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Chapman L, Lester KJ, Cartwright-Hatton S. Maternal perspectives on the intergenerational transmission of eating disorders. J Eat Disord 2024; 12:123. [PMID: 39182125 PMCID: PMC11344927 DOI: 10.1186/s40337-024-01088-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 08/18/2024] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND Studies indicate that the children of mothers who have eating disorders are at an increased risk of developing eating disorders themselves. The aim of this qualitative study was to broaden and extend current understandings of the experiences of mothers with eating disorders. The present report focuses on maternal perspectives, experiences, and support needs in relation to the intergenerational transmission of eating disorders. METHOD Semi-structured online interviews were conducted with parents living in the UK, USA, and Australia. Participants were eighteen mothers with a self-reported lifetime diagnosis of one or more eating disorders, who had experienced symptoms since becoming a parent, and who had at least one child aged 2 years or older. Data were analysed using reflexive thematic analysis. RESULTS Four major themes relating to the impacts of having an eating disorder on children and intergenerational transmission were identified. These were: impacts (maternal perspectives on the ways having an eating disorder impacted their children, and their reflections around having been impacted by their own parents); breaking the cycle (strategies employed by mothers in efforts to prevent their children developing eating disorders of their own); communicating about the eating disorder (maternal experiences around disclosing or not disclosing having an eating disorder to their children); and support needs (maternal and perceived familial support needs in relation to breaking cycles of intergenerational transmission). CONCLUSIONS For mothers with eating disorders, concerns about the potential impacts on their children and fears about intergenerational transmission are salient, and these may vary for children at different ages. The mothers who participated in our study described engaging in a number of conscious strategies in efforts to manage the risks of eating disorder development in their children, but implementing these strategies was not without challenges. Implications for preventative programs to reduce the intergenerational transmission of eating disorders are discussed.
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Affiliation(s)
- Laura Chapman
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, UK.
- Centre for Academic Mental Health, Bristol Medical School, Canynge Hall, Clifton, Bristol, BS8 2PN, UK.
| | - Kathryn J Lester
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, UK.
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Meier K, Apon LC, Van Hoeken D, Van Eeden AE, Hoek HW, Oldehinkel AJ. Impact of parenthood on eating pathology in young adults. Int J Eat Disord 2024; 57:1746-1755. [PMID: 38801161 DOI: 10.1002/eat.24225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 04/23/2024] [Accepted: 04/23/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVE Few studies investigated parenthood as a predictor of eating pathology in young adulthood. We studied the association between parenthood, in the first year after becoming a parent and beyond, and eating pathology. Furthermore, we examined whether moving in together with a partner affected this association. METHOD This study used data of four measurement waves from TRAILS (Tracking Adolescents' Individual Lives Survey), a Dutch community cohort study (N = 2229) from preadolescence into young adulthood. The Eating Disorder Diagnostic Scale (EDDS), a measure to assess eating pathology, was assessed at ages 22, 26, and 29. Risk for eating disorder was assessed at age 19. Pregnant participants were excluded. RESULTS Parenthood was not associated with an increase of eating pathology in the first year after becoming a parent and beyond. Instead, parents were more likely to report being free from eating pathology symptoms compared to childless individuals (OR 2.07, 95% CI: 1.11-3.84). Among those who reported experiencing at least one eating problem, parenthood was not associated with the number of eating problems. Moving in together with a partner did not alter the association between parenthood and eating problems and neither did this association differ between males and females. DISCUSSION Parenthood in young adulthood was associated with a decreased risk of having eating pathology. PUBLIC SIGNIFICANCE STATEMENT In this longitudinal study among young adults, parenthood was not associated with the development of eating pathology.
