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Nimbley E, Gillespie-Smith K, Duffy F, Maloney E, Ballantyne C, Sharpe H. "It's not about wanting to be thin or look small, it's about the way it feels": an IPA analysis of social and sensory differences in autistic and non-autistic individuals with anorexia and their parents. J Eat Disord 2023; 11:89. [PMID: 37277884 DOI: 10.1186/s40337-023-00813-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 05/24/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Despite increasing evidence to support an overlap between autism and anorexia nervosa (AN), underlying mechanisms remain poorly understood. Social and sensory factors have emerged as promising targets in both autism and AN, however there remains scope to compare these differences across autistic and non-autistic experiences of AN. Drawing on dyadic multi-perspectives, this study explored experiences of social and sensory differences in autistic and non-autistic adults and their parents and/or carers. METHODS Using interpretative phenomenological analysis (IPA), dyadic interviews were conducted with 14 dyads, with seven autistic dyads and seven non-autistic dyads. Data analysis was subjected to a triangulation of interpretations: (1) the participants themselves; (2) a neurotypical researcher; (3) and an Autistic researcher with lived/living experience of AN. RESULTS IPA identified three themes in each group, with similarities and differences between autistic and non-autistic dyads. Similar themes were identified regarding the importance of social connectedness and socio-emotional difficulties, as well a common lack of trust in the social and sensory self and body. Autism-specific themes centred on feelings of social 'defectiveness', disparities between sensing and expressing certain cues, and lifelong, multi-sensory processing differences. Non-autistic themes reflected social comparisons and inadequacy, and sensitivities to the learning of ideals and behaviour through early experiences. CONCLUSIONS While similarities were observed across both groups, there appeared to be notable differences in the perceived role and influence of social and sensory differences. These findings may have important implications on the delivery and modification of eating disorder interventions. Specifically, they suggest that while treatment targets may look similar, subtle differences in underlying mechanisms and approaches may be required for Autistic individuals with AN across sensory, emotion and communication-based interventions.
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Affiliation(s)
- Emy Nimbley
- Department of Clinical Psychology in the School of Health in Social Science, University of Edinburgh, Old Medical School, Elsie Inglis Quadrangle, Teviot Place, Edinburgh, EH8 9AG, Scotland, UK.
| | - Karri Gillespie-Smith
- Department of Clinical Psychology in the School of Health in Social Science, University of Edinburgh, Old Medical School, Elsie Inglis Quadrangle, Teviot Place, Edinburgh, EH8 9AG, Scotland, UK
| | - Fiona Duffy
- Department of Clinical Psychology in the School of Health in Social Science, University of Edinburgh, Old Medical School, Elsie Inglis Quadrangle, Teviot Place, Edinburgh, EH8 9AG, Scotland, UK
- NHS Lothian Child and Adolescent Mental Health Services, Royal Edinburgh Hospital, Edinburgh, Scotland, UK
| | - Ellen Maloney
- School of Philosophy, Psychology and Language, University of Edinburgh, Edinburgh, Scotland, UK
| | - Carrie Ballantyne
- School of Education and Social Sciences, University of the West of Scotland, Glasgow, UK
| | - Helen Sharpe
- Department of Clinical Psychology in the School of Health in Social Science, University of Edinburgh, Old Medical School, Elsie Inglis Quadrangle, Teviot Place, Edinburgh, EH8 9AG, Scotland, UK
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Robertson AM, Cruwys T, Stevens M, Platow MJ. Aspirational leaders help us change: Ingroup prototypicality enables effective group psychotherapy leadership. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2023; 62:243-259. [PMID: 36458503 PMCID: PMC10947317 DOI: 10.1111/bjc.12406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 11/10/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVES Research suggests that leaders are effective when they are ingroup prototypical (represent the identity of the group they seek to lead). However, it is unclear whether leaders should represent the group's current identity ("who we are") or aspired identity ("who we want to be"). This study investigated which of these forms of prototypicality best predicted leadership effectiveness in group psychotherapy. DESIGN Longitudinal study. METHODS 519 questionnaire responses were obtained from 112 women attending a four-session body acceptance program. Focal measures included participant ratings of how often they thought their psychotherapy leaders and fellow group members would (a) engage in dieting thoughts and behaviours and (b) approve of dieting. Given the program's body acceptance focus, leader prototypicality was conceptualized as the difference between participants' perceptions of how often their leaders, versus group members, would diet at the start of therapy. Leadership effectiveness was conceptualized as reductions in perceived group approval of dieting across therapy. Two therapeutic outcomes were considered: body satisfaction and dieting intentions. RESULTS A mixed-effects repeated measures analysis indicated that group approval of dieting decreased more rapidly when participants perceived their leaders to be aspirational (thought that group leaders dieted less frequently than group members) than when they perceived them to be exemplary (thought that group leaders dieted as frequently as group members). Changes in group approval of dieting mediated the relationship between leader prototypicality and improved therapeutic outcomes. CONCLUSIONS Findings suggest that group psychotherapy leaders may increase their effectiveness by striving to embody their group's aspired identity.
