Skip to main content

Advertisement

SpringerLink
Log in

A longitudinal examination of burden and psychological distress in carers of people with an eating disorder

  • Original Paper
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

Eating disorders are chronic conditions that require ongoing, high level care. Despite the chronic nature of eating disorders, to date, previous research examining eating disorder carer burden and psychological distress has been cross-sectional only. Therefore, the current study aimed to conduct a preliminary longitudinal examination of the predictors of carer burden and psychological distress for carers of those with an eating disorder.

Methods

A self-report, quantitative questionnaire approach was utilised. Forty-two carers completed three self-report questionnaires over a period of 9 months (initial, 4½ and 9 months) assessing carer burden, psychological distress, carer needs, expressed emotion, coping strategies and social support.

Results

Maladaptive coping, expressed emotion and carer needs were significant longitudinal predictors of carer burden. Carer psychological distress could not be predicted longitudinally.

Conclusions

In order to reduce carer burden, interventions should test whether reducing maladaptive coping strategies, expressed emotion and addressing carer needs lead to lower carer burden and distress.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Fairburn CG, Harrison PJ (2003) Eating disorders. Lancet 361:407–416. doi:10.1016/S0140-6736(03)12378-1

    Article  PubMed  Google Scholar 

  2. Hoek HW, van Hoeken D (2003) Review of the prevalence and incidence of eating disorders. Int J Eat Disord 34:383–396. doi:10.1002/eat.10222

    Article  PubMed  Google Scholar 

  3. Beumont P (2000) Anorexia nervosa as a mental and physical illness: the medical perspective. In: Gaskill D, Sanders F (eds) The encultured body: policy implications for healthy body image and disordered eating behaviours. Queensland University of Technology, Brisbane, pp 80–94

    Google Scholar 

  4. Fairburn CG, Hay PJ, Welch SL (1993) Binge eating and bulimia nervosa: distribution and determinants. In: Fairburn CG, Wilson GT (eds) Binge eating: nature, assessment, and treatment. The Guilford Press, New York, pp 123–143

    Google Scholar 

  5. Murray T (2003) Wait not, want not: factors contributing to the development of anorexia nervosa and bulimia nervosa. The Fam J Couns Therapy Couples Fam 11:276–280. doi:10.1177/1066480703252470

    Google Scholar 

  6. Winn S, Perkins S, Walwyn R, Schmidt U, Eisler I, Treasure J, Berelowitz M, Dodge L, Frost S, Jenkins M, Johnson-Sabine E, Keville S, Murphy R, Robinson P, Yi I (2007) Predictors of mental health problems and negative caregiving experiences in carers of adolescents with bulimia nervosa. Int J Eat Disord 40:171–178. doi:10.1002/eat.20347

    Article  PubMed  Google Scholar 

  7. Treasure J, Murphy R, Szmukler G, Todd G, Gavan K, Joyce J (2001) The experience of caregiving for severe mental illness: a comparison between anorexia nervosa and psychosis. Soc Psychiatry Psychiatric Epidemiol 36:343–347. doi:10.1007/s001270170039

    Article  CAS  Google Scholar 

  8. Graap H, Bleich S, Herbst F, Trostmann Y, Wancata J, de Zwaan M (2008) The needs of carers of patients with anorexia and bulimia nervosa. Eur Eat Disord Rev 16:21–29. doi:10.1002/erv.804

    Article  PubMed  Google Scholar 

  9. Kuipers E, Bebbington PE (2005) Research on burden and coping strategies in families of people with mental disorders: Problems and perspectives. In: Sartorius N, Leff J, Lopez-Ibor JJ, Maj M, Okasha A (eds) Families and mental disorders: from burden to empowerment. John Wiley and Sons, New Jersey

  10. Winn S, Perkins S, Murray J, Murphy R, Schmidt U (2004) A qualitative study of the experience of caring for a person with bulimia nervosa. Part 2: carers’ needs and experiences of services and other support. Int J Eat Disord 36:269–279. doi:10.1002/eat.20068

    Article  PubMed  Google Scholar 

  11. Dimitropoulos G, Carter J, Schachter R, Woodside DB (2008) Predictors of family functioning in carers of individuals with anorexia nervosa. Int J Eat Disord 41:739–747. doi:10.1002/eat.20562

    Article  PubMed  Google Scholar 

  12. Whitney J, Eisler I (2005) Theoretical and empirical models around caring for someone with an eating disorder: the reorganization of family life and inter-personal maintenance factors. J Ment Health 14:575–585. doi:10.1080/09638230500347889

    Article  Google Scholar 

  13. Haigh R, Treasure J (2003) Investigating the needs of carers in the area of eating disorders: development of the Carers’ Needs Assessment Measure (CaNAM). Eur Eat Disord Rev 11:125–141. doi:10.1002/erv.487

