Parents’ illness representations of their child with anorexia nervosa: A systematic review of qualitative studies using the common-sense model

Objective: There is a wealth of qualitative research indicating that parents experience distress while caring for a child with anorexia nervosa. Applying the Common Sense Model of Self-Regulation (CSM) may help to understand the antecedents of parental distress, which could inform how to support parents in treatment. The aim of this systematic review was to deductively synthesise outcomes from qualitative research in relation to parents’ experiences of caring for a child with anorexia nervosa using the CSM. Method: Systematic search of three electronic databases (psychINFO, MEDLINE, and EMBASE) alongside a two-way screening process was used to identify eligible studies. Qualitative themes were synthesised using a “best fit” framework analysis and reported according to CSM dimensions of cognitive and emotional illness representations. Results: 26 studies published between 1970 to 2022 were eligible for inclusion for this review. Parents perceived their child’s anorexia nervosa as a major health threat observable by illness representations that anorexia nervosa was uncontrollable, incomprehensible, chronic, and associated with negative consequences. Parents generally took responsibility for causing anorexia nervosa. These illness representations were linked with emotional representations of fear, anxiety, shame, guilt, loneliness, and depression. Conclusions: The findings provide evidence of the utility of using the CSM to understand the antecedents of parents’ distress and negative impacts of caring for a child with anorexia nervosa. Recommendations for future research and clinical practice are discussed emphasising the need to understand parents perceptions of their child’s illness to putatively maximise treatment benefits for families.