Caring for people with eating disorders: Factors associated with psychological distress and negative caregiving appraisals in carers of people with eating disorders

Jenna Whitney · Rachel Haigh · John A Weinman · Janet L. Treasure

137 citations0/0 files storedBritish Journal of Clinical Psychology

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Eating Disorders and Behaviors Nursing care and research Family Caregiving in Mental Illness

Abstract

OBJECTIVES: Carers of people with eating disorders (ED) have high levels of distress, but little is known about the contributing factors. The aim of this study was to examine predictors of carers' distress and caregiving appraisals using a model of caregiving adapted from the previous literature. DESIGN: A cross-sectional design was used. METHODS: A sample of 115 individuals currently caring for someone with an ED participated in the study. Carers completed self-report assessments of psychological distress (GHQ-12; Goldberg & Williams, 1988), experience of caregiving (Szmukler et al., 1996), illness representations (IPQ-SCV; Barrowclough, Lobban, Hatton, & Quinn, 2001) and caregiving needs (CaNAM; Haigh & Treasure, 2003). Simple and multiple hierarchical regressions were conducted. RESULTS: Approximately 36% (39/109) of carers had scores on the GHQ which indicated mental health difficulties, with 17% (19/109) experiencing high psychological distress. A negative experience of caregiving was associated with carers' distress. The dependency of the individual with the ED and stigma associated with the illness were most highly predictive of carers' distress. Shorter illness duration, higher levels of needs (lower levels of support) and perceptions of high illness consequences contributed to greater negative caregiving appraisals. The belief that the illness was attributable to the sufferers' personality was related to fewer positive appraisals. CONCLUSIONS: Adjusting to the impact of a family member experiencing an ED is problematic, as suggested by the relationship between shorter illness duration and greater negative appraisals of caregiving. Interventions to help reduce dependency and alleviate stigma may help to decrease carers' distress.

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References

1983The Hospital Anxiety and Depression Scale 1985Stress, appraisal, and coping 1988A user's guide to the General Health Questionnaire 2002The Revised Illness Perception Questionnaire (IPQ-R)1996The illness perception questionnaire: A new method for assessing the cognitive representation of illness 2003The self-regulation of health and illness behaviour 2006Anorexia nervosa: Valued and visible. A cognitive‐interpersonal maintenance model and its implications for research and practice 1998Self-regulation, health, and behavior: A perceptual-cognitive approach

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2009Development and validation of the Accommodation and Enabling Scale for Eating Disorders (AESED) for caregivers in eating disorders 2007Expressed emotion in eating disorders assessed via self‐report: An examination of factors associated with expressed emotion in carers of people with anorexia nervosa in comparison to control families 2008The assessment of the family of people with eating disorders 2012The use of motivational interviewing in eating disorders: A systematic review 2018

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