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Stigma and treatment of eating disorders in Ireland: healthcare professionals’ knowledge and attitudes

Published online by Cambridge University Press:  22 May 2015

F. McNicholas ,
C. O’Connor ,
L. O’Hara  and
N. McNamara
F. McNicholas*
Affiliation:
School of Medicine & Medical Science, University College Dublin, Belfield, Dublin, Ireland Lucena Clinic, Rathgar, Dublin, Ireland
C. O’Connor
Affiliation:
Lucena Clinic, Rathgar, Dublin, Ireland
L. O’Hara
Affiliation:
School of Medicine & Medical Science, University College Dublin, Belfield, Dublin, Ireland
N. McNamara
Affiliation:
Department of Psychology, University of Bedfordshire, Luton, Bedfordshire, UK
*
*Address for correspondence: F. McNicholas, Professor Of Child & Adolescent Psychiatry, School of Medicine & Medical Science, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland. (Email: fiona.mcnicholas@sjog.ie)
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Abstract

Objectives

This study examines aspects of healthcare professionals’ knowledge and attitudes about eating disorders (EDs), which might impede the effective detection or treatment of EDs in Ireland.

Methods

A total of 1,916 healthcare professionals were invited to participate in a web-based survey. Participants were randomly allocated to view one of five vignettes depicting a young person with symptoms consistent with anorexia nervosa, bulimia nervosa, binge-eating disorder, depression or type 1 diabetes. Study-specific questions examined participants’ responses to the vignettes and ED knowledge and experience.

Results

In total, 171 clinicians responded (9% response rate). Participants had an average of 15.8 years of clinical experience (s.d.=9.2) and included psychiatrists, GPs, psychologists and counsellors. Although participants’ knowledge of EDs was moderately good overall, responses showed poor recognition of the symptoms of EDs compared with depression [χ2 (4, n=127)=20.17, p<0.001]. Participants viewed EDs as chronic disorders that primarily affected females. Participants believed that clinicians like working with patients with depression and diabetes more than with AN patients [F (4,101)=5.11, p=0.001]. Among the professionals surveyed, psychiatrists were the most knowledgeable about EDs [F (4,82)=9.18, p<0.001], and were more confident in their ability to diagnose and treat EDs than professionals of all other disciplines, except psychologists [F (4,85)=8.99, p<0.001]. Psychiatrists were also the most pessimistic about ED patients’ long-term life prospects [χ2 (4, n=65)=15.84, p=0.003].

Conclusions

This study recommends that specific attention should be given to EDs in professional educational programmes across healthcare disciplines. This training should not be restricted to improving healthcare professionals’ knowledge of EDs, but should also strive to increase service-providers’ awareness of how their own potentially stigmatising attitudes can undermine engagement with treatment.

Keywords

Attitudeseating disordershealth professionalsknowledgestigmayouth

Information

Type
Original Research
Information
Irish Journal of Psychological Medicine , Volume 33 , Supplement 1 , March 2016 , pp. 21 - 31
Copyright
© College of Psychiatrists of Ireland 2015 

