Exploration of Friendship Experiences, before and after Illness Onset in Females with Anorexia Nervosa: A Qualitative Study.
BACKGROUND
Difficulties with social relationships have been implicated in both the development and maintenance of Anorexia Nervosa (AN) but the friendship experiences of individuals with AN have not been explored in depth.


METHODS
Ten adults with AN took part in a semi-structured interview about their friendship experiences both before and since the onset of their illness.


RESULTS
Five principle themes were identified through thematic analysis: Social Concern; Impact of AN; Social Connectedness; Inflexibility and Preferred Social Activity. Difficulties with friendship were present prior to the onset of AN in all cases, with participants experiencing anxiety in relation to various aspects of their friendships. Participants described mixed experiences of how their AN has affected their friendships but most participants described having less contact with their friends since becoming unwell.


CONCLUSIONS
This research highlights the role that social difficulties may play in the development of AN, whilst also emphasising the importance of addressing problems with friendship in the course of inpatient treatment.
Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
Heather
http://orcid.org/0000-0002-1014-9920
H
Westwood
Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
Vanessa
V
Lawrence
South London and Maudsley NHS Foundation Trust, London, United Kingdom.
Caroline
C
Fleming
Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.|South London and Maudsley NHS Foundation Trust, London, United Kingdom.|Ilia State University, Tbilisi, Georgia.
Kate
K
Tchanturia
J Health Psychol. 2013 Jan;18(1):26-37
22491496
Eat Weight Disord. 2004 Dec;9(4):249-57
15844396
Int J Eat Disord. 1999 Mar;25(2):177-86
10065395
Eur Eat Disord Rev. 2014 Sep;22(5):366-72
25113819
Int J Eat Disord. 2008 Nov;41(7):650-6
18446832
Women Health. 2013;53(7):730-40
24093452
Eur Eat Disord Rev. 2014 May;22(3):200-5
24616049
Eur Eat Disord Rev. 2011 Jul-Aug;19(4):296-302
21714039
Int J Eat Disord. 2014 May;47(4):394-9
24347025
Autism. 2013 May;17(3):296-316
23188883
Lancet Psychiatry. 2014 Oct;1(5):368-76
26361000
Int J Eat Disord. 1997 Jan;21(1):31-8
8986515
Eat Behav. 2015 Apr;17:14-8
25528718
Br J Clin Psychol. 2007 Mar;46(Pt 1):67-83
17472202
J Health Psychol. 2015 Jan;20(1):27-36
23933950
PLoS One. 2013 Oct 25;8(10):e77757
24204951
Appetite. 2013 Aug;67:125-33
23583741
J Psychol. 2012 Jan-Apr;146(1-2):243-57
22303623
Eat Behav. 2008 Jan;9(1):82-90
18167326
Cogn Behav Pract. 2016 Aug;23(3):316-328
27429544
Int J Eat Disord. 2011 Sep;44(6):531-9
20957704
Eat Weight Disord. 2014 Jun;19(2):159-68
24668325
Nutrients. 2012 Sep;4(9):1260-72
23112914
Eat Behav. 2003 Jan;3(4):387-96
15000998
Eur Eat Disord Rev. 2014 Nov;22(6):454-62
25277720
Compr Psychiatry. 2013 Jan;54(1):41-5
22534033
Psychiatry Res. 2015 Nov 30;230(1):70-7
26323166
Int J Eat Disord. 2012 Dec;45(8):962-9
22693046
J Abnorm Child Psychol. 2014 Nov;42(8):1381-93
24882502
Prim Care Companion CNS Disord. 2015 Apr 30;17(2):null
26445689
J Abnorm Child Psychol. 2008 Feb;36(2):135-50
18172754
Biol Psychiatry. 2007 Feb 1;61(3):348-58
16815322
J R Soc Med. 1994 Aug;87(8):441-4
8071911
Int J Eat Disord. 2015 Nov;48(7):936-41
25946712
Neurosci Biobehav Rev. 2016 May;64:252-71
26915928
Int J Eat Disord. 2015 Dec;48(8):1141-9
26337405
Neuropsychiatr Dis Treat. 2014 May 21;10:915-27
24899810
Eur Eat Disord Rev. 2016 Jan;24(1):34-42
26364834
Behav Res Ther. 2002 Jul;40(7):773-91
12074372
PLoS One. 2011;6(6):e20835
21695147
J Health Psychol. 2006 Jul;11(4):533-51
16769734
Psychiatry Res. 2016 Feb 28;236:165-72
26778369
Int J Eat Disord. 2005 May;37(4):313-20
15856495
Eur Eat Disord Rev. 2016 Nov;24(6):489-493
27510320
Arch Gen Psychiatry. 1999 May;56(5):468-76
10232302
Behav Res Ther. 2007 Jul;45(7):1557-77
17258173
Eur Eat Disord Rev. 2015 Jan;23(1):62-7
25382845
Int J Eat Disord. 2001 Apr;29(3):280-8
11262506
Body Image. 2015 Jun;14:20-8
25867525
Clin Psychol Rev. 2014 Feb;34(1):29-43
24321132
Eur Eat Disord Rev. 2014 Jul;22(4):267-77
24888426
J Affect Disord. 2016 Feb;191:1-7
26599363
J Evid Inf Soc Work. 2015 ;12 (3):272-88
25661898
Behav Cogn Psychother. 2015 Nov;43(6):705-31
26393777
Eur Eat Disord Rev. 2014 Nov;22(6):430-8
25267532
World J Biol Psychiatry. 2014 Dec;15(8):586-98
24882144
BMJ. 2009 Sep 24;339:b3800
19778976
PLoS One. 2014 Oct 31;9(10):e111697
25360690
PLoS One. 2015 Jul 02;10(7):e0131724
26133552
Child Dev. 2000 Mar-Apr;71(2):447-56
10834476
PLoS One. 2012;7(1):e28331
22253689
J Eat Disord. 2013 Apr 15;1:13
24999394
PLoS One. 2016 Jul 26;11(7):e0159910
27458808