    Article  Google Scholar 

  14. Graap H, Bleich S, Herbst F, Scherzinger C, Trostmann Y, Wancata J, de Zwaan M (2008) The needs of carers: a comparison between eating disorders and schizophrenia. Soc Psychiatry Psychiatric Epidemiol 43:800–807. doi:10.1007/s00127-008-0364-7

    Article  Google Scholar 

  15. Whitney J, Haigh R, Weinman J, Treasure J (2007) Caring for people with eating disorders: factors associated with psychological distress and negative caregiving appraisals in carers of people with eating disorders. Br J Clin Psychol 46:413–428. doi:10.1348/014466507X173781

    Article  PubMed  Google Scholar 

  16. Hodes M, Le Grange D (1993) Expressed emotion in the investigation of eating disorders: a review. Int J Eat Disord 13:279–288. doi:10.1002/1098-108X(199304)13:3<279:AID-EAT2260130306>3.0.CO;2-2

    Article  PubMed  CAS  Google Scholar 

  17. Rein Z, Perdereau F, Curt F, Jeammet P, Fermanian J, Godart N (2006) Expressed emotion and anorexia nervosa: the validation of the five-minute speech sample in reference to the Camberwell Family Interview. Int J Eat Disord 39:217–223. doi:10.1002/eat.20245

    Article  PubMed  Google Scholar 

  18. Vaughn C, Leff J (1976) The measurement of expressed emotion in the families of psychiatric patients. Br J Soc Clin Psychol 15:157–165

    Article  PubMed  CAS  Google Scholar 

  19. Zabala MJ, MacDonald P, Treasure J (2009) Appraisal of caregiving burden, expressed emotion and psychological distress in families of people with eating disorders: a systematic review. Eur Eat Disord Rev 17:338–349. doi:10.1002/erv.925

    Article  PubMed  Google Scholar 

  20. Coomber K, King RM (2011) Coping strategies and social support as predictors and mediators of eating disorder carer burden and psychological distress. Soc Psychiatry Psychiatric Epidemiol. doi:10.1007/s00127-011-0384-6

    Google Scholar 

  21. Hillege S, Beale B, McMaster R (2006) Impact of eating disorders on family life: individual parents’ stories. J Clin Nurs 15:1016–1022. doi:10.1111/j.1365-2702.2006.01367.x

    Article  PubMed  Google Scholar 

  22. Perkins S, Winn S, Murray J, Murphy R, Schmidt U (2004) A qualitative study of the experience of caring for a person with bulimia nervosa. Part 1: the emotional impact of caring. Int J Eat Disord 36:256–268. doi:10.1002/eat.20067

    Article  PubMed  Google Scholar 

  23. Whitney J, Murray J, Gavan K, Todd G, Whitaker W, Treasure J (2005) Experience of caring for someone with anorexia nervosa: qualitative study. Br J Psychiatry 187:444–449. doi:10.1192/bjp.187.5.444

    Article  PubMed  Google Scholar 

  24. Lazarus RS, Folkman S (1984) Stress, appraisal, and coping. Springer Publishing Company, New York

    Google Scholar 

  25. Folkman S, Moskowitz JT (2004) Coping: pitfalls and promise. Annu Rev Psychol 55:745–774. doi:10.1146/annurev.psych.55.090902.141456

    Article  PubMed  Google Scholar 

  26. Schreurs KMG, de Ridder DTD (1997) Integration of coping and social support perspectives: implications for the study of adaptation to chronic diseases. Clin Psychol Rev 17:89–112. doi:10.1016/S0272-7358(96)00050-5

    Article  PubMed  CAS  Google Scholar 

  27. Pakenham KI, Chui J, Bursnall S, Cannon T (2007) Relations between social support, appraisal and coping and both positive and negative outcomes in young carers. J Health Psychol 12:89–102. doi:10.1177/1359105307071743

    Article  PubMed  Google Scholar 

  28. Sepulveda AR, Whitney J, Hankis M, Treasure J (2008) Development and validation of an Eating Disorders Symptom Impact Scale (EDSIS) for carers of people with eating disorders. Health Qual Life Outcomes 6:28. doi:10.1186/1477-7525-6-28

    Article  PubMed  Google Scholar 

  29. Goldberg D, Williams P (1988) A user’s guide to the general health questionnaire. NFER-NELSON, Windsor

    Google Scholar 

  30. Carver CS (1997) You want to measure coping but your protocol’s too long: consider the Brief COPE. Int J Behav Med 4:92–100. doi:10.1207/s15327558ijbm0401_6

    Article  PubMed  CAS  Google Scholar 

  31. Sarason IG, Sarason BR, Shearin EN, Pierce GR (1987) A brief measure of social support: practical and theoretical implications. J Soc Pers Relat 4:497–510. doi:10.1177/0265407587044007

    Google Scholar 

  32. Wiedemann G, Rayki O, Feinstein E, Hahlweg K (2002) The Family Questionnaire: development and validation of a new self-report scale for assessing expressed emotion. Psychiatry Res 109:265–279. doi:10.1016/S0165-1781(02)00023-9

