Exploration of Friendship Experiences, before and after Illness Onset in Females with Anorexia Nervosa: A Qualitative Study

Abstract

BackgroundDifficulties with social relationships have been implicated in both the development and maintenance of Anorexia Nervosa (AN) but the friendship experiences of individuals with AN have not been explored in depth.MethodTen adults with AN took part in a semi-structured interview about their friendship experiences both before and since the onset of their illness.ResultsFive principle themes were identified through thematic analysis: Social Concern; Impact of AN; Social Connectedness; Inflexibility and Preferred Social Activity. Difficulties with friendship were present prior to the onset of AN in all cases, with participants experiencing anxiety in relation to various aspects of their friendships. Participants described mixed experiences of how their AN has affected their friendships but most participants described having less contact with their friends since becoming unwell.ConclusionThis research highlights the role that social difficulties may play in the development of AN, whilst also emphasising the importance of addressing problems with friendship in the course of inpatient treatment.

An experimental investigation into the use of eye‐contact in social interactions in women in the acute and recovered stages of anorexia nervosa

“…However, the downside of this avoidance strategy is that it inadvertently communicates disinterest to others, such that the intended solution to social discomfort becomes the problem. This may explain the small social networks reported by this patient group (Westwood, Lawrence, Fleming, & Tchanturia, 2016). Thus, this work could inform cognitive behavioral models and treatments for EDs (e.g., Fairburn, 2008), other evidence-based treatments for AN like MANTRA (Schmidt et al, 2015), and treatment adjuncts like CREST with regards to the nature and possible mechanisms of the subtle social skill differences that might make social interactions more challenging for people with AN which can then be targets for social experiments.…”

“…This may explain the small social networks reported by this patient group (Westwood, Lawrence, Fleming, & Tchanturia, 2016). This may explain the small social networks reported by this patient group (Westwood, Lawrence, Fleming, & Tchanturia, 2016).…”

Same behaviours, different reasons: what do patients with co-occurring anorexia and autism want from treatment?

“…Potential mechanisms underlying the relationship between AN and autism could include shared cognitive traits: commonly with research in autism, literature shows that people with AN exhibit problems with rigidity, central coherence, and emotional and social processing that may persist following recovery (Harrison, Mountford, & Tchanturia, 2014;Lang, Lopez, Stahl, Tchanturia, & Treasure, 2014;Katie Lang et al, 2016;Leppanen, Sedgewick, Treasure, & Tchanturia, 2018;Westwood, Lawrence, Fleming, & Tchanturia, 2016;Westwood, Stahl, Mandy, & Tchanturia, 2016). Significantly, heightened autistic traits in people with AN are associated with more severe presentations and poorer treatment outcomes (Nielsen, Anckarsater, Gillberg, Rastam, & Wentz, 2015;Tchanturia, Adamson, Leppanen, & Westwood, 2017;Tchanturia, Larsson, & Adamson, 2016), leading to suggestions that traditional treatment approaches may need to be adapted for this population (Dudova, Kocourkova, & Koutek, 2015;Stewart, McEwen, Konstantellou, Eisler, & Simic, 2017;.…”

Autism Spectrum Disorder in Anorexia Nervosa: An Updated Literature Review

“…Since then, growing research has attempted to elucidate the nature of the relationship between the two disorders, focusing on both elevated presence of ASD in AN and shared underlying difficulties in cognitive, social and emotional functioning [10–13]. …”

“…While there is growing evidence of similarities between the two disorders in terms of cognitive and socioemotional processing [12, 11, 13], studies focusing purely on such similarities are outside the scope of this review. While some studies have examined ASD across the spectrum of EDs, the majority have focused on its prevalence within AN.…”