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Affiliation(s)
- Alysia M. Robertson
- Research School of Psychology, The Australian National UniversityCanberraACTAustralia
| | - Tegan Cruwys
- Research School of Psychology, The Australian National UniversityCanberraACTAustralia
| | - Mark Stevens
- Research School of Psychology, The Australian National UniversityCanberraACTAustralia
| | - Michael J. Platow
- Research School of Psychology, The Australian National UniversityCanberraACTAustralia
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Maher AL, Allen A, Mason J, Houlihan C, Wood AP, Huckstepp T. Exploring the association between early adaptive schemas and self-reported eating disorder symptomatology. Clin Psychol Psychother 2023; 30:152-165. [PMID: 36203412 PMCID: PMC10092118 DOI: 10.1002/cpp.2789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 07/15/2022] [Accepted: 09/30/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The current study aimed to examine the relationship between early adaptive schemas and eating disorder symptomatology in adults. METHOD A cross-sectional, correlational design was used to collect data from 352 females and 36 males aged between 18 and 49 years (M = 25.70, SD = 7.04). Participants completed an online questionnaire, which included The Young Positive Schema Questionnaire (YPSQ), Eating Disorder Examination-Questionnaire (EDE-Q) and demographic measures. RESULTS Four separate hierarchical multiple regression analyses showed that high levels of Healthy Boundaries and low levels of Optimism significantly predicted lower Restraint, Eating Concern, Shape Concern and Weight Concern scores. Additionally, higher scores in Emotional Openness and Social Belonging significantly predicted lower Eating Concern, while higher scores in Self-Care significantly predicted lower levels of Shape Concern. CONCLUSION The findings highlight the protective function that certain early adaptive schemas may play in mitigating eating disorder symptomatology. Moreover, the findings allude to potential modifiable therapy targets in the treatment of eating disorders. Further research is needed to investigate any differences in early adaptive schemas between eating disorder diagnoses.
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Affiliation(s)
- Anthea L Maher
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Andrew Allen
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Queensland, Australia.,Sunshine Coast Mind and Neuroscience-Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland, Australia
| | - Jonathan Mason
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Queensland, Australia.,Sunshine Coast Mind and Neuroscience-Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland, Australia
| | - Catherine Houlihan
- Eating Disorder Service, Queensland Hospital and Health Service, Maroochydore, Queensland, Australia
| | - Andrew P Wood
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Queensland, Australia.,Sunshine Coast Mind and Neuroscience-Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland, Australia
| | - Tyrone Huckstepp
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Queensland, Australia.,Sunshine Coast Mind and Neuroscience-Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland, Australia
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Mikhaylova O, Dokuka S. Anorexia and Young Womens' Personal Networks: Size, Structure, and Kinship. Front Psychol 2022; 13:848774. [PMID: 35519652 PMCID: PMC9063839 DOI: 10.3389/fpsyg.2022.848774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/14/2022] [Indexed: 11/24/2022] Open
Abstract
Anorexia is a serious threat to young women's wellbeing worldwide. The effectiveness of mental health intervention and treatment is often evaluated on the basis of changes in the personal networks; however, the development of such measures for young women with anorexia is constrained due to the lack of quantitative descriptions of their social networks. We aim to fill this substantial gap. In this paper, we identify the basic properties of these women's personal networks such as size, structure, and proportion of kin connections. The empirical analysis, using a concentric circles methodology, is based on 50 ego networks constructed on data drawn from interviews with Russian-speaking bloggers who have been diagnosed with anorexia and write about this condition. We conclude that young women with anorexia tend to support a limited number of social ties; they are prone to select women as alters, but do not have a preference to connect to their relatives. Further research is needed to elucidate whether these personal network characteristics are similar among women with anorexia who belong to different age, ethnic, cultural, and income groups.
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Affiliation(s)
| | - Sofia Dokuka
- Institute of Education, HSE University, Moscow, Russia
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Rowlands K, Grafton B, Cerea S, Simic M, Hirsch C, Cruwys T, Yellowlees R, Treasure J, Cardi V. A multifaceted study of interpersonal functioning and cognitive biases towards social stimuli in adolescents with eating disorders and healthy controls. J Affect Disord 2021; 295:397-404. [PMID: 34500369 DOI: 10.1016/j.jad.2021.07.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 07/02/2021] [Accepted: 07/12/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cognitive biases towards social stimuli have been identified as one of the putative modifiable mechanisms to remediate interpersonal difficulties in adolescents with mental disorders. However, evidence for these biases in adolescents with eating disorders is scarce. METHODS This study assessed interpersonal sensitivity, cognitive biases towards social stimuli, and quantity and quality of social group memberships in adolescents with eating disorders (n = 80), compared to healthy controls (n = 78), and examined whether a negative interpretation bias would mediate the relationship between interpersonal sensitivity, eating disorder symptoms and positive group memberships. RESULTS Adolescents with eating disorders displayed greater interpersonal awareness, negative interpretation biases of ambiguous social information and poorer quality relationships with their social groups compared to healthy controls. In a simple mediation model, interpersonal awareness predicted eating disorder symptoms, and this effect was partially mediated by a negative interpretation bias. CONCLUSIONS Psychological interventions which aim to reduce a negative interpretation bias might help to reduce the severity of eating disorder symptoms in adolescents with eating disorders.
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Affiliation(s)
- Katie Rowlands
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
| | - Ben Grafton
- Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Crawley, Australia
| | - Silvia Cerea
- Department of General Psychology, University of Padova, Italy
| | - Mima Simic
- Child and Adolescent Eating Disorders Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Colette Hirsch
- Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Tegan Cruwys
- Research School of Psychology, The Australian National University, Canberra ACT 2601, Australia
| | - Robyn Yellowlees
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Janet Treasure
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Valentina Cardi
- Department of General Psychology, University of Padova, Italy
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