Exploration of friendship experiences in adolescent eating disorders

Abstract

Aims: Friendship plays an important and central role in adolescent life. This thesis was conducted in two parts to address two broad aims relating to friendship in adolescence. The first aim was to establish what is currently known about the impact of perfectionism on adolescent interpersonal relationships. Specifically, it was of interest to determine whether perfectionism exerts a negative influence on adolescent friendships. The second aim was to explore the friendship experiences of adolescents diagnosed with an eating disorder (ED) in order to address a significant gap in the current literature. Method: A systematic review of the literature relating to perfectionism and interpersonal functioning in adolescence was carried out with a view to addressing the first aim. With regards to the second aim a grounded theory study was conducted with adolescents currently in treatment for an eating disorder. The young people were asked about their experiences of friendship and emerging concepts were followed up in a concurrent process of data collection and analysis. Results: The systematic review highlighted an absence of research on interpersonal functioning and perfectionism in adolescence, with only seven studies identified that met inclusion criteria. The results were further complicated by inconsistencies in the conceptualisation of perfectionism in the identified studies. The empirical study uncovered the efforts that adolescents go to to achieve acceptance in their friendships. It also revealed that the development of an ED is experienced as creating distance in adolescent friendships. This affects both the actual amount of time that young people spend with their friends as well as the emotional connection that they are able to feel in their friendships. Conclusions: There is a need to reconsider the conceptualisation of perfectionism in future research with a consistent acknowledgement of the interpersonal dimensions of the concept. It is important to acknowledge the significant impact that ED development can have on adolescent relationships. Young people may require support to address these difficulties and preserve their friendships to avoid long term negative consequences.