    Article  PubMed  Google Scholar 

  33. Kyriacou O, Treasure J, Schmidt U (2008) Expressed emotion in eating disorders assessed via self-report: an examination of factors associated with expressed emotion in carers of people with anorexia nervosa in comparison to control families. Int J Eat Disord 41:37–46. doi:10.1002/eat.20469

    Article  PubMed  Google Scholar 

  34. Onwuegbuzie AJ, Leech NL (2004) Post hoc power: a concept whose time has come. Underst Statistics 3:201–230. doi:10.1207/s15328031us0304_1

    Article  Google Scholar 

  35. Faul F, Erdfelder E, Lang AG, Buchner A (2007) G*Power: a flexible statistical power analysis program for the social, behavioural, and biomedical sciences. Behav Res Methods 39:175–191. doi:10.3758/BF03193146

    Article  PubMed  Google Scholar 

  36. Olshevski JL, Katz AD, Knight BG (1999) Stress reduction for caregivers. Taylor and Francis, Philadelphia

    Google Scholar 

  37. Butzlaff RL, Hooley JM (1998) Expressed emotion and psychiatric relapse. Arch Gen Psychiatry 55:547–552. doi:10.1001/archpsyc.55.6.547

    Article  PubMed  CAS  Google Scholar 

  38. Eisler I, Dare C, Hodes M, Russell G, Dodge E, le Grange D (2000) Family therapy for adolescent anorexia nervosa: the results of a controlled comparison of two family interventions. J Child Psychol Psychiatry 41:727–736. doi:10.1111/1469-7610.00660

    Article  PubMed  CAS  Google Scholar 

  39. Joyce J, Leese M, Kuipers E, Szmuckler G, Harris T, Staples E (2003) Evaluating a model of caregiving for people with psychosis. Soc Psychiatry Psychiatric Epidemiol 38:189–195. doi:10.1007/s00127-003-0618-3

    Article  CAS  Google Scholar 

  40. Gaugler JE (2010) The longitudinal ramifications of stroke caregiving: a systematic review. Rehabil Res 55:108–125. doi:10.1037/a0019023

    Google Scholar 

  41. Goode KT, Haley WE, Roth DL, Ford GR (1998) Predicting longitudinal changes in caregiver physical and mental health: a stress process model. Health Psychol 17:190–198. doi:10.1037/0278-6133.17.2.190

    Article  PubMed  CAS  Google Scholar 

  42. Svavarsdottir EK (2005) Caring for a child with cancer: a longitudinal perspective. J Adv Nurs 50:153–161. doi:10.1111/j.1365-2648.2005.03374.x

    Article  PubMed  Google Scholar 

  43. Hirst M (2005) Caregiver distress: a prospective, population-based study. Soc Sci Med 61:697–708. doi:10.1016/j.socscimed.2005.01.001

    Google Scholar 

  44. Cohen J (1992) A power primer. Quant Methods Psychol 112:155–159. doi:10.1037/0033-2909.112.1.15

    CAS  Google Scholar 

  45. Kyriacou O, Treasure J, Schmidt U (2008) Understanding how parents cope with living with someone with anorexia nervosa: modelling the factors that are associated with carer distress. Int J Eat Disord 41:233–242. doi:10.1002/eat.20488

    Article  PubMed  Google Scholar 

  46. Sepulveda AR, Todd G, Whitaker W, Grover M, Stahl D, Treasure J (2010) Expressed emotion in relatives of patients with eating disorders following skills training program. Int J Eat Disord 43:603–610. doi:10.1002/eat.20749

    Article  PubMed  Google Scholar 

  47. Sepulveda AR, Lopez C, Todd G, Whitaker W, Treasure J (2008) An examination of the impact of “the Maudsley Eating Disorder Collaborative Care Workshops” on the well-being of family members: a pilot study. Soc Psychiatry Psychiatric Epidemiol 43:584–591. doi:10.1007/s00127-008-0336-y

    Article  Google Scholar 

  48. Pierce GR, Sarason BR, Sarason IG, Joseph HJ, Henderson CA (1996) Conceptualizing and assessing social support in the context of the family. In: Pierce GR, Sarason BR, Sarason IG (eds) Handbook of social support and the family. Plenum Press, New York, pp 3–25

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Psychology, Deakin University, Locked Bag 20000, Geelong, VIC, 3220, Australia

    Kerri Coomber & Ross M. King

Authors
  1. Kerri Coomber
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ross M. King
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ross M. King.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Coomber, K., King, R.M. A longitudinal examination of burden and psychological distress in carers of people with an eating disorder. Soc Psychiatry Psychiatr Epidemiol 48, 163–171 (2013). https://doi.org/10.1007/s00127-012-0524-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-012-0524-7

Keywords

Search

Navigation