A systematic scoping review of carer accommodation in eating disorders

Ashish Kumar; Hubertus Himmerich; Johanna Louise Keeler; Janet Treasure

doi:10.1186/s40337-024-01100-1

A systematic scoping review of carer accommodation in eating disorders

Ashish Kumar, Hubertus Himmerich, Johanna Louise Keeler^*, Janet Treasure

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

Abstract

Background: The accommodation of eating disorder (ED) behaviours by carers is one of the maintaining processes described in the cognitive interpersonal model of anorexia nervosa. This systematic scoping review aimed to explore studies examining accommodating and enabling behaviour, including how it impacts upon the carer’s own mental health and the outcome of illness in their loved ones. Methods and results: In this systematic scoping review, five databases (PubMed, Web of Science, MEDLINE, PsycInfo, CINAHL) were searched for studies measuring accommodating and enabling behaviour in carers of people with EDs. A total of 36 studies were included, of which 10 were randomised trials, 13 were longitudinal studies, nine were cross-sectional studies and four were qualitative studies. Carers of people with EDs were found to have high level of accommodating and enabling behaviour which reduced following treatment, although no single type of intervention was found to be superior to others. Higher accommodation in carers was associated with higher level of emotional distress, anxiety and fear. There was mixed evidence around whether accommodating and enabling behaviour in carers impacted the outcome of illness in their loved ones. Conclusion: Accommodating and enabling behaviours are frequently seen in carers of people with AN, and carer-focused interventions are able to reduce these behaviours, although it is unclear if any intervention shows superiority. There may be nuances in the impact of these behaviours related to interactions within the support network and variations in the forms of co-morbidity in patients. More studies with a larger sample size and which include both mothers and fathers are required.

Original language	English
Article number	143
Journal	Journal of Eating Disorders
Volume	12
Issue number	1
DOIs	https://doi.org/10.1186/s40337-024-01100-1
Publication status	Published - Dec 2024

Keywords

Accommodation
Anorexia nervosa
Eating disorders
Enabling behaviours
Systematic scoping review

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1186/s40337-024-01100-1

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title = "A systematic scoping review of carer accommodation in eating disorders",

abstract = "Background: The accommodation of eating disorder (ED) behaviours by carers is one of the maintaining processes described in the cognitive interpersonal model of anorexia nervosa. This systematic scoping review aimed to explore studies examining accommodating and enabling behaviour, including how it impacts upon the carer{\textquoteright}s own mental health and the outcome of illness in their loved ones. Methods and results: In this systematic scoping review, five databases (PubMed, Web of Science, MEDLINE, PsycInfo, CINAHL) were searched for studies measuring accommodating and enabling behaviour in carers of people with EDs. A total of 36 studies were included, of which 10 were randomised trials, 13 were longitudinal studies, nine were cross-sectional studies and four were qualitative studies. Carers of people with EDs were found to have high level of accommodating and enabling behaviour which reduced following treatment, although no single type of intervention was found to be superior to others. Higher accommodation in carers was associated with higher level of emotional distress, anxiety and fear. There was mixed evidence around whether accommodating and enabling behaviour in carers impacted the outcome of illness in their loved ones. Conclusion: Accommodating and enabling behaviours are frequently seen in carers of people with AN, and carer-focused interventions are able to reduce these behaviours, although it is unclear if any intervention shows superiority. There may be nuances in the impact of these behaviours related to interactions within the support network and variations in the forms of co-morbidity in patients. More studies with a larger sample size and which include both mothers and fathers are required.",

keywords = "Accommodation, Anorexia nervosa, Eating disorders, Enabling behaviours, Systematic scoping review",

author = "Ashish Kumar and Hubertus Himmerich and Keeler, {Johanna Louise} and Janet Treasure",

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doi = "10.1186/s40337-024-01100-1",

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AU - Himmerich, Hubertus

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N2 - Background: The accommodation of eating disorder (ED) behaviours by carers is one of the maintaining processes described in the cognitive interpersonal model of anorexia nervosa. This systematic scoping review aimed to explore studies examining accommodating and enabling behaviour, including how it impacts upon the carer’s own mental health and the outcome of illness in their loved ones. Methods and results: In this systematic scoping review, five databases (PubMed, Web of Science, MEDLINE, PsycInfo, CINAHL) were searched for studies measuring accommodating and enabling behaviour in carers of people with EDs. A total of 36 studies were included, of which 10 were randomised trials, 13 were longitudinal studies, nine were cross-sectional studies and four were qualitative studies. Carers of people with EDs were found to have high level of accommodating and enabling behaviour which reduced following treatment, although no single type of intervention was found to be superior to others. Higher accommodation in carers was associated with higher level of emotional distress, anxiety and fear. There was mixed evidence around whether accommodating and enabling behaviour in carers impacted the outcome of illness in their loved ones. Conclusion: Accommodating and enabling behaviours are frequently seen in carers of people with AN, and carer-focused interventions are able to reduce these behaviours, although it is unclear if any intervention shows superiority. There may be nuances in the impact of these behaviours related to interactions within the support network and variations in the forms of co-morbidity in patients. More studies with a larger sample size and which include both mothers and fathers are required.

AB - Background: The accommodation of eating disorder (ED) behaviours by carers is one of the maintaining processes described in the cognitive interpersonal model of anorexia nervosa. This systematic scoping review aimed to explore studies examining accommodating and enabling behaviour, including how it impacts upon the carer’s own mental health and the outcome of illness in their loved ones. Methods and results: In this systematic scoping review, five databases (PubMed, Web of Science, MEDLINE, PsycInfo, CINAHL) were searched for studies measuring accommodating and enabling behaviour in carers of people with EDs. A total of 36 studies were included, of which 10 were randomised trials, 13 were longitudinal studies, nine were cross-sectional studies and four were qualitative studies. Carers of people with EDs were found to have high level of accommodating and enabling behaviour which reduced following treatment, although no single type of intervention was found to be superior to others. Higher accommodation in carers was associated with higher level of emotional distress, anxiety and fear. There was mixed evidence around whether accommodating and enabling behaviour in carers impacted the outcome of illness in their loved ones. Conclusion: Accommodating and enabling behaviours are frequently seen in carers of people with AN, and carer-focused interventions are able to reduce these behaviours, although it is unclear if any intervention shows superiority. There may be nuances in the impact of these behaviours related to interactions within the support network and variations in the forms of co-morbidity in patients. More studies with a larger sample size and which include both mothers and fathers are required.

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A systematic scoping review of carer accommodation in eating disorders

Abstract

Keywords

UN SDGs

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