{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T11:09:29Z","timestamp":1780312169635,"version":"3.54.0"},"reference-count":10,"publisher":"Royal College of Psychiatrists","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych Bull"],"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>In his analysis of \u2018ignorance culture\u2019 in eating disorder services, Downs describes how repeated alarms raised by patients, carers and clinicians are routinely ignored, deflected or reframed as individual pathology. In this Opinion piece, I reflect on the clinical implications of that analysis, arguing that ignorance culture is enacted through everyday treatment structures that misread multi-layered presentations, invalidate advocacy and displace responsibility. Drawing on dialectical theory and biosocial frameworks, and using multidiagnostic eating disorder\u2013dialectical behaviour therapy as an illustrative example, I suggest that addressing ignorance culture requires treatment models that operationalise responsibility rather than merely espouse it.<\/jats:p>","DOI":"10.1192\/bjb.2026.10257","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T10:44:31Z","timestamp":1780310671000},"page":"1-3","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["When alarms are ignored: clinical reflections on ignorance culture in eating disorder care"],"prefix":"10.1192","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7248-3740","authenticated-orcid":false,"given":"Anita","family":"Federici","sequence":"first","affiliation":[{"name":"The Centre for Psychology and Emotion Regulation"},{"name":"York University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"S2056469426102575_ref6","volume-title":"Treating Eating Disorders with DBT: The MED-DBT Protocol","author":"Federici","year":"2026"},{"key":"S2056469426102575_ref5","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-026-01528-7"},{"key":"S2056469426102575_ref7","doi-asserted-by":"publisher","DOI":"10.1080\/10640266.2020.1723371"},{"key":"S2056469426102575_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.eatbeh.2025.101951"},{"key":"S2056469426102575_ref4","volume-title":"Empathy Reconsidered: New Directions in Psychotherapy","author":"Linehan","year":"1997"},{"key":"S2056469426102575_ref1","doi-asserted-by":"publisher","DOI":"10.1192\/bjb.2025.10199"},{"key":"S2056469426102575_ref8","article-title":"Toward dignity-centred ethics in the treatment of longstanding and severe eating disorders: a lived experience-led narrative review","volume":"2","author":"Downs","year":"2025","journal-title":"Acad Ment Health Well Being"},{"key":"S2056469426102575_ref2","volume-title":"Treating Trauma in Dialectical Behavior Therapy: The DBT Prolonged Exposure Protocol (DBT-PE)","author":"Harned","year":"2022"},{"key":"S2056469426102575_ref3","volume-title":"Cognitive-Behavioral Treatment of Borderline Personality Disorder","author":"Linehan","year":"1993"},{"key":"S2056469426102575_ref10","volume-title":"The Oxford Handbook of Dialectical Behaviour Therapy","author":"Sayrs","year":"2017"}],"container-title":["BJPsych Bulletin"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2056469426102575","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T10:44:33Z","timestamp":1780310673000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2056469426102575\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,1]]},"references-count":10,"alternative-id":["S2056469426102575"],"URL":"https:\/\/doi.org\/10.1192\/bjb.2026.10257","relation":{},"ISSN":["2056-4694","2056-4708"],"issn-type":[{"value":"2056-4694","type":"print"},{"value":"2056-4708","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,1]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}