BACKGROUND: An extensive literature exists describing treatment interventions and recovery from eating disorders (EDs); however, this body of knowledge is largely symptom-based and from a clinical perspective and thus limited in capturing perspectives and values of individuals with lived experience of an ED. In this study, we performed a systematic review to coproduce a conceptual framework for personal recovery from an ED based on primary qualitative data available in published literature. METHODS: A systematic review and qualitative meta-synthesis approach was used. Twenty studies focusing on ED recovery from the perspective of individuals with lived experience were included. The studies were searched for themes describing the components of personal recovery. All themes were analyzed and compared to the established connectedness; hope and optimism about the future; identity; meaning in life; and empowerment (CHIME) and Substance Abuse and Mental Health Services Administration (SAMHSA) frameworks of recovery, which are applicable to all mental disorders. Themes were labeled and organized into a framework outlining key components of the ED personal recovery process. RESULTS: Supportive relationships, hope, identity, meaning and purpose, empowerment, and self-compassion emerged as the central components of the recovery process. Symptom recovery and its relationship to the personal recovery process are also significant. DISCUSSION: Individuals with lived experience of EDs noted six essential elements in the personal ED recovery process. This framework is aligned with several of the key components of the CHIME and SAMHSA frameworks of recovery, incorporating person-centered elements of the recovery process. Future research should validate these constructs and develop instruments (or tools) that integrate the lived experiences into a measurement of recovery from an ED.
ANTECEDENTES: Existe una extensa literatura que describe las intervenciones de tratamiento y la recuperación de los trastornos de la conducta alimentaria (TCA); sin embargo, este conjunto de conocimientos se basa en gran medida en los síntomas y además desde una perspectiva clínica y, por lo tanto, es limitado para capturar las perspectivas y los valores de las personas con experiencia vivida de un TCA. En este estudio, realizamos una revisión sistemática para coproducir un marco conceptual para la recuperación personal de un TCA basado en datos cualitativos primarios disponibles en la literatura publicada. MÉTODOS: Se utilizó una revisión sistemática y un enfoque de meta-síntesis cualitativa. Se incluyeron veinte estudios centrados en la recuperación del TCA desde la perspectiva de individuos con experiencia vivida. Se buscaron en los estudios temas que describieran los componentes de la recuperación personal. Todos los temas fueron analizados y comparados con los marcos de recuperación establecidos de CHIME y SAMHSA, que son aplicables a todos los trastornos mentales. Los temas fueron etiquetados y organizados en un marco que describe los componentes clave del proceso de recuperación personal del TCA. RESULTADOS: las relaciones de apoyo, la esperanza, la identidad, el significado y el propósito, el empoderamiento y la autocompasión surgieron como los componentes centrales del proceso de recuperación. La recuperación de los síntomas y su relación con el proceso de recuperación personal también es significativa. CONCLUSIONES: Las personas con experiencia vivida de un TCA destacaron por seis elementos esenciales en el proceso personal de recuperación del TCA. Este marco está alineado con varios de los componentes clave de los marcos de recuperación de CHIME y SAMHSA, incorporando elementos centrados en la persona del proceso de recuperación. La investigación futura debería validar estos constructos y desarrollar instrumentos (o herramientas) que integren las experiencias vividas en una medición de recuperación de un TCA.
Feeding and Eating Disorders/therapy , Humans , Qualitative Research
Developed in collaboration with WHO Department of Mental Health and Substance Abuse, this study (conducted in India, the UK, and the USA) integrated feedback from mental health service users into the development of the chapter on mental, behavioural, and neurodevelopmental disorders for ICD-11. The ICD-11 will be used for health reporting from January, 2022. As a reporting standard and diagnostic classification system, ICD-11 will be highly influential by informing policy, clinical practice, and research that affect mental health service users. We report here the first study to systematically seek and collate service user perspectives on a major classification and diagnostic guideline. Focus groups were used to collect feedback on five diagnoses: depressive episode, generalised anxiety disorder, schizophrenia, bipolar type 1 disorder, and personality disorder. Participants were given the official draft diagnostic guidelines and a parallel lay translation. Data were then thematically analysed, forming the basis of co-produced recommendations for WHO, which included features that could be added or revised to better reflect lived experience and changes to language that was confusing or objectionable to service users. The findings indicated that an accessible lay language version of the ICD-11 could be beneficial for service users and their supporters.
Focus Groups/methods , International Classification of Diseases/standards , Mental Disorders/diagnosis , Mental Health Services/organization & administration , World Health Organization/organization & administration , Anxiety Disorders/classification , Anxiety Disorders/diagnosis , Bipolar Disorder/classification , Bipolar Disorder/diagnosis , Depressive Disorder/classification , Depressive Disorder/diagnosis , Evaluation Studies as Topic , Female , Guidelines as Topic , Humans , India/epidemiology , Male , Mental Disorders/classification , Mental Disorders/psychology , Mental Health Services/standards , Personality Disorders/classification , Personality Disorders/diagnosis , Schizophrenia/classification , Schizophrenia/diagnosis , United Kingdom/epidemiology , United States/epidemiology
Replies to comments by Muralidharan et al (see record 2017-13255-009) on the original article by Silver and Nemec (see record 2016-43088-001). The original authors thank the commentators for raising additional questions regarding "peerness." They were honored that their paper prompted this thought and effort to submit comments. (PsycINFO Database Record
Mental Disorders , Peer Group , Health Promotion , Humans , Mental Disorders/therapy
TOPIC: This article raises questions regarding defining the role of peer specialists and related employment practices. PURPOSE: The questions raised may be used to guide future research. SOURCES USED: Areas needing further investigation were identified through personal and professional experience, discussions with colleagues, and a review of published literature on peer workers. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Questions are raised regarding the definition of "peerness"; the variety and contradictions in definitions of the role of the peer specialist; existing and potential avenues for career advancement; credentialing standards; the design, implementation, and evaluation of existing and effective peer support service models, including integration of peer workers in other service models; and best practices for supporting the well-being of peer workers and their nonpeer colleagues. More and higher quality research data are needed in order to inform and contribute to the use and support of peer specialists in promoting positive system transformation. (PsycINFO Database Record
Mental Disorders/rehabilitation , Peer Group , Specialization , Humans
