Tamara Berends

The Anorexia Relapse Prevention Guidelines in Practice: A Case Report

PURPOSE The purpose of this case report is to illustrate the application of the Anorexia Relapse Prevention Guidelines in nursing practice. DESIGN AND METHODS In a single case report, the implementation of the intervention was described. FINDINGS A purposive use of the Anorexia Relapse Prevention Guidelines provides insight into the actual process of relapse, which contributes to an early recognition of relapse symptoms and permits early intervention aimed at recovery. NURSING IMPLICATIONS Use of the Guidelines will lead to the implementation of well-structured professional procedures which are likely to support the patients recovery.

Patients With Anorexia Nervosa Who Self-Injure: A Phenomenological Study

PURPOSE This study investigates self-injury from the perspective of patients with anorexia nervosa. DESIGN AND METHODS A phenomenological design was used. Twelve patients participated. Data were collected using a semi-structured interview guide. FINDINGS Participants display self-injurious behavior predominantly in situations when they are forced to eat. They are terrified of gaining weight and use self-injurious behavior to cope with their anxiety. Self-injury is envisioned as a technique to regain control of their own eating pattern without bothering anyone. They feel shame for not controlling their emotions more constructively. PRACTICE IMPLICATIONS Healthcare professionals should systematically observe signals and explore less harmful strategies that help to regulate overwhelming feelings.

Self-injurious behaviour in patients with anorexia nervosa: a quantitative study

BackgroundMany patients with an eating disorder report difficulties in regulating their emotions and show a high prevalence of self-injurious behaviour. Several studies have stated that both eating disorder and self-injurious behaviour help emotion regulation, and are thus used as coping mechanisms for these patients. We aimed to determine the prevalence of self-injurious behaviour, its characteristics and its emotion-regulation function in patients with anorexia nervosa or an eating disorder not otherwise specified (n = 136).MethodsA cross-sectional design using a self-report questionnaire. Mann–Whitney U-tests were conducted to compare the background and clinical variables between patients with self-injurious behaviour and patients without this type of behaviour. Changes in emotional state before and after self-injurious behaviour were tested by Wilcoxon signed rank tests.ResultsOur results showed a 41% prevalence of self-injurious behaviour in the previous month. Patients who performed self-injurious behaviour had a statistically significant longer treatment history for their eating disorder than those who did not. Whereas 55% of self-injuring patients had a secondary psychiatric diagnosis, only 21% of participants without self-injurious behaviour did. Regarding the impact of self-injurious behaviour, our results showed a significant increase in “feeling relieved” and a significant decrease in “feeling angry at myself”, “feeling anxious” and “feeling angry at others”. This indicates that self-injurious behaviour can be regarded as an emotion-regulation behaviour. Participants were usually aware of the causes of their self-injurious behaviour acts.ConclusionsProfessionals should systematically assess the occurrence of self-injurious behaviour in eating disorder patients, pay special attention to patients with more severe and comorbid psychopathology, and those with a long treatment history. This assessment should be followed by a functional analysis of the self-injurious behaviour and by effective therapeutic interventions alongside the eating disorder treatment.

Relapse prevention in anorexia nervosa: Experiences of patients and parents

One of the main aims of treatment after successful recovery from anorexia nervosa (AN) is to prevent a relapse. The Guideline Relapse Prevention (GRP) Anorexia Nervosa offers a structured approach to relapse prevention. This study explores how patients and their parents experience working with the guideline. It also describes the factors that support or hinder successful application of the guideline. A descriptive qualitative research design was chosen involving in-depth interviews with seventeen patients with anorexia nervosa and six sets of parents. Patients and family members were generally satisfied with the support provided by the GRP. It contributed significantly to a better understanding of the personal process of relapse. Patients and families valued being able to keep in touch with their professional during the aftercare programme. The GRP supports the patients use of self-management strategies for relapse prevention.