FI but also unexplored.

Язык: Английский

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Treatment as involuntary, incompatible, and intimidating: exploring dropout processes in a randomized controlled trial for eating disorders

Nordic Journal of Psychiatry, Год журнала: 2025, Номер unknown, С. 1 - 8

Опубликована: Март 6, 2025

Ambivalence to treatment and dropout are particularly common in Eating Disorder (ED) treatment, hindering recovery posing a serious threat the external validity of outcome research. Attrition may bias findings randomized controlled trials (RCTs), exacerbates risk that complex cases underestimated, which is since RCTs inform development evidence-based practices. An increased understanding processes contribute patient retention, still, patients' perspectives on voluntary rare. We explore responses involved an RCT. Six female, cis-gendered non-completers were interviewed after dropout; rich descriptions from few informants rendered Interpretative Phenomenological Analysis suitable. developed three Master Themes with two subthemes each: «I had no choice» (fear disappointing, other-orientation), did not fit in» (alienation, poor treatment), left survive» (Existing through illness, Need regain control self) under overarching Core Theme «Treatment as involuntary, incompatible, intimidating». Our underscored centrality perceived coercion, feeling pressured choose recovery, alienation, misalignment goals, seemingly existential critical urge self during overwhelming emotions evoked when confronted mandatory components. RCT non-completers' accounts corroborate previous patient-as-expert research experiences naturalistic settings. Refined methods called for bridge research-practice gap.

Язык: Английский

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Early Maladaptive Schemas Mediate the Relationship Between Childhood Trauma and Interpersonal Problems in Eating Disorders

Clinical Psychology & Psychotherapy, Год журнала: 2025, Номер 32(2)

Опубликована: Март 1, 2025

ABSTRACT Recent research highlights the role of childhood trauma in development eating disorders (EDs), suggesting that adverse experiences can disrupt emotional and cognitive development, leading to early maladaptive schemas (EMSs) interpersonal problems. EMSs are psychological structures encompassing cognition, emotions, images, bodily sensations. These hypothesized mediate relationship between ED pathology. This study aimed extend investigation how leads difficulties, mediated by EMSs. cross‐sectional recruited 321 patients with EDs: n = 77 Anorexia Nervosa–Restricting (AN‐R), 26 AN–Binge/Purge (AN‐BP), 94 Bulimia Nervosa (BN), 124 Binge Eating Disorder (BED). They completed Examination (EDE), Inventory Interpersonal Problems (IIP‐32), Young Schema Questionnaire (YSQ‐S3), Childhood Trauma (CTQ‐SF). Path analyses were conducted examine associations trauma, EMSs, Results indicated BED reported highest levels sexual abuse. Those BN exhibited higher scores across all EMS domains. Positive correlations found adversities, domains, problems, except for abuse schema Mediation revealed significant indirect effects on problems through disconnection rejection domain. consolidates notion patients, highlighting importance addressing improve therapeutic outcomes. Future should focus longitudinal better understand temporal these relationships.

Язык: Английский

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Suggesting internal family systems-informed eye movement desensitisation and reprocessing as a treatment for personality structural dissociation

Discover Psychology, Год журнала: 2025, Номер 5(1)

Опубликована: Март 29, 2025

Язык: Английский

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Optimising Psychosocial Interventions for People With Severe and Enduring Eating Disorders (SEED) Perspectives of Healthcare Professionals in Ireland: A Qualitative Study

International Journal of Mental Health Nursing, Год журнала: 2025, Номер 34(2)

Опубликована: Апрель 1, 2025

ABSTRACT To date, no studies have explored healthcare professionals' perceptions on the acceptability and effectiveness of psychosocial interventions for patients with severe enduring eating disorders in Ireland. The aims this study were to explore how professionals view use these approaches can be improved. A qualitative design was utilised opinions. Semi‐structured, one‐to‐one interviews used collect data from ( n = 16) mental health settings. Interviews audio‐recorded transcribed verbatim before being analysed using thematic analysis. Four themes identified: (1) therapeutic relationship, (2) patient‐centred approaches, (3) co‐morbidities (4) pathway care services. Findings strongly suggest need set their own goals improve treatment outcomes quality life. Furthermore, findings also a strong correlation between history trauma diagnosis disorders. Therefore, training provide trauma‐informed is needed.

Язык: Английский

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Posttraumatic stress disorder (PTSD) and complex PTSD in eating disorder treatment‐seekers: Prevalence and associations with symptom severity

Journal of Traumatic Stress, Год журнала: 2024, Номер 37(4), С. 672 - 684

Опубликована: Апрель 18, 2024

Abstract Although childhood trauma and posttraumatic stress disorder (PTSD) have been well‐researched in eating epidemiology, prevalence rates are unavailable for complex PTSD (CPTSD). Under recently introduced ICD‐11 criteria, individuals with CPTSD both symptoms additional disturbances self‐organization (DSO). Using this study aimed to determine the of DSO symptoms, diagnostic CPTSD, exposure treatment‐seekers. Participants ( N = 217) were attending residential, partial hospitalization, outpatient services who completed measures disorder– trauma‐related adverse experiences. One third participants reported over half probable 3.8% 28.4% CPTSD. was significantly more prevalent than common higher levels care. Both symptom severity positively correlated impairment, r s .285–.642. a significant unique explanatory factor impairment. The findings highlight populations association between psychopathology independent symptoms. Implications discussed adjunct treatment approaches comorbid disorders or

Язык: Английский

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Two identical twin pairs discordant for longstanding anorexia nervosa and OSFED: lived experience accounts of eating disorder and recovery processes

Journal of Eating Disorders, Год журнала: 2024, Номер 12(1)

Опубликована: Сен. 2, 2024

Research into the risk of anorexia nervosa (AN) has examined twin pairs to further understanding contributions genetics, trait inheritance, and environmental factors eating disorder (ED) development. Investigations experiences EDs have been biologically-based not considered qualitative, phenomenological aspects experiences. A gap in literature exists regarding discordant twins with EDs. This research was developed response, aim deepen AN create novel ideas for testing. The case studies presented this article provide lived experience insights two identical pairs: one pair longstanding 'atypical' (the recovered). perspectives each co-twin (one without) explore a number that may contributed discordance these cases, how responded impact their lives. Through use first-person accounts study presentation, centres social justice values leadership involvement research. aims extend current knowledge twins, particularly ED development, duration, diagnosis treatment, recovery processes.

Язык: Английский

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