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Adolescents with a diagnosis of Anorexia Nervosa (AN): primary caregivers experience of recognition and decisions around initial help-seeking Samuel Thomson,

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Presentation on theme: "Adolescents with a diagnosis of Anorexia Nervosa (AN): primary caregivers experience of recognition and decisions around initial help-seeking Samuel Thomson,"— Presentation transcript:

1 Adolescents with a diagnosis of Anorexia Nervosa (AN): primary caregivers experience of recognition and decisions around initial help-seeking Samuel Thomson, ST6 Child and Adolescent Psychiatry Collaborators Michael Marriott, Jo McLaughlin, Katherine Telford, Hou Law, Kapil Sayal

2 Idea development Rarely present themselves Onus on parents Duration of illness related to outcome (Rosenvinge & Mouland, 1990; Steinhausen, 2002; Ratnasuriya et al., 1991) DUED, c.f. DUP

3 Springboard Childhood Onset Anorexia Nervosa: The Experience of Parents (Bryant-Waugh et al., 2004). Theme > slow recognition

4 Aim Main caregivers experiences of: Recognition Decision to seek help

5 Methodology 8 retrospective semi-structured interviews with primary caregiver 1 hour Audio-recorded Transcribed verbatim

6 Inclusion criteria 11-18 years at time of referral to CAMHS Broadly defined anorexia nervosa in past 3 years Great Ormond Street (GOS) Diagnostic Checklist* (Bryant-Waugh & Kaminski 1996)

7 Analysis Themes systematically identified from data Inductive (IPA) No a priori assumptions Credibility checks

8 Participant demographics

9 Results Normalisation Ambivalence/Ambiguity Decision Point Relationships

10 Normalisation Initial weight loss positive or related to normal adolescent development Noticed childs rigidity around food Cautious not to pressure their children Expected weight loss to be short-lived

11 Ambivalence/Ambiguity Denial Incomprehensible Suspicions grew watched closely Build up evidence Secrecy Research

12 Decision Point Unsuccessful attempts to reason with or reward their children Chronic failure help-seeking Holidays exposed pathology Wanted acknowledgement of the seriousness of the situation and prompt action since they feared for their childs life Disappointed by further attempts to contain Catch 22

13 Relationships Avoidance of conflict Betrayal Powerlessness Positive and negative effects on family Isolated by negative + simplistic responses of others Stigma

14 Conclusions Parents require advice and support to confirm their suspicions. Otherwise parents are left to accumulate concerns and often approach professional help at a late stage Reliable information sources may help equip parents to clarify early concerns Since parents commonly approached the Internet for guidance, improving awareness of useful and accurate web-sites could reduce delays in help seeking

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16 References Bryant-Waugh, R., Cottee-Lane, D. & Pistrang N. (2004). Childhood Onset Anorexia Nervosa: The Experience of Parents. European Eating Disorders Review, 12, 169-177. Ratnasuriya, R. H., Eisler, I., Szmukler G. I. & Russell G. F. (1991). Anorexia nervosa: outcome and prognostic factors after 20 years. The British Journal of Psychiatry, 158, 495-502. Rosenvinge, J. H. & Mouland S. O. (1990). Outcome and prognosis of anorexia nervosa. A retrospective study of 41 subjects. The British Journal of Psychiatry, 156, 92-97. Steinhausen, H-C. (2002). The Outcome of Anorexia Nervosa in the 20th Century. American Journal of Psychiatry, 159:8, 1284-1293.

17 Thanks samuelthomson@live.co.uk


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