Family Functioning and Relationship Quality for Adolescents in Family‐based Treatment with Severe Anorexia Nervosa Compared with Non‐clinical Adolescents

Wallis, Andrew; Miskovic‐Wheatley, Jane; Madden, Sloane; Rhodes, Paul; Crosby, Ross D.; Cao, Li; Touyz, Stephen

doi:10.1002/erv.2562

Cited by 16 publications

(17 citation statements)

References 46 publications

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“…The results can further aid the development of interventions aimed at supporting caregivers. In future studies, it is important to carefully monitor how each parent/caregiver responds to and copes with treatment (Wallis et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Parental caregiver burden and recovery of adolescent anorexia nervosa after multi-family therapy

2019

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This study investigated whether parental caregiving burden changed during adjunct multi-family therapy of adolescent anorexia nervosa and eating disorders not otherwise specified (EDNOS) and whether caregiver burden at baseline and changes in caregiver burden during treatment were associated with treatment outcome. Twenty-four females, 13 to 16 years old, and their parents, participated in the study. Caregiver burden was measured with the Eating Disorders Symptom Impact Scale, by mothers (n = 23) and fathers (n = 22). Treatment outcome was measured by adolescent body mass index, level of global functioning and self-rated eating disorder symptoms by the Eating Disorders Examination Questionnaire 4.0. All patient outcomes improved and overall caregiver burden decreased significantly during treatment. When broken down in aspects of caregiver burden the decrease in parental perceived isolation, was found to be associated with improvement of BMI and Children's Global Assessment Scale. When analyzing fathers and mothers separately, we found that maternal feelings of guilt and paternal perceived burden of dysregulated behaviors at base-line were correlated to treatment outcome. Future studies are needed to clarify the role of caregiver burden as a potential mediator of treatment results. Clinical Implications • Multi-Family Therapy shows preliminary effectiveness as an adjunct treatment for adolescent anorexia nervosa. • Parents' parental burden decreased pre-to post Multi-family Therapy. • Fathers' perceived dysregulated behaviors in the patient pretreatment were associated with decrease of Body Mass Index during treatment. • Fathers are a resource in treatment and should be more specifically supported in the participation of Multi-Family Therapy.

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Section: Discussionmentioning

confidence: 99%

Parental caregiver burden and recovery of adolescent anorexia nervosa after multi-family therapy

2019

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“…Using self-report measures of attachment, significant differences in attachment were found by Batista et al (2018), who used the Experiences in Close Relationships-Revised (Fraley et al, 2000) in a sample of 35 adolescents with AN and 35 Healthy Control (HC) adolescents. By contrast, Wallis et al (2018), who used a brief version of the IPPA , did not find any differences between their AN sample (n = 54) and HC sample (n = 49), either at baselinewhen the AN group were starting FBTor 14 months later, when the two samples again completed the IPPA. The 14-month follow-up represents 6 months after the end of treatment, which was 20 sessions of FBT.…”

Section: Studies Of Attachment In Adolescent Eating Disorder Samplesmentioning

confidence: 81%

Attachment and mentalization as predictors of outcome in family therapy for adolescent anorexia nervosa (Thesis)