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References

Aitken, C, Power, R, Dwyer, R (2008). A very low response rate in an on-line survey of medical practitioners. Australian and New Zealand Journal of Public Health 32, 288–289.CrossRefGoogle Scholar
Asch, DA, Jedrziewski, MK, Christakis, NA (1997). Response rates to mail surveys published in medical journals. Journal of Clinical Epidemiology 50, 1129–1136.CrossRefGoogle ScholarPubMed
Booth, ML, Bernard, D, Quine, S, Kang, MS, Usherwood, T, Alperstein, G, Bennett, DL (2004). Access to health care among Australian adolescents: young people’s perspectives and their socio-demographic distribution. Journal of Adolescent Health 34, 97–103.CrossRefGoogle Scholar
Byrne, P (2000). Stigma of mental illness and ways of diminishing it. Advances in Psychiatric Treatment 6, 65–72.CrossRefGoogle Scholar
Chambers, D, Murphy, F, Keeley, HS (2015). All of us? An exploration of the concept of mental health literacy based on young people’s responses to fictional mental health vignettes. Irish Journal of Psychological Medicine 32, 129–136.Google Scholar
Copty, M, Whitford, DL (2005). Mental health in general practice: assessment of current state and future needs. Irish Journal of Psychological Medicine 22, 83–86.Google Scholar
Crisafulli, MA, Van Holle, A, Bulik, CM (2008). Attitudes towards anorexia nervosa: the impact of framing on blame and stigma. International Journal of Eating Disorders 41, 333–339.CrossRefGoogle ScholarPubMed
Crisp, A (2005). Stigmatisation of and discrimination against people with eating disorders including a report of two nationwide surveys. European Eating Disorders Review 13, 147–152.CrossRefGoogle Scholar
Cull, WL, O’Connor, KG, Sharp, S, Tang, SS (2005). Response rates and response bias for 50 surveys of pediatricians. Health Services Research 40, 213–226.Google Scholar
Currin, L, Schmidt, U, Treasure, J, et al. (2006). Entry into Specialist Services for the Eating Disorders : Audit of Clinical Pathways Through Primary and Secondary Care. Report from the Specialist Clinical Audit Programme for South London, Kent, Surrey and Sussex. Bexley, UK: NHS Specialist Clinical Audit Office.Google Scholar
Currin, L, Waller, G, Schmidt, U (2009). Primary care physicians’ knowledge of and attitudes towards the eating disorders: do they affect clinical actions? International Journal of Eating Disorders 42, 453–458.Google Scholar
Department of Health & Children (2006). A Vision for Change: Report of the Expert Group on Mental Health Policy. Government Publications Office: Dublin.Google Scholar
Dryer, R, Tyson, GA, Kiernan, MJ (2013). Bulimia nervosa: professional and lay people's beliefs about the causes. Australian Psychologist 48, 338–344.Google Scholar
Easter, MM (2012). ‘Not all my fault’: genetics, stigma, and personal responsibility for women with eating disorders. Social Science & Medicine 75, 1408–1416.Google Scholar
Ebneter, DS, Latner, JD (2013). Stigmatizing attitudes differ across mental health disorders: a comparison of stigma across eating disorders, obesity, and major depressive disorder. Journal of Nervous and Mental Disorders 201, 281–285.CrossRefGoogle ScholarPubMed
Flahavan, C (2006). Detection, assessment and management of eating disorders; how involved are GPs? Irish Journal of Psychological Medicine 23, 96–99.Google Scholar
Griffiths, S, Mond, JM, Murray, SB, Touyz, S (2014). Young people’s stigmatizing attitudes and beliefs about anorexia nervosa and muscle dysmorphia. International Journal of Eating Disorders 47, 189–195.CrossRefGoogle ScholarPubMed
Griffiths, S, Mond, JM, Murray, SB, Touyz, S (in press). The prevalence and adverse associations of stigmatization in people with eating disorders. International Journal of Eating Disorders. Early online publication. doi: 10.1002/eat.22353.Google Scholar
Hackler, AH, Vogel, DL, Wade, NG (2010). Attitudes toward seeking professional help for an eating disorder: the role of stigma and anticipated outcomes. Journal of Counseling & Development 88, 424–431.CrossRefGoogle Scholar
Health Research Board (2013). HRB Statistics Series 25: Activities of Irish Psychiatric Units and Hospitals 2013. Dublin: Health Research Board. Retrieved 20 November 2014, from http://www.hrb.ie/uploads/tx_hrbpublications/HRB025_Statistics_Series_25_Activities_of_Irish_Psychiatric_Units_and_Hospitals_2013_online.pdf Google Scholar
