Parental strategies used in the family meal session of family-based treatment for adolescent anorexia nervosa: Links with treatment outcomes

Objective: Examine relationships between parental mealtime strategies used in the family meal session of Family-Based Treatment (FBT) and adolescent outcomes at EOT (session 20). Method: Eighteen families with an adolescent receiving FBT-AN participated. Parental strategies during videoed family meals were assessed using a family mealtime coding system. Change scores were calculated for both adolescent ëW and EDE scores. Results: Increased use of parental direct and non-direct eating prompts during the family meal was associated with greater adolescent weight gain at EOT. Use of parental mealtime strategies was not associated with any significant change in adolescent eating psychopathology at EOT. Discussion: Parental verbal eating prompts during the family meal may be effective in promoting short-term weight gain. During the family meal session, parents should be encouraged to maintain a direct focus on their adolescent child’s eating behaviour which may assist their child with food consumption and potential weight gain. Further research examining food-based interactions among parents and their adolescent child with AN is needed

How do parents of adolescent patients with anorexia nervosa interact with their child at mealtimes? A study of parental strategies used in the family meal session of family-based treatment

Objective: To examine the range and frequency of parental mealtime strategies used during the family meal session of Family-Based Treatment (FBT) for adolescent anorexia nervosa, and to explore the relationships between parental mealtime strategies, mealtime emotional tone and parental 'success' at encouraging adolescent food consumption. Method: Participants were 21 families with a child aged between 12 and 18 years receiving FBT for adolescent anorexia nervosa. Video recordings of the family meal session (FBT session two) were coded using the Family Mealtime Coding System adapted in this study for use with adolescents (FMCS-A) to identify frequency of parental strategies, emotional tone of the meal (measured by adolescent positive and negative vocalisations) and frequency of prompted mouthfuls consumed by the adolescent (measured by the number of mouthfuls consumed by the adolescent immediately following parental interactions). Results: A range of parental mealtime strategies were in use. Those used repeatedly included direct eating prompts, non-direct eating prompts, physical prompts, and providing information or food-related choices. Several parental mealtime strategies (direct and non-direct eating prompts) were found to be consistently associated with the tone of adolescents' vocalisations and the number of mouthfuls consumed in response to a parental prompt. Discussion: Despite associations with negativity from the adolescent, the use of food-related prompts (both verbal and physical) seems to be associated with increased eating. This indicates the potentially important role of parental control of eating. Following replication, these findings might provide a focus for therapists when supporting and coaching parents during the family meal session. © 2014 Wiley Periodicals, Inc

Embodied experiences of injured endurance runners: a qualitative meta-synthesis

A meta-synthesis was conducted to explore the experiences of ultra-runners who had sustained a running related injury. We identified 10 narrative studies which were synthesised thematically before being re-organised within an Embodiment framework producing 5 taxonomies; The Disciplined Body, Embodied Distress, Corporeal Running Identity, Intersubjectivity of pain and Embodied Coping. Ultra-running is a body centred activity exemplifying Merleau-Ponty’s embodiment. These runners develop a heightened kinaesthetic awareness and embodied sense of space developed through many hours of ‘burning in’ movement pathways. Running as a habituated and pre-reflective action means that when experiencing injury, the entire world of the ultra-runner is disrupted, calling into question their corporeal identity. Ultra-runners who experience pain or injury may have the opportunity to resist dominant pain narratives by adopting an embodied approach to healing. This meta-synthesis has implications for further research, examining the embodied meaning injured ultra-runners make from injury and how this impacts their experiences of their bodies.</p

Stories of acceptance and resistance: illness identity construction in athletes (mis)diagnosed with a personality disorder

Mental illness identities are personally and socially constructed and impact psychological wellbeing. This study explored how athletes diagnosed with a personality disorder construct their illness identity and the various ways this impacted experience. Guided by an interpretivist paradigm, we recruited two powerlifters, Samantha and Alex, who engaged in a series of one-to-one interviews. In total, 11 hours of data was collected and analysed using dialogical narrative analysis. The personality disorder diagnosis had significant but divergent influences on each athlete. Samantha accepted the diagnosis, aligning to dominant medical understandings of mental illness and using these to construct renewed understandings of the self. In contrast, Alex told a counternarrative to dominant medical discourses of mental illness, which was characterised by stories of activism. Alex sought an alternate diagnosis, autism spectrum disorder (ASD), which better validated their experience. We discuss implications of this work for those operating in sport, such as the importance of allowing athletes to develop their own understandings of mental illness to allow for the construction of an authentic self.</p

Supplementary Information Files for: Diverse paradigms and stories: mapping ‘mental illness’ in athletes through meta-study

Supplementary Information Files for: Diverse paradigms and stories: mapping ‘mental illness’ in athletes through meta-studyThis meta-study systematically appraises and synthesizes research into athletes’ experiences of mental illness. Our critical review of 37 studies conformed to the meta-study structure of meta-theory, meta-method, and meta-data analysis. We also produced a meta-synthesis of findings to deliver new insights into athlete mental illness. Athlete accounts of mental illness pertained to experience of the following: depression, eating disorders, gambling addiction and substance-related disorders (alcohol and drugs). Following a critical interrogation of original articles’ theory, method, and findings, we noted a general lack of methodological coherence (congruence between philosophical stance, theoretical position, and methodology). Through the process of a thematic synthesis, we developed 4 new themes: origins of certainty and ambiguity, a gradual sense of decline, mental illness as a threat to identity, and constructing recovery stories. Athletes drew upon dominant illness discourses to construct mental illness and recovery experiences. Our results provide us with an understanding of how mental illness and recovery were experienced within an elite sport involvement. We recommend future research embraces more diverse methodologies and authors ensure a strong alignment between guiding philosophies and methodological approach<br