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Affiliation(s)
- K Meier
- Parnassia Psychiatric Institute, The Hague, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| | - L C Apon
- Dutch Healthcare Authority, Utrecht, The Netherlands
| | - D Van Hoeken
- Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - A E Van Eeden
- Parnassia Psychiatric Institute, The Hague, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| | - H W Hoek
- Parnassia Psychiatric Institute, The Hague, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
- Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, New York, USA
| | - A J Oldehinkel
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
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Eaton CM. Infant Feeding Experiences of Women Who Recovered From Anorexia Nervosa. J Obstet Gynecol Neonatal Nurs 2023; 52:384-393. [PMID: 37524312 DOI: 10.1016/j.jogn.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/28/2023] [Accepted: 06/03/2023] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVE To describe the infant feeding experiences of women who recovered from anorexia nervosa (AN). DESIGN Descriptive phenomenology. SETTING Personal interviews. PARTICIPANTS Sixteen women with histories of AN. METHODS I used Colaizzi's descriptive phenomenological method. In individual audio-recorded interviews, I asked participants to describe their experiences of being mothers who recovered from AN and how this affected feeding their infants. RESULTS The direct and indirect effects of histories of AN permeated the participants' infant feeding experiences. Participants did not anticipate the overarching challenges of infant feeding in relation to AN, and nurses and clinicians lack guidelines for screening and management. I coded and analyzed 16 transcripts that revealed five overarching themes: Unbound: My Past Does Not Have to Predict the Future, Navigating the Rollercoaster of Pregnancy and the Postpartum Body, Ripples of Trauma in Infant Feeding, The Maddening Maze: Remnants of Anorexia, and Perfectly Imperfect: Recovery and Mothering. CONCLUSION Results elucidate the complexity of the infant feeding experiences of women who recovered from AN and the importance of screening for a history of AN. Nurses and women's health care providers should discuss the implications of such a history on prenatal planning, pregnancy, postpartum recovery, and the overall experience of infant feeding. This may help nurses and clinicians provide care for women with known histories of AN by improving the detection of possible symptoms and identifying referral sources for appropriate intervention.
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Chapman L, Cartwright-Hatton S, Lester KJ. "I think it is woven through me, and sadly that means it is woven through our family life": the experiences and support needs of mothers with eating disorders. J Eat Disord 2023; 11:147. [PMID: 37644486 PMCID: PMC10466810 DOI: 10.1186/s40337-023-00868-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/11/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Eating disorders may disrupt parenting, and there is evidence to suggest that the children of parents with eating disorders are at greater risk for the development of eating disorders themselves. This study sought to broaden and extend current understandings of the lived experiences of mothers who have eating disorders. METHOD A qualitative study using thematic analysis was conducted. Eighteen mothers living in the UK, USA, and Australia took part in semi-structured online interviews. Participants were mothers to at least one child aged two years or older, had received a lifetime diagnosis of one or more eating disorders, and reported experiencing symptoms since becoming a parent. RESULTS Data were analysed using an inductive approach to reflexive thematic analysis. Four major themes, each with subthemes, were identified. These were: parenthood as a double-edged sword; the eating disorder impacts on parenting; blame and burden; and seeking support. CONCLUSIONS The lived experiences of mothers indicate a complex relationship between eating disorders and parenthood. While parenting can impact eating disorders, eating disorders can also impact parenting, in a range of ways that extend beyond the domains of food, eating and the body. There is a pressing need for the development of specialised, non-judgemental support options for parents with eating disorders and their families.
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Affiliation(s)
- Laura Chapman
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, UK.
| | | | - Kathryn J Lester
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, UK.
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Mack RA, Stanton CE, Carney MR. The importance of including occupational therapists as part of the multidisciplinary team in the management of eating disorders: a narrative review incorporating lived experience. J Eat Disord 2023; 11:37. [PMID: 36894981 PMCID: PMC9996838 DOI: 10.1186/s40337-023-00763-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/26/2023] [Indexed: 03/11/2023] Open
Abstract
The literature demonstrates the importance of utilizing a multidisciplinary approach in the treatment of eating disorders, however there is limited literature identifying the optimal team of professionals for providing comprehensive and effective care. It is widely accepted that the multidisciplinary treatment team should include a physician, a mental health professional, and a dietitian, but there is minimal literature explaining what other professionals should be involved in the medical assessment and management of eating disorders. Additional team members might include a psychiatrist, therapist, social worker, activity therapist, or occupational therapist. Occupational therapists are healthcare professionals who help their clients participate in the daily activities, referred to as occupations, that they have to do, want to do, and enjoy doing. Many factors (e.g., medical, psychological, cognitive, physical) can impact a person's ability to actively engage in their occupations. When a person has an eating disorder, it is likely that all four of the aforementioned factors will be affected, thus individuals undergoing treatment for an eating disorder benefit from the incorporation of occupational therapy in supporting their recovery journey. This narrative review strives to provide education on the role of the occupational therapist in treating eating disorders and the need for increased inclusion of this profession on the multidisciplinary team. Additionally, this narrative review offers insight into an individual's personal experience with occupational therapy (i.e., lived experience) during her battle for eating disorder recovery and the unique value that occupational therapy offered her as she learned to manage her eating disorder. Research suggests that occupational therapy should be included in multidisciplinary teams focused on managing eating disorders as it empowers individuals to return to activities that bring personal meaning and identity.
