Relapse in Eating Disorders: A Systematic Review and Thematic Synthesis of Individuals' Experiences

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy Pub Date : 2025-07-01 DOI:10.1002/cpp.70101

Natasha Heal-Cohen, Sophie M. Allan, Nieve Gauvain, Rachel Nabirinde, Aaron Burgess

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引用次数: 0

Abstract

Objective

Relapse is common in eating disorders (EDs); however, it has received significantly more attention within quantitative research. This systematic review aimed to synthesize qualitative findings regarding the experiences of relapse for people with EDs.

Method

A search for studies reporting qualitative data that included experiences of relapse in individuals with EDs was conducted. This included a systematic search of MEDLINE, CINAHL, PsycInfo, Scopus, SSCI, and PQDT Global along with supplementary searching. A total of 1594 titles and abstracts and 168 full texts were screened for eligibility. Sixteen studies were included in the review. Quality appraisal was conducted using the CASP checklist. Data were extracted from each paper and thematic synthesis of relevant data from study findings/discussion was completed in NVivo.

Results

Most included studies involved female participants in the United States, Canada, and United Kingdom with anorexia and bulimia nervosa. Five analytical themes were generated: 1) “I wasn't letting go”: Relapse as enticing; 2) “Bound to lose”: Relapse as unstoppable; 3) “If the going gets tough I've always got this”: Relapse as protective; 4) “Coming back with your tail between your legs”: Relapse as destructive; 5) “So much of this journey … is learning”: Relapse as instructive.

Discussion

Findings highlight the gap between psychological and behavioral improvements that precede relapse, and the contrasting ways relapse is described and experienced. They support a focus on motivational factors and underlying psychological difficulties in treatment, extending beyond a behavioral focus. Further research is needed to understand relapse experiences among males and individuals from the global majority.

Summary

Individuals with EDs who relapsed described desiring or feeling powerless to control relapse. Findings suggest the need for greater emphasis on developing intrinsic motivation and self-efficacy in order to sustain recovery.
Residual ED cognitions and unaddressed psychological vulnerabilities were implicated in relapse. Findings caution against premature discharge before sufficient cognitive and emotional progress has been made.
In response to relapse, clinicians should aim to foster hope, compassion and tailor treatment to address the recovery needs revealed by relapse.

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饮食失调的复发：个人经验的系统回顾和专题综合

目的：饮食失调症（EDs）患者易复发；然而，它在定量研究中得到了更多的关注。本系统综述旨在综合有关ed患者复发经历的定性研究结果。方法对报道定性数据的研究进行检索，其中包括ed患者复发的经历。这包括MEDLINE、CINAHL、PsycInfo、Scopus、SSCI和PQDT Global的系统检索以及补充检索。共筛选了1594个标题和摘要以及168个全文。该综述纳入了16项研究。使用CASP检查表进行质量评估。从每篇论文中提取数据，并在NVivo中完成研究结果/讨论中相关数据的专题综合。结果大多数纳入的研究涉及美国、加拿大和英国患有厌食症和神经性贪食症的女性参与者。由此产生了五个分析主题：1)“我不会放手”：复发是诱人的；2)“注定要输”：复发是不可阻挡的；3)“如果事情变得艰难，我总是这样做”：复发是一种保护；4)“夹着尾巴回来”：复发是破坏性的；5)“这段旅程的大部分都是学习”：故态复明。研究结果强调了复发前心理和行为改善之间的差距，以及描述和体验复发的不同方式。他们支持在治疗中关注动机因素和潜在的心理困难，而不仅仅是关注行为。需要进一步的研究来了解男性和全球大多数人的复发经历。复发的ed患者描述渴望或感觉无力控制复发。研究结果表明，为了维持康复，需要更加重视发展内在动机和自我效能感。残存的ED认知和未解决的心理脆弱性与复发有关。研究结果告诫人们，在认知和情感取得充分进展之前，不要过早出院。在应对复发时，临床医生应该致力于培养希望、同情和定制治疗，以解决复发所揭示的康复需求。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical psychology & psychotherapy PSYCHOLOGY, CLINICAL-

CiteScore

6.30

自引率

5.60%

发文量

106

期刊介绍： Clinical Psychology & Psychotherapy aims to keep clinical psychologists and psychotherapists up to date with new developments in their fields. The Journal will provide an integrative impetus both between theory and practice and between different orientations within clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy will be a forum in which practitioners can present their wealth of expertise and innovations in order to make these available to a wider audience. Equally, the Journal will contain reports from researchers who want to address a larger clinical audience with clinically relevant issues and clinically valid research.