Family, friends, and feelings: the role of relationships to parents and peers and alexithymia in adolescents with anorexia nervosa

Abstract

Background Anorexia nervosa (AN) is associated with impairments in socio-emotional functioning, including difficulties in interpersonal relationships as well as alexithymia (difficulties identifying and describing one’s emotions). Although the onset of the disorder is mostly in adolescence, a developmental period in which interpersonal relationships to parents as well as peers undergo major changes, only few studies have investigated the quality of interpersonal relationships in adolescent AN patients. Furthermore, the mechanisms linking poor relationship quality to eating disorder psychopathology are not yet clarified, albeit some research suggests that alexithymia might play a pivotal role. The aims of the present study were investigating the quality of interpersonal relationships to parents and peers in adolescents with AN compared to healthy adolescents as well as exploring the mediating role of alexithymia in the association between relationship quality and eating disorder symptoms. Methods Self-report questionnaires were used to assess relationship quality (Inventory of Parent and Peer Attachment) and alexithymia (Toronto Alexithymia Scale) in 12–18 year old female adolescents with AN (n = 35) in comparison to healthy adolescents (n = 40). Results Adolescents with AN reported lower relationship quality to both of their parents and to peers compared to healthy controls. Relationship quality scores were negatively correlated to alexithymia as well as eating disorder symptoms. Alexithymia fully meditated the association between eating disorder symptoms and relationship quality to parents and partially mediated the association between eating disorder symptoms and relationship quality to peers. Conclusion The results indicate difficulties in interpersonal relationships among adolescents with AN and emphasize the role of peer relationships for adolescents’ eating disorder psychopathology. Alexithymia seems to play an important role in explaining the link between quality of relationships and eating disorder psychopathology. Results suggest that treatment should not only focus on family relationships but also address relationships to peers as well as adolescents’ competence in identifying and dealing with their emotions.

Attention Biases for Eating Disorder-Related Stimuli Versus Social Stimuli in Adolescents with Anorexia Nervosa – An Eye-Tracking Study

“…The interview was administered to the adolescent participants by trained interviewers, i.e., study staff with a Bachelor's or Master's degree in Psychology who received several hours of training and supervision before conducting and evaluating the interviews. In previous studies using this training procedure we found the interrater-reliability of the Kinder-DIPS to be very good (e.g., accordance rates of 100% for current diagnoses of AN or MD in clinical groups as well as for no lifetime diagnoses in non-clinical groups; Lukas et al, 2022;Sfärlea et al, 2020), in line with Neuschwander et al (2013), who reported accordance rates of at least 97% for all diagnoses. However, interrater-reliability could not be assessed for the present study.…”

Lost in between–the transition process from a child and adolescent eating disorder service to adult mental health services in the German health care system

“…In a large meta‐analysis by Murphy and Hutton (2018), the authors demonstrated that the alliance‐outcome relationship, for example, the correlation between therapeutic alliance and treatment success, is greater in 12‐ to 19‐year‐old individuals than in adults. Moreover, in a recent study, adolescents with AN reported a lower relationship quality with both their parents and peers than did healthy controls (Lukas et al., 2022). In contrast to their peer group in Germany, with approximately one‐half of people living in a relationship, only slightly more than one‐third of our sample had a partner.…”

Körperpsychotherapeutische Gruppentherapie für jugendliche Patientinnen mit Anorexia nervosa

“…Anorexia nervosa ist mit Schwierigkeiten, die eigenen Gefühle zu erkennen und zu verbalisieren (Alexithymie), sowie mit Schwierigkeiten in zwischenmenschlichen Beziehungen verbunden (Lukas et al. 2022 ).…”

“…Es kommt zum Verlust eines ganzheitlichen Körperselbsterlebens in verschiedene Geraden von Fragmentierung. Anorexia nervosa ist mit Schwierigkeiten, die eigenen Gefühle zu erkennen und zu verbalisieren (Alexithymie), sowie mit Schwierigkeiten in zwischenmenschlichen Beziehungen verbunden (Lukas et al 2022).…”