Interventions aimed at improving outcome in AN may need to focus on reducing caregiving strains and carers' distress, particularly of mothers.

Background: Families of people with eating disorders are often caught up in rule bound eating and safety behaviours that characterise the illness. The main aim of this study was to develop a valid and specific scale to measure family accommodation in the context of having a relative with an eating disorder.

The FQ was sensitive both to CC and EOI. Interventions aimed at reducing EE may need to focus on decreasing carers' anxiety and teaching skills to moderate difficult behaviors.

Patients with anorexia nervosa (AN) may experience difficulties in emotional processing that can adversely affect treatment and maintenance of the illness. Focus groups or questionnaires were undertaken with patients with AN, parents and clinicians, with the aim to explore the most salient issues pertaining to emotions and social cognition in AN. Qualitative thematic analysis was used to analyse the data. Seven primary themes were identified showing congruence across groups: 'emotional awareness and understanding'; 'emotional intolerance'; 'emotional avoidance'; 'emotional expression and negative beliefs'; 'extreme emotional responses'; 'social interactions and relationships'; and 'lack of empathy'. Clinical and empirical implications are discussed.

The National Institute for Clinical Excellence (NICE) guidelines for eating disorders recommend that carers should be provided with information and support and that their needs should be considered if relevant. The aim of this paper is to describe how to structure an assessment of carers needs so that the family factors that can contribute to the maintenance of eating disorder symptoms are examined. We describe in detail the pattern of interpersonal reactions that can result when a family member has an eating disorder. Shared traits such as anxiety, compulsivity and abnormal eating behaviours contribute to some of the misperceptions, misunderstandings and confusion about the meaning of the eating disorder for family members. Unhelpful attributions can fuel a variety of emotional reactions (criticism, hostility, overprotection, guilt and shame). Gradually these forces cause family members to accommodate to the illness or be drawn in to enable some of the core symptoms.