Holliday, J, Wall, E, Treasure, J, Weinman, J (2005). Perceptions of illness in individuals with anorexia nervosa: a comparison with lay men and women. International Journal of Eating Disorders 37, 50–56.CrossRefGoogle ScholarPubMed
Jones, WR, Saeidi, S, Morgan, JF (2012). Knowledge and attitudes of psychiatrists towards eating disorders. European Eating Disorders Review 21, 84–88.Google Scholar
Jorm, AF, Korten, AE, Jacomb, PA, Christensen, H, Henderson, S (1999). Attitudes towards people with a mental disorder: a survey of the Australian public and health professionals. Australian and New Zealand Journal of Psychiatry 33, 77–83.CrossRefGoogle ScholarPubMed
Kim, HL, Hollowell, CM, Patel, RV, Bales, GT, Clayman, RV, Gerber, GS (2000). Use of new technology in endourology and laparoscopy by American urologists: internet and postal survey. Urology 56, 760–765.CrossRefGoogle ScholarPubMed
Linville, D, Brown, T, O’Neil, M (2012). Medical providers’ self-perceived knowledge and skills for working with eating disorders: a national survey. Eating Disorders 20, 1–13.Google ScholarPubMed
Maier, A, Ernst, JP, Müller, S, Gross, D, Zepf, FD, Herpertz-Dahlmann, B, Hagenah, U (2014). Self-perceived stigmatization in female patients with anorexia nervosa – results from an explorative retrospective pilot study of adolescents. Psychopathology 47, 127–132.CrossRefGoogle ScholarPubMed
McLean, SA, Paxton, SJ, Massey, R, Hay, PJ, Mond, JM, Rodgers, B (2014). Stigmatizing attitudes and beliefs about bulimia nervosa: gender, age, education and income variability in a community sample. International Journal of Eating Disorders 47, 353–361.CrossRefGoogle Scholar
McNicholas, F, Keogh, L, Dooley, B, Lennon, R, Ahern, S, Lydon, A, Coyle, C, Whelan, A (2010). Eating problems in children & adolescents – EPICA. Irish Journal of Psychological Medicine 27, 172–178.CrossRefGoogle Scholar
Mond, JM, Hay, PJ (2008). Public perceptions of binge eating and its treatment. International Journal of Eating Disorders 41, 419–426.Google Scholar
Moss-Morris, R, Weinman, J, Petrie, K, Horne, R, Cameron, L, Buick, D (2002). The revised illness perception questionnaire (IPQ-R). Psychology and Health 17, 1–16.CrossRefGoogle Scholar
Quiles Marcos, Y, Weinman, J, Terol Cantero, MC, Belendez Vazquez, M (2009). The dissimilarity between patients’ and relatives’ perception of eating disorders and its relation to patient adjustment. Journal of Health Psychology 14, 306–312.Google Scholar
Roehrig, JP, McLean, CP (2010). A comparison of stigma towards eating disorders versus depression. International Journal of Eating Disorders 43, 671–674.Google Scholar
Stevenson, C, McNamara, N, Muldoon, O (2014). Stigmatised identity and service usage in disadvantaged communities: residents’, community workers’ and service providers’ perspectives. Journal of Community & Applied Social Psychology 24, 453–466.CrossRefGoogle Scholar
Stewart, MC, Keel, PK, Schiavo, RS (2006). Stigmatization of anorexia nervosa. International Journal of Eating Disorders 39, 320–325.Google Scholar
Stewart, MC, Schiavo, RS, Herzog, DB, Franko, DL (2008). Stereotypes, prejudice, and discrimination of women with anorexia nervosa. European Eating Disorders Review 16, 311–318.Google Scholar
Strother, E, Lemberg, R, Stanford, SC, Turberville, D (2012). Eating disorders in men: underdiagnosed, undertreated and misunderstood. Eating Disorders 20, 346–355.CrossRefGoogle ScholarPubMed
Thompson-Brenner, H, Satir, DA, Franko, DL, Herzog, DB (2012). Clinician reactions to patients with eating disorders: a review of the literature. Psychiatric Services 63, 73–78.CrossRefGoogle ScholarPubMed
Weinman, J, Petrie, KJ, Moss-Morris, R, Horne, R (1996). The illness perception questionnaire: a new method for assessing the cognitive representation of illness. Psychology & Health 11, 431–445.Google Scholar
Zwickert, K, Rieger, E (2013). Stigmatizing attitudes towards individuals with anorexia nervosa: an investigation of attribution theory. Journal of Eating Disorders 1, 5, doi:10.1186/2050-2974-1-5.Google Scholar
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