Jewell¹

2021

Preprint

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Family therapy for adolescent anorexia nervosa (FT-AN) is the first line treatment for the disorder, but little is known about who the treatment works for, or how it works. This thesis investigates the potential value of the constructs of attachment and mentalization as predictors of outcome in family therapy for adolescent AN. The thesis presents a systematic review of attachment and mentalization and their association with child and adolescent eating pathology in which 22 relevant studies were found. In keeping with the evidence base for adults with eating disorders, both attachment and mentalization were found to be correlates of eating pathology in childhood and adolescence. However, evidence for these constructs in the process of treatment in child and adolescent eating disorders is scarce. In a second systematic review, the psychometric properties of attachment measures in middle childhood and adolescence were investigated across 53 studies. The overall conclusion of the study is that there is a lack of evidence of adequate psychometric properties for attachment measures in this age group.In the main study, attachment and mentalization were investigated as predictors of outcome in a sample of adolescents and their parents (n = 192) receiving FT-AN across three specialist outpatient eating disorder services. Mentalization, but not attachment, was found to predict poor clinical outcome at nine months after starting of treatment, with the strongest predictive effect being excessive certainty about mental states as assessed in parents. Therapeutic alliance scores at one month were predictive of outcome but did not play a mediating role in relation to baseline attachment or mentalization. In a further empirical study, definitions of eating disorder recovery were investigated through a qualitative analysis of comments on recovery-focused social media forums. Two super-ordinate themes emerged: firstly, recovery was defined as encompassing broad psychosocial domains of wellbeing; secondly, recovery was understood to be an ongoing process. Social connectedness to others was regarded as important both to the process and definition of eating disorder recovery. The final chapter of the thesis integrates findings from across the studies with emerging theoretical developments in the fields of attachment and mentalization. It is argued that attachment and mentalization represent worthwhile constructs for further FT-AN research, with a particular emphasis on the need to better understand the mechanisms by which excessive mental state certainty might lead to poor clinical outcomes.

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“…Knowing the importance of communication for the development of healthy bonds, such problems in relating to other people can, at least in part, be understood in the light of the findings of Wallis et al (2018), who identified difficulties in interpersonal communication of fathers. In the same perspective, Treasure et al (2019) draw attention to the fact that fathers recognize that improving communication skills could be a useful and valuable tool, both for the relationship with their daughters and for the relationship with others in general.…”

Section: Resultsmentioning

confidence: 99%

“…The analyzed literature also indicates the need for support and strengthening of fathers in the face of a complex condition such as EDs. In this sense, Wallis et al (2018) expose the fathers' difficulty in dealing with the impact of the development process of daughters with AN and suggest that strengthening the support provided by health professionals to these fatherss may be important. In the same perspective, Korotana et al (2018) emphasize the importance of making efforts to provide support and strengthen the relationship between the father and the daughter being treated for ED.…”

Section: Resultsmentioning

confidence: 99%

“…It was observed that impoverished family relationships significantly affect the family and result in losses, both at the collective and individual levels. Thus, Wallis et al (2018) report marked losses in the functioning of families of young people diagnosed with AN in several areas, such as difficulties in solving problems and conflicts, as well as in the establishment of limits, impulse control and behaviors self-regulation, leading fathers and mothers to describe family dynamics as problematic in many situations. In accordance with such evidence, Balottin et al (2017) identified difficulties in the attention shared by the members of the studied families, as well as in the interactions between father and daughter and in the integration between the members to perform collective tasks and share information and feelings.…”

Section: Resultsmentioning

confidence: 99%

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Paternity and Parenting in the Context of Eating Disorders: An Integrative Literature Review

Simões

Santos

2021

Psic.: Teor. e Pesq.

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Family relationships seem to have relevant contribution to the etiopathogenesis of Eating Disorders (EDs). This study aimed to analyze the scientific production about the paternity and parenting experiences of fathers whose daughters developed EDs. The literature review was conducted through the databases LILACS, PubMed, PsycINFO, Web of Science and EMBASE, in the period from 1999 to 2019. From the 878 retrieved papers, 23 were selected for the analysis. The results show that paternity and parenting experiences are influenced by father’s personality traits. The dominant representation is of an affectionless and not empathetic father, as well as punitive and insensitive to the daughter’s emotional needs. Knowing the paternal experiences is central to subside sensible care to both, daughters’ and fathers’ demands.

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Family Functioning and Relationship Quality for Adolescents in Family‐based Treatment with Severe Anorexia Nervosa Compared with Non‐clinical Adolescents

Cited by 16 publications

References 46 publications

Parental caregiver burden and recovery of adolescent anorexia nervosa after multi-family therapy

Parental caregiver burden and recovery of adolescent anorexia nervosa after multi-family therapy

Attachment and mentalization as predictors of outcome in family therapy for adolescent anorexia nervosa (Thesis)

Paternity and Parenting in the Context of Eating Disorders: An Integrative Literature Review

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