Gauging Distress in an Adult AN Patient's Partner

Distress was lowest when both partners agreed on the need for change.

Reprinted from Eating Disorders Review
November/December Volume 26, Number 6
©2015 IAEDP

Being in a romantic relationship with a patient with anorexia nervosa (AN) can be challenging. And, for patients with AN, their romantic partners may be their main interpersonal relationship. Such relationships can endure significant amounts of strain, but it is still unclear what influence a partner's level of distress has upon the partner with an eating disorder.

In one of the first empirical studies to use data from direct observations of adult female patients with AN and their intimate partners, University of North Carolina researchers found that the partners experienced the least distress when their attempts to get the patient to change harmful behaviors fit well with the patient's perception of the negative consequences of the illness and her motivation to change the behaviors (Int J Eat Disord. 2015; 48:67). Partners had the least amount of distress when they tried to promote changes in AN behaviors and also attempted to show understanding of the patient's experience.

Melanie S. Fischer and her fellow researchers in the Departments of Psychology and Psychiatry at the University of North Carolina at Chapel Hill examined cross-sectional relationships between self-reports of patients' perceived negative consequences of AN, their partners' level of caregiver distress, negative affect, satisfaction with the relationship, and use of promoting change and acceptance/validation. Sixteen adult patient-partner pairs were studied as they started a couple-based intervention for AN. The couples had to have been in a committed relationship and living together for at least one year. In addition, the patient had to have a body mass index greater than 16 kg/m2. 

Working as a team lessens distress

When both partners worked as a team to promote change and work toward recovery, partner distress was less. Those partners who displayed higher acceptance/validation reported less negative affect. It seems logical that this would be well-received by patients and assist in coping with illness strains. However, the researchers also noted that if partners have negative affect, it might be difficult for them to show understanding and to validate the patient's struggles with AN.

The authors are correct in thinking of their findings as "exploratory." It was a single study and the sample was small. Still, this is potentially highly valuable work as it expands our knowledge relative to treating adults with AN, an area of greater need.