Department of Psychology, Nottingham Trent University, UK.
Eating Disorder Service, Nottinghamshire Healthcare Foundation NHS Trust, UK.
Psychol Psychother. 2021 Sep;94(3):721-736. doi: 10.1111/papt.12340. Epub 2021 Mar 24.
Recovery from anorexia nervosa (AN) is difficult to define, and efforts to establish recovery criteria have led to several versions being proposed. Using the perspectives of people with histories of AN and therapists working in the field, we sought to explore the face validity of Khalsa et al (2017) as one of the most recent examples of proposed systematic recovery criteria.
We interviewed 11 health service users (SUs) with histories of AN who had previously received treatment alongside 8 eating disorder therapists (EDTs), exploring their views on the proposed AN recovery criteria.
Data from verbal and written interviews were analysed thematically. Separate thematic analyses of SU and EDT interviews highlighted where concerns converged and diverged across participants.
Both groups saw some merits of having universally recognized recovery criteria, and the multidimensional approach was welcomed, but EDTs were uncomfortable with considering their use in therapy and SUs felt key components were missing around emotional coping and life quality. SUs disliked the prominence of body mass index (BMI) in the criteria, and all struggled with the proposed duration for recovery. Conceptually, the notion of recovery as an endpoint rather than a journey was contested.
Our findings indicate disparities between academically derived recovery criteria and lived experiences and indicate perceived challenges in using such criteria in therapeutic settings. Including SUs and EDTs in the development of criteria may improve the likelihood of consolidating AN recovery criteria, but conceptual challenges remain.
AN recovery is complex, and the use of research-based AN recovery criteria in therapeutic settings could have a detrimental effect on SUs' outcomes. EDTs should be aware of efforts to define AN recovery criteria. EDTs should engage with debates on defining AN recovery and seek to promote participation in such debates to SUs.
神经性厌食症（AN）的康复难以界定，为了确立康复标准，人们提出了几种版本。本研究从有 AN 病史的患者和在该领域工作的治疗师的角度出发，探讨了 Khalsa 等人（2017 年）提出的最新系统康复标准之一的表面有效性。
我们采访了 11 名有 AN 病史且曾接受过治疗的卫生服务使用者（SU）和 8 名饮食障碍治疗师（EDT），探讨他们对拟议的 AN 康复标准的看法。
对口头和书面访谈数据进行了主题分析。对 SU 和 EDT 访谈的单独主题分析突出了参与者之间的关注点是如何趋同和分歧的。
两组人都认为有普遍认可的康复标准有一些好处，多维方法受到欢迎，但 EDT 对在治疗中使用这些标准感到不舒服，而 SU 则认为情绪应对和生活质量方面的关键内容缺失。SU 不喜欢标准中对体重指数（BMI）的重视，并且所有人都对恢复所需的时间感到困惑。从概念上讲，将恢复视为终点而不是旅程的概念受到了质疑。
我们的研究结果表明，学术上提出的康复标准与患者的实际体验存在差异，并表明在治疗环境中使用这些标准存在感知到的挑战。在制定标准时纳入 SU 和 EDT，可能会提高巩固 AN 康复标准的可能性，但仍存在概念上的挑战。
AN 的康复过程复杂，在治疗环境中使用基于研究的 AN 康复标准可能会对 SU 的康复结果产生不利影响。EDT 应了解定义 AN 康复标准的努力。EDT 应参与有关定义 AN 康复的辩论，并寻求促进 SU 参与此类辩论。
