BACKGROUND Individuals with anorexia nervosa have reported feelings of loneliness, social anhedonia, and interpersonal difficulties. This study sought to clarify the nature of interpersonal relationships in adults with anorexia, which may help improve existing interventions while also facilitating the attainment of something that might compete with the drive for thinness: friendships. METHODS The present study used a mixed-methods approach to investigate friendship experiences in three groups: anorexia (n = 27), participants with a history of anorexia who are weight restored (n = 20), and healthy controls (n = 24). Thematic analysis was used to isolate the most prevalent themes that emerged from an open-ended interview of experiencing friendships in a subset of participants. Three self-report questionnaires investigating friendship valuation and attachment styles were also administered. RESULTS 11 unique themes emerged in the data: social comparison, reciprocity, trust, fear of negative evaluation, perceived skills deficit, logistical barriers, reliability, identity issue, low interest, similarity, and conflict avoidance. Only 17% of those with anorexia reported experiencing friendships as positive, relative to 82% of healthy controls and 52% of weight restored participants. Lastly, on self-report measures, participants with anorexia reported greater reliance on themselves versus others, greater use of care-seeking behaviors, and more fear/anger at the thought of losing an attachment figure (p < .05 in all cases). CONCLUSION Results suggest that individuals with anorexia have particular challenges which interfere with the formation and maintenance of friendships, such as viewing friendships negatively and struggling with social comparisons in friendships. Assessing and addressing barriers to intimacy may motivate those with anorexia to relinquish dangerous symptoms that maintain the illness.

中文翻译：

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一种在神经性厌食症中概念化友谊的混合方法。

背景 患有神经性厌食症的个体报告了孤独感、社交快感缺乏和人际关系困难。这项研究试图阐明厌食症成年人人际关系的性质，这可能有助于改善现有的干预措施，同时也有助于实现可能与追求瘦身的动力相竞争的东西：友谊。方法 本研究使用混合方法调查三组的友谊经历：厌食症 (n = 27)、有厌食史且体重恢复的参与者 (n = 20) 和健康对照组 (n = 24)。主题分析被用来隔离在一部分参与者中体验友谊的开放式访谈中出现的最普遍的主题。还进行了三份调查友谊评估和依恋风格的自我报告问卷。结果 数据中出现了 11 个独特的主题：社会比较、互惠、信任、对负面评价的恐惧、感知技能缺陷、后勤障碍、可靠性、身份问题、低兴趣、相似性和避免冲突。相对于 82% 的健康对照组和 52% 的体重恢复的参与者而言，只有 17% 的厌食症患者表示友谊是积极的。最后，在自我报告测量方面，厌食症参与者报告说，与他人相比，他们更依赖自己，更多地使用寻求护理的行为，以及对失去依恋对象的想法更加恐惧/愤怒（在所有情况下，p < .05）。结论 结果表明，厌食症患者面临着干扰友谊的形成和维持的特殊挑战，例如消极地看待友谊和在友谊中的社会比较中挣扎。评估和解决亲密关系的障碍可能会促使厌食症患者放弃维持疾病的危险症状。