Family connections for family members of people with eating disorders and personality disorders

Understanding Eating Disorders

Eating Disorders (ED) produce significant disturbances related to food intake and often result in intense preoccupation with weight and shape, as well as the use of strategies to manage this preoccupation, such as dieting and purging (American Psychiatric Association, 2013). These strategies can lead to medical complications affecting weight and shape or, in severe cases, can affect most of the body’s organs, leading to significant alterations (Lopez and Treasure, 2011). In addition, social functioning is also frequently altered and various psychological problems may appear, such as: depression, anxiety, social isolation, family conflicts, low self-esteem, a negative self-concept, and reduced autonomy.

Sometimes it is frequently the case that the person, in addition to having ED, has dysfunctional personality traits that can exacerbate the clinical picture. For example, when the patient with ED frequently has problems with his or her group of friends or work colleagues, with partners, with family members that go beyond what is to be expected for his or her age. When their personality pattern generates adaptation problems in the different areas of their life (personal, social, work, etc.), either dysfunctional personality traits or, especially in more severe cases, a Personality Disorder (PD) may be at the basis. Figures show that ED has a high comorbidity with dysfunctional personality traits or personality disorders (27-93%).

How does it affect the family?

The fact of having an ED also generates considerable suffering in their primary family members, which can impact their daily lives and lead to mental health problems. Typically, caregivers frequently express the need for information on how to help their loved one with ED recover from the disease, thus representing an enormous responsibility. Considering the high levels of distress, anxiety, and burden experienced by caregivers, in addition to the significant interpersonal problems of the patients, are factors that directly influence the patient’s evolution. It is, therefore, necessary that family members are also included in treatment programs offering support and psychoeducation.

Interventions for family members.

Until now, various interventions have been developed to address this need to provide information and care to caregivers, while involving them in the patient’s treatment. Currently, the involvement of family members is the most recommended clinical guideline (NICE Guidelines), constituting an essential tool for the recovery of their loved ones. However, despite the excellent existing treatments, it should be noted that these programs focus on the specific symptoms of ED and do not include intervention on comorbid symptoms, such as the presence of self-harm, suicidal behaviour and participants who may also have a PD. Therefore, it is necessary to carry out studies in Spain with relatives of people with eating disorders and dysfunctional personality traits or personality disorders to demonstrate the effectiveness of the new programs.

Research Project:

“Family Connections for relatives of patients with Eating Disorders and Personality Disorders”.

Funding: Consejería de Innovación, Universidades, Ciencia y Sociedad Digital: Subvenciones para Grupos de Investigación Consolidables – AICO/2021.
Duration: 3 years 01/01/2021 to 12/31/2023.
-rincipal Researcher: PhD Verónica Guillén Botella and PhD Heliodoro Marco Salvador.

In order to advance in this line of work and improve the clinical situation and quality of life of family members of people with ED and PD in our country, it is necessary to have intervention protocols focused exclusively on family members and to test their efficacy in controlled studies. The aim of this research is to train family members in the different skills required for the effective management of patients with ED and PD or dysfunctional personality traits. Family Connections has been shown in other studies to be a good strategy for family members to learn to manage patients’ crises much more effectively and this can help to relieve the stress and burden on family members in their day-to-day lives. This, in turn, can help to improve family relationships as well as the family atmosphere. This is precisely what the present project aims to achieve by translating and adapting the “Family Connections” protocol to the Spanish population and testing its efficacy and efficiency in a randomised controlled trial compared to the usual treatment.

Aim of the project:

The objectives of this research project are, on the one hand, to adapt and test in the Spanish population the modules of the intervention protocol “Family Connections”, designed to be applied specifically to relatives of patients with ED-PD. On the other hand, to test its efficacy and efficiency in relatives of patients with ED-PD in a randomised controlled study. .

Inclusion and Exclusion Criteria:

In the case of relatives, the following inclusion and exclusion criteria will be followed:

Being a relative of a person with a diagnosis of an Eating Disorder (Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, or ED Not Specified) or dysfunctional personality traits (or a complete PD).
Sign the informed consent form.
The presence of any serious pathology in the family member that prevents the intervention from being carried out (such as psychosis, schizophrenia, intellectual disability, substance dependence, etc.) will be an exclusion criterion.

In the case of patients, the following inclusion and exclusion criteria will be established:

Meet the diagnostic criteria for Eating Disorder and or dysfunctional personality traits.
To express agreement to participate in the study in writing by signing the informed consent form and, in the case of minors, the consent form must be signed by the parents.
The presence of another serious pathology such as psychosis, schizophrenia, intellectual disability, etc. will be an exclusion criterion.

Those interested in participating:

Write an email to dparedes@uji.es

Interested people will be contacted, a brief assessment will be conducted, and if they meet the inclusion criteria, they will be eligible to receive the Family Connections programme for family members of people with eating disorders and personality disorders.

Intervention:

This is a free intervention, which is part of this research project. The intervention is a group intervention lasting 3 months and includes 12 sessions following a 2-hour group format every week. The intervention is led by a therapist and co-therapist who are accredited to deliver Family Connections groups.

*This project is currently active.