Scutt Eleanor, Langdon-Daly Jasmin, Smithson Janet
University of Exeter, Exeter, UK.
Somerset NHS Foundation Trust, Taunton, UK.
J Eat Disord. 2022 Aug 20;10(1):123. doi: 10.1186/s40337-022-00646-2.
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.
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.
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.
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.
神经性厌食症（AN）患者的兄弟姐妹因经历该疾病对其兄弟姐妹及家庭系统的影响，而出现强烈情绪、家庭角色变化以及幸福感下降等情况。这些因素，再加上遗传影响，可能使兄弟姐妹除了面临其他心理健康问题外，患饮食失调心理病理学的风险也会增加。本研究旨在探讨患有AN的患者的兄弟姐妹自身有饮食困难的经历，并调查对该人群饮食困难的发展和预防可能重要的问题。
这项定性研究采用了反思性主题分析方法。十名目睹兄弟姐妹患有AN且自身有饮食困难的成年人参与了半结构化访谈。
参与者自身的饮食困难受到以下具体经历的影响：目睹患有AN的兄弟姐妹用餐时情绪激动、对体型和饮食的关注度增加以及与兄弟姐妹的比较。父母之间的婚姻不和等困难经历很常见，情绪管理困难也是如此。家庭中AN的发病使参与者承担起照顾兄弟姐妹的责任，并因担心给父母增加额外负担而隐瞒自己的困难。这降低了他们认为能够获得支持的能力，对一些人来说，还增加了作为应对所经历压力的一种机制而限制饮食的欲望。关于瘦的价值的系统性观念普遍存在且具有影响力。保护因素，如不想变得像患有AN的兄弟姐妹那样不适以及对AN负面后果的理解，有助于康复。
患有AN的患者的兄弟姐妹的饮食困难可能受到对苗条的竞争、对饮食和体型的关注度增加以及管理困难情绪的需求的影响。当兄弟姐妹患上AN时，人们可能会经历的社会联系中断和难以找到情感支持，可能会进一步影响对饮食困难的易感性。需要进一步研究支持患有AN的患者的兄弟姐妹的最佳方法。
