title: A pilot study of associations between treatment for anorexia nervosa and carers' distress.
abstract: In order to investigate the degree to which symptom reduction in the treatment of adults with anorexia nervosa (AN) impacted on their carers' psychological distress, we examined 12 participants in an outpatient treatment trial and their nominated 'significant other'. Measures of eating psychopathology in the person being treated for AN were collected on six occasions: baseline, session 4, session 10, session 25 (end of treatment), and at three-month and 12-month follow-up. At these same time points, measures of psychological distress were collected from carers. Early significant reductions in eating psychopathology were found in the AN group at session 4, whereas significant reductions in carers' distress were found at three-month follow-up and maintained at 12-month follow-up. These reductions were moderated by baseline body mass index of the person with AN. Carers whose significant other had a lower BMI at baseline received most benefit in terms of symptom reduction at 12-month follow-up. Clinical implications include the need to provide more direct support to carers in order to achieve more clinically significant reductions in distress, and the need to discuss a carer's expectations of the recovery process.
  
  
  CONCLUSIONS
  Only 61% of adults being treated for anorexia nervosa (AN) were willing to allow their carer to be contacted by researchers in order to ask them to complete questionnaires over the duration of treatment and follow-up. Significant reductions in eating psychopathology from those being treated for AN was followed by significant reductions in their carers' distress some 12 months later. Reductions of carers' distress was associated with only a small effect size and may indicate that more clinically significant reductions requires individualised support for the carers. Carers whose significant other had a lower body mass index at baseline received most benefit in terms of symptom reduction at 12-month follow-up, which may indicate a need to clarify a carer's expectations of the recovery process.
authors.affiliation: School of Psychology, Flinders University, South Australia, Australia.
authors.forename: Judith
authors.initials: J
authors.lastname: Slater
authors.affiliation: Division of Psychological Medicine, Eating Disorders Research Unit, Department of Academic Psychiatry, King's College, 5th Floor Thomas Guy House, Guy's Hospital, London, UK.
authors.forename: Janet
authors.initials: J
authors.lastname: Treasure
authors.affiliation: Section of Eating Disorders (PO59), Institute of Psychiatry, De Crespigny Park, Denmark Hill, London, UK.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Schmidt
authors.affiliation: Weight Disorder Unit, Flinders Medical Centre, South, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Gilchrist
authors.affiliation: School of Psychology, Flinders University, South Australia, Australia.
authors.forename: Tracey D
authors.initials: TD
authors.lastname: Wade
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology / Q000628:therapy*; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D015928:Cognitive Behavioral Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010865:Pilot Projects; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: anorexia nervosa; carer; eating psychopathology; psychological distress