A description of the interpersonal impact of an eating disorder on family members

: an examination of whether cultural, kin ship factors and specific ED behaviours contribute to carer’s distress and the maintenance of the illness.

Abstract

The high risk and the intrusive nature of ED symptoms can elicit emotionally driven reactions such as high expressed emotion (criticism, hostility and over protection) and behaviors (accommodation) from close others (Anastasiadou et al., 2014). These responses form one facet of the set of maintaining behaviours which may affect symptoms and duration of illness according to the cognitive interpersonal model on AN (Schmidt & Treasure, 2006; Treasure & Schmidt, 2013). However, less work has been carried out to examine the impact of bulimia and binge eating disorder on family members (parents, siblings and partners) and how their distress and caregiving style will affect the treatment outcome. 
The first section of the thesis focuses on parental experiences, examining whether intrafamilial factors that are described by the cognitive interpersonal maintenance model, could be manifested in Greek parents of people with eating disorders (BN, AN, BED) and examines any differences in caregiving behaviours between Greek and English parents of people with Anorexia and Bulimia Nervosa in terms of psychological distress, expressed emotions and accommodating behaviors. The next part of the thesis focuses on exploring the impact of eating disorder on marital and sibling’s relationship and comparing caregiving styles between siblings and spouses of adult patients with eating disorders and people with T1 and T2 Diabetes Mellitus. Cross sectional studies were then conducted to examine the caregivers’ experiences in terms of psychological distress, expressed emotions and accommodating behaviors. The third part includes one longitudinal study, examining the applicability of the interpersonal maintenance model on patients with bulimia and binge eating disorder. 
The findings of this thesis provide further evidence of experiences of all types of carers (parents, siblings, spouses) of people with all forms of eating disorder, (Bulimia Nervosa and Binge Eating Disorder and Anorexia Nervosa) and the applicability of the interpersonal maintenance model on caregivers and patients with Bulimia Nervosa and Binge Eating Disorder. Moreover, findings highlight the role of cultural differences in family functioning which may affect carers ’reactions to illness (particularly expressed emotions and accommodation).

Date of Award	1 Dec 2019
Original language	English
Awarding Institution	King's College London
Supervisor	Janet Treasure (Supervisor) & Ulrike Schmidt (Supervisor)