The intersection of ADHD and anorexia: a qualitative exploration of how ADHD shapes eating disorder experiences.

IF 5.7 3区 医学 Q2 NUTRITION & DIETETICS
Romi Goldschlager, Kurea Adrian, Eva Gregertsen, Katia Manariti, Eveline Mu, Jayashri Kulkarni
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Abstract

Introduction: Anorexia nervosa (AN) is an eating disorder (ED) characterised by restrictions in energy intake, intense fear of weight gain and distorted body image. AN may coexist with attention-deficit/hyperactivity disorder (ADHD), a neurotype characterised by differences in attention and/or impulsivity and hyperactivity. Despite increasing recognition of neurodivergence in EDs, the co-occurrence of ADHD and AN remains markedly under-researched. Clarifying their interaction will improve diagnostic accuracy, tailor treatments, and ultimately enhance outcomes for individuals living with both neurobiological profiles. The objective of this study is to investigate how features of ADHD and AN influence the lived experience of adults with both profiles.

Methods: Fifteen adults with co-occurring ADHD and AN participated in semi-structured interviews exploring how features of each profile shaped their experience. Qualitative data was analysed using Braun and Clarke's reflexive thematic analysis.

Results: Four themes were developed. The interaction and overlap of features of ADHD and AN as well as challenges teasing the two apart was central for participants. ADHD and AN features were intentionally and unintentionally instrumentalised, perpetuating the co-occurring profile and making participants' experiences of co-occurring ADHD-AN challenging to navigate. Participants experienced profound shame resulting from ADHD-related systemic factors which in some cases appeared to predispose them to the development of AN. Overall, participants emphasised the importance of making ADHD-AN visible, highlighting the need for both this research and clinical attunement and dexterity to support individual patient experiences.

Conclusions: To our knowledge, this is the first qualitative study providing evidence of how the features of ADHD and AN interact. The findings emphasise shared challenges in living with the co-occurring profiles, highlighting the need for increased understanding and greater recognition of ADHD-AN.

ADHD和厌食症的交集:ADHD如何塑造饮食失调经历的定性探索。
神经性厌食症(Anorexia神经性厌食症)是一种饮食失调症(ED),其特征是限制能量摄入,强烈恐惧体重增加和扭曲的身体形象。AN可能与注意力缺陷/多动障碍(ADHD)共存,ADHD是一种以注意力和/或冲动和多动差异为特征的神经类型。尽管越来越多的人认识到ed中的神经分化,但ADHD和AN的共同发生仍然明显缺乏研究。明确它们的相互作用将提高诊断的准确性,定制治疗,并最终提高患有两种神经生物学特征的个体的预后。本研究的目的是探讨ADHD和AN的特征如何影响具有这两种特征的成年人的生活经历。方法:15名同时患有ADHD和AN的成年人参加了半结构化访谈,探讨每种特征如何影响他们的经历。定性数据分析采用Braun和Clarke的反身性主题分析。结果:发展了四个主题。ADHD和AN特征的相互作用和重叠以及将两者分开的挑战是参与者的核心。ADHD和AN特征被有意无意地工具化,使共同发生的概况永续存在,并使参与者的共同发生的ADHD-AN经历难以驾驭。参与者经历了由与注意力缺陷多动障碍相关的系统因素造成的深刻羞耻,在某些情况下,这些因素似乎使他们易患AN。总的来说,与会者强调了使ADHD-AN可见的重要性,强调了这项研究和临床调节和灵活性的必要性,以支持个体患者的体验。结论:据我们所知,这是第一个提供ADHD和AN特征如何相互作用证据的定性研究。研究结果强调了共同面临的挑战,强调了增加对ADHD-AN的理解和认识的必要性。
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来源期刊
Journal of Eating Disorders
Journal of Eating Disorders Neuroscience-Behavioral Neuroscience
CiteScore
5.30
自引率
17.10%
发文量
161
审稿时长
16 weeks
期刊介绍: Journal of Eating Disorders is the first open access, peer-reviewed journal publishing leading research in the science and clinical practice of eating disorders. It disseminates research that provides answers to the important issues and key challenges in the field of eating disorders and to facilitate translation of evidence into practice. The journal publishes research on all aspects of eating disorders namely their epidemiology, nature, determinants, neurobiology, prevention, treatment and outcomes. The scope includes, but is not limited to anorexia nervosa, bulimia nervosa, binge eating disorder and other eating disorders. Related areas such as important co-morbidities, obesity, body image, appetite, food and eating are also included. Articles about research methodology and assessment are welcomed where they advance the field of eating disorders.
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