Kumar Ashish, Himmerich Hubertus, Keeler Johanna Louise, Treasure Janet
Children's Eating Disorder Service, Knowsley Resource and Recovery Centre, Mersey Care NHS Foundation Trust, Prescot, UK.
Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
J Eat Disord. 2024 Sep 17;12(1):143. doi: 10.1186/s40337-024-01100-1.
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.
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.
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.
照顾者对饮食失调（ED）行为的迁就，是神经性厌食症认知人际模型中所描述的维持过程之一。这项系统性综述旨在探究有关迁就和促成行为的研究，包括其如何影响照顾者自身的心理健康以及其亲人的疾病结局。
在这项系统性综述中，检索了五个数据库（PubMed、科学网、MEDLINE、PsycInfo、护理学与健康领域数据库），以查找测量饮食失调患者照顾者迁就和促成行为的研究。共纳入36项研究，其中10项为随机试验，13项为纵向研究，9项为横断面研究，4项为定性研究。发现饮食失调患者的照顾者有高水平的迁就和促成行为，这种行为在治疗后有所减少，不过未发现单一类型的干预措施优于其他措施。照顾者中较高水平的迁就与更高程度的情绪困扰、焦虑和恐惧相关。关于照顾者的迁就和促成行为是否会影响其亲人的疾病结局，证据不一。
在神经性厌食症患者的照顾者中，迁就和促成行为很常见，以照顾者为重点的干预措施能够减少这些行为，尽管尚不清楚是否有任何干预措施具有优越性。这些行为的影响可能存在细微差别，与支持网络内的互动以及患者共病形式的差异有关。需要开展更多样本量更大且纳入父母双方的研究。
