A Glimpse into Partner Distress with Adult Anorexia Nervosa

Romantic partners can be the main personal connection for adults with anorexia nervosa (AN). A small study recently examined associations between perceived negative consequences of AN, caregiver distress, negative affect, and the degree of satisfaction with the relationship (Int J Eat Disord 2014; Aug 4. doi: 10.1002/eat.22338). The researchers also wanted to investigate how partners promoted change.

A team of researchers at the University of North Carolina, Chapel Hill, and the Karolinska Institute, Stockholm, Sweden, recruited adults with AN and their partners for a study of individual therapy for AN, plus a couples-based intervention. Sixteen couples fulfilled the study criteria: (1) being in a committed relationship for at least 1 year; and (2) the patient had a body mass index (BMI) greater than 16 kg/m². Patients with lower BMIs were referred for higher levels of care before being considered for the study. The mean age was 31.2 years (patients) and 34.25 years (partners).

Partner behaviors were assessed with an observational coding system developed especially for the study, which utilized a 10-minute videotape, during which the couple shared their thoughts and feelings about a problem area in their relationship that was related to the partner’s AN.

Working together against AN produced the least amount of stress

Caregiver distress was lower when the partner’s attempts to get the patient to change were “in sync”with the patient’s level of the perceived negative consequences of the disorder (which might reflect motivation to change). In contrast, when the patient perceived few negative effects from the disorder, change promotion was less helpful. Partners with higher levels of acceptance of the reality of AN and validation of the disorder experienced less negative affect.

The authors suggest that future research examine how partner behavior impacts AN treatment outcome.