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Affiliation(s)
- Rebekah A Mack
- The Johns Hopkins Hospital, 600 N. Wolfe Street, Baltimore, MD, 21287, USA.
| | - Caroline E Stanton
- Prisma Health Kidnetics, 29 N. Academy Street, Greenville, SC, 29601, USA
| | - Marissa R Carney
- The Johns Hopkins Hospital, 600 N. Wolfe Street, Baltimore, MD, 21287, USA
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Martini MG, Taborelli E, Easter A, Bye A, Eisler I, Schmidt U, Micali N. Effect of maternal eating disorders on mother-infant quality of interaction, bonding and child temperament: A longitudinal study. EUROPEAN EATING DISORDERS REVIEW 2023; 31:335-348. [PMID: 36471387 PMCID: PMC10107506 DOI: 10.1002/erv.2960] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 11/13/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022]
Abstract
AIMS This study aims to investigate the effect of maternal eating disorders (ED) on mother-infant quality of interaction at 8 weeks and bonding and child temperament at 1 and 2 years postnatally. We also aimed to explore the relationship between maternal ED psychopathology, comorbid psychiatric difficulties, and both mother-infant quality of interaction and bonding in women with ED. Women were recruited to a prospective longitudinal study. By the time of giving birth, the sample consisted of 101 women of the initial 137 (73.7%). Overall, 62 women (ED = 36; HC = 26) participated in the 8-week assessment, 42 (ED = 20; HC = 22) at 1 year, and 78 (ED = 34; HC = 44) at 2 years. Mann-Whitney U Test was used to explore association between maternal ED and mother-infant quality of interaction and between maternal ED and bonding. Spearman correlations were used to explore associations between maternal ED psychopathology, comorbid psychiatric difficulties, and both mother-infant quality of interaction and bonding. RESULTS We found no differences between early mother-infant interaction and bonding in mothers with ED in comparison to HC. High levels of maternal ED psychopathology were correlated with high anxiety levels, higher negative affectivity, and lower extraversion in children of ED mothers both at 1 and 2 years. Furthermore, high levels of ED psychopathology were also associated with lower effortful control at 1 year. CONCLUSIONS Findings imply that maternal ED have an impact on child temperament. Future research should focus on resilience and on which protective factors might lead to positive outcomes. These factors can be then used as therapeutic and preventative targets.
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Affiliation(s)
- Maria Giulia Martini
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.,Children and Young People Eating Disorder Service, Central and North West London NHS Foundation Trust, London, UK.,Great Ormond Street Institute of Child Health, University College, London, UK
| | - Emma Taborelli
- Great Ormond Street Institute of Child Health, University College, London, UK
| | - Abigail Easter
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Amanda Bye
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Ivan Eisler
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.,Maudsley Centre for Child and Adolescent Eating Disorders (MCCAED), Maudsley Hospital, London, UK
| | - Ulrike Schmidt
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Nadia Micali
- Great Ormond Street Institute of Child Health, University College, London, UK.,Department of Psychiatry, University of Geneva, Geneva, Switzerland.,Mental Health Services in the Capital Region of Denmark, Eating Disorders Research Unit, Psychiatric Centre Ballerup, Ballerup, Denmark
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Farářová A, Papežová H, Gricová J, Štěpánková T, Čapek V, Reedtz C, Lauritzen C, van Doesum K. ChildTalks+: a study protocol of a pre-post controlled, paired design study on the use of preventive intervention for children of parents with a mental illness with focus on eating disorders. BMC Psychiatry 2022; 22:715. [PMID: 36384579 PMCID: PMC9670502 DOI: 10.1186/s12888-022-04349-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 10/29/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Children of parents with a mental illness are at high risk of developing a mental disorder as a result of transgenerational transmission. Without effective intervention, they could form the next generation of psychiatric patients. ChildTalks+ is a preventive intervention involving four structured psychoeducational sessions designed for parents affected by a mental disorder and their children. Its aim is to reduce the risk of mental disorders in children of parents with mental illness. This study draws on our clinical practice and involves a group of patients with eating disorders. The aim of the project, which will run in the Czech Republic, is to evaluate the effectiveness of ChildTalks+ methodology. METHODS ChildTalks+ therapists (professionals from health, social, and educational facilities) will recruit 66 families where a parent is treated for a mental disorder and the family includes children aged 6-18. Paired allocation into an intervention group (N = 33) and a control group (N = 33) will be based on the number of risk factors identified in the family. Both groups will complete questionnaires at the baseline, post-test, and follow-up assessments after six and 12 months. The intervention group will receive the ChildTalks+ intervention within 2 months of the baseline assessment; the control group after the last assessment. Questionnaires will be completed by parents and children aged 12+ and, in two cases, 15+ years. Quantitative data will be supplemented with qualitative data from ChildTalks+ therapists working with patients with eating disorders. DISCUSSION The ChildTalks+ intervention is expected to strengthen parenting competencies and family protective factors, improve family communication, increase awareness of parental mental health issues, and improve the wellbeing of children of parents with mental illness with long-term sustainable outcomes. The study should contribute to the evidence base for the ChildTalks+ program and help identify key themes in the implementation of similar preventive interventions. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05554458. Registered 26 September 2022. Retrospectively registered.
