Illness perceptions in anorexia nervosa: A qualitative investigation

Abstract

Objectives. Anorexia nervosa (AN) is an eating disorder characterized by the egosyntonic nature of symptoms, denial of illness, and ambivalence about treatment engagement. Within the physical health literature, people's beliefs about their illness have been found to impact upon coping and treatment outcomes and this has largely been explored using the self-regulation model. This model has also been applied to mental health and more recently to AN, with beliefs about the disorder being associated with readiness to change. However, qualitative investigations have indicated that physical health models have limited applicability for assessing people's beliefs about mental illness. This may be particularly pertinent to AN, given the complexity of the disorder. Therefore, this study explored illness perceptions in AN using a qualitative design which was not restricted by a physical illness model but focused on personal models of AN from the perspective of those experiencing the disorder.

Design. Semi-structured interviews were conducted with thirteen participants who were currently in treatment for AN.

Method. Interview transcripts were analysed using grounded theory methodology.

Results. An interpretative theory of illness perceptions in AN was developed and comprised four related categories: ‘making sense of AN’, ‘the relationship between AN and the self’, ‘the recovery struggle’, and ‘coping with treatment’.

Conclusion. Patient's accounts transcended the dimensions offered by physical illness models, with the implication that methods for assessing illness beliefs in AN require adaptation for a full understanding to be gained and the complexity of perceptions to be captured.