“Putting your own oxygen mask on first”: a qualitative study of siblings of adults with anorexia or bulimia

Karlstad, Jannike; Moe, Cathrine Fredriksen; Wattum, Mari; Stokland, Ragni Adelsten; Brinchmann, Berit Støre

doi:10.1186/s40337-021-00440-6

Cited by 13 publications

(15 citation statements)

References 27 publications

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“…A third study [32] reported how healthy sisters (n = 21) of women with ED may also evince more difficulties and avoidance in the recognition of their own emotions as compared to non-related controls, through both self-report and experimental task based on picture of faces. Further recent studies proposed additional qualitative reports of distress in this population [33,34].…”

Section: Psychological Mechanismsmentioning

confidence: 86%

Parental-Bonding and Alexithymia in Adolescents with Anorexia Nervosa, Their Parents, and Siblings

Mannarini

Kleinbub

2022

Behavioral Sciences

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Anorexia nervosa (AN) patients and their family-members share alexithymia, anxiety, depression, and other psychological symptoms, in the context of altered attachment. These domains have been individually studied in the context of eating disorders; few attempts have been made to study their interaction, especially including family members. In this study, alexithymia, parental-bonding, and psychopathology were assessed in 32 Italian families consisting of an adolescent AN patient, a sibling, and their parents. We aimed to (a) describe a sample of Italian families with a child affected by AN, notably including siblings; (b) investigate interactions between assessed constructs in patients and their siblings; and (c) investigate possible intergenerational effects. Results showed high alexithymia and psychopathological symptoms in patients but not in siblings, although the latter reported high obsession–compulsion and paranoid ideation scores. Patients’ and siblings’ alexithymia correlated with psychopathology. Parents reported generally low alexithymia. Perceived parental bonding was found to be suboptimal in most participants, yet no clear relationship was found between specific parenting styles and other measured traits, nor did we find any other relevant intergenerational effect. Anorexia nervosa implies psychological difficulties for all family members. Siblings’ psychopathological traits are especially concerning and currently understudied. Implications for future research and clinical interventions are discussed.

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Section: Psychological Mechanismsmentioning

confidence: 86%

Parental-Bonding and Alexithymia in Adolescents with Anorexia Nervosa, Their Parents, and Siblings

Mannarini

Kleinbub

2022

Behavioral Sciences

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“…She has conducted two years of fieldwork with MFT for adults with EDs and has published two articles based on this work [2,3]. She has also supervised master's students [27] and a PhD student [28,29] on studies about EDs. Although she has not worked clinically with persons with EDs, she has expertise in ethics and her thinking is inspired by the Danish philosopher and theologian K.E.…”

Section: Beritmentioning

confidence: 99%

“…Research shows that EDs greatly affect parents, siblings and the wider family [25][26][27][28][29] and are experienced as more demanding for the family than, for example, psychotic disorders [30][31][32]. Furthermore, studies show that those closest to a family member with an ED suffer from isolation and receive little help from support services [27][28][29][33][34][35].…”

Section: Introductionmentioning

confidence: 99%

Multiple perspectives and dialogue in understanding experiences of living with eating disorders: Two narratives—four unpackings

et al. 2022

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Background This is a response to Conti et al.’s article, “Listening in the dark: why we need stories of people living with severe and enduring anorexia nervosa” (published in JED, 2016), and its call for relational metaphors and a relational approach to supplement the traditional medical/psychological diagnostic language used to describe the life experiences and complex emotions of people affected by an eating disorder. Methods Four authors with different backgrounds unpack two narratives, ‘The Prima Donna with the Green Dress’ and ‘Breaking down the Wall’, both narrated during fieldwork in multifamily therapy. The narratives are unpacked from the perspective of a therapist within multifamily therapy, a researcher who conducted the fieldwork, a researcher based in phenomenology and a researcher based in narrative inquiry. The authors enter into dialogue with the narratives, and with each other. Results The four authors focus on different elements within the narratives and understand them differently. One, focuses on strength and pride, and art expression as a different form of language for people living with an eating disorder. Another, on the experience of isolation, boundaries, and balancing openness and closedness. A third, sees the narratives as expressing a wish to see and be seen, and the fourth focuses on the absence of, and longing for, a shared space to explore. Conclusion The aim is not to reach a correct or shared interpretation of the narratives but to explore how different perspectives may contribute to different insights, not only about one family in particular but about, more generally, the experiences of people living with an eating disorder. Our work shows the significance of engaging with multiple perspectives and dialogue as supplements to the traditional medical/psychiatric diagnostic language in both clinical practice and research.

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“…The combined difficulties of changing family roles, coupled with feelings of fear, guilt and sadness about their sibling's illness [16,[46][47][48], make this experience very distressing. Additionally, well siblings may struggle to discuss their feelings due to a reduced availability of family members and a desire not to burden them further [49,50]. These difficulties are discussed in the model as social and emotional maintaining factors.…”

Section: Introductionmentioning

confidence: 99%

Experiences of eating difficulties in siblings of people with anorexia nervosa: a reflexive thematic analysis

2022

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Background Siblings of people with anorexia nervosa (AN) have been found to experience strong emotions, changing family roles and poorer wellbeing as a consequence of experiencing the effects of the illness on their sibling and family system. These factors, combined with genetic influences, may put siblings at an increased risk of developing eating disorder psychopathology in addition to other mental health issues. This research aims to explore the experiences of siblings of people with AN who have had eating difficulties themselves and investigate issues that may be important to the development and prevention of eating difficulties in this population. Methods This qualitative study used a reflexive thematic analysis approach. Ten adults who had witnessed a sibling with AN and experienced eating difficulties themselves participated in semi-structured interviews. Analysis Participants’ own eating difficulties were affected by the specific experience of witnessing a sibling with AN through mealtimes becoming emotionally charged, an increased focus on body size and diet, and comparisons with their sibling. Difficult experiences, such as marital discord amongst parents were common, as was a difficulty in managing emotions. The onset of AN within the family caused participants to take on caring responsibilities for their sibling and to hide their own difficulties for fear of adding additional burden to their parents. This reduced their perceived ability to access support and for some increased a desire to restrict as a coping mechanism for the stress they were experiencing. Systemic beliefs regarding the value of thinness were prevalent and influential. Protective factors, such as not wanting to become as unwell as a sibling with AN and an understanding of the negative consequences of AN, aided recovery. Conclusions Eating difficulties in siblings of people with AN may be influenced by competition for slimness, increased focus on diet and body size, and a need to manage difficult emotions. The disruption to social connections and a difficulty finding emotional support that may be experienced by people when a sibling develops AN may further influence susceptibility to eating difficulties. Further research is needed into the best ways to support siblings of people with AN.

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“Putting your own oxygen mask on first”: a qualitative study of siblings of adults with anorexia or bulimia

Cited by 13 publications

References 27 publications

Parental-Bonding and Alexithymia in Adolescents with Anorexia Nervosa, Their Parents, and Siblings

Parental-Bonding and Alexithymia in Adolescents with Anorexia Nervosa, Their Parents, and Siblings

Multiple perspectives and dialogue in understanding experiences of living with eating disorders: Two narratives—four unpackings

Experiences of eating difficulties in siblings of people with anorexia nervosa: a reflexive thematic analysis

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