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Affiliation(s)
- Adéla Farářová
- First Faculty of Medicine, Charles University, Prague, Czech Republic. .,Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
| | - Hana Papežová
- grid.4491.80000 0004 1937 116XFirst Faculty of Medicine, Charles University, Prague, Czech Republic ,grid.411798.20000 0000 9100 9940Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jana Gricová
- grid.4491.80000 0004 1937 116XFirst Faculty of Medicine, Charles University, Prague, Czech Republic ,grid.411798.20000 0000 9100 9940Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Tereza Štěpánková
- grid.4491.80000 0004 1937 116XFirst Faculty of Medicine, Charles University, Prague, Czech Republic ,grid.411798.20000 0000 9100 9940Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Václav Čapek
- grid.4491.80000 0004 1937 116XFirst Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Charlotte Reedtz
- grid.10919.300000000122595234RKBU North, Faculty of Health, UiT – Arctic University of Norway, Tromsø, Norway
| | - Camilla Lauritzen
- grid.10919.300000000122595234RKBU North, Faculty of Health, UiT – Arctic University of Norway, Tromsø, Norway
| | - Karin van Doesum
- grid.5590.90000000122931605Department of Clinical Psychology, Radboud University, Nijmegen, Netherlands
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The Real Deal: A Qualitative Investigation of Authentic Leadership in Irish Primary School Leaders. SOCIETIES 2022. [DOI: 10.3390/soc12040106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Recognition of the importance of authentic leadership is growing in popularity amonleadership scholars. However, little remains known about how it is valued or received among practicing school leaders. The purpose of this research was to explore the perspectives and experiences of school leaders with reference to authentic leadership in Irish primary school leaders. As this is a scoping study, a qualitative research design was adopted, using semi-structured interviews with school leaders. Core traits of self-awareness, balanced processing, relational transparency and internalized perspectives, that are associated with authentic leadership emerged as important for those interviewed. Barriers and facilitators of authentic leadership were also identified including educational policy, procedures and school culture.
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Parental eating disorders: A systematic review of parenting attitudes, behaviours, and parent-child interactions. Clin Psychol Rev 2021; 88:102031. [PMID: 34246839 DOI: 10.1016/j.cpr.2021.102031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/01/2021] [Accepted: 04/14/2021] [Indexed: 11/22/2022]
Abstract
A substantial proportion of adults with eating disorders are parents. Studies suggest these parents may experience a range of parenting challenges, and their children may be at an increased risk for the development of eating disorders themselves. With parenting practices being one potential environmental mechanism for the intergenerational transmission of eating disorders, we systematically searched Scopus, Web of Science, PubMed, MEDLINE, PsychINFO, and PsychArticles for controlled studies in which parenting attitudes, behaviours, and parent-child interactions were examined for parents with and without probable eating disorders. 26,512 abstracts were screened, and 167 full-text manuscripts were retrieved, with 33 studies meeting the review inclusion criteria. Studies suggest that parents with eating disorders experience higher levels of parenting stress than control parents, and may on average be more intrusive, less sensitive, and provide less structuring/facilitation in non-feeding interactions with their children. These parents also appear, on average, to experience increased concern about their children's weight, and parent-child mealtime interactions may be problematic and characterised by high levels of conflict. Suggestions for future research are made with a view to enhancing understandings of the intergenerational transmission of eating disorders, which may lead to the identification of intervention targets for parents with eating disorders and their children.
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