title: Cognitive interpersonal maintenance model of eating disorders: intervention for carers.
abstract: BACKGROUND
  Carers of people with eating disorders report high levels of distress. In addition, carers' responses to the illness may perpetuate eating disorder symptoms. A cognitive interpersonal maintenance model of eating disorders is proposed and interventions for carers may improve well-being in both carers and patients. Aims To examine an interpersonal maintenance model of eating disorders, using a self-help intervention for carers.
  
  
  METHODS
  A pre-test-post-test design was used with carers randomised into self-help or guided self-help, which included the Expert Carers Helping Others (ECHO) intervention. Carers' distress, well-being, proposed maintenance factors, and carer reports on the status of the patient were measured.
  
  
  RESULTS
  Carers' distress reduced and secondary outcomes improved. Improvement in carers' status and perceived improvements in patients were associated with reductions in expressed emotion and in accommodating and enabling behaviours. Self-help and guided self-help versions were comparable.
  
  
  CONCLUSIONS
  Changes in maintenance factors from the theoretical model were associated with a reduction in carers' distress and improvement in perceived patient functioning. Interventions which specifically target maintaining factors may be of benefit.
authors: Department of Psychological Medicine, 5th Floor Bermondsey Wing, Guy's Hospital, London SE1 9RT, UK. Elizabeth.Goddard@kcl.ac.uk.
authors: Elizabeth
authors: E
authors: Goddard
authors: Pamela
authors: P
authors: Macdonald
authors: Ana Rosa
authors: AR
authors: Sepulveda
authors: Ulrike
authors: U
authors: Naumann
authors: Sabine
authors: S
authors: Landau
authors: Ulrike
authors: U
authors: Schmidt
authors: Janet
authors: J
authors: Treasure
mesh_terms: D000223:Adaptation, Psychological; D017028:Caregivers / Q000193:education / Q000523:psychology*; D019260:Expressed Emotion; D001068:Feeding and Eating Disorders / Q000451:nursing / Q000523:psychology*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009042:Motivation; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy; D013315:Stress, Psychological; D006113:United Kingdom