Consent to treatment in adolescents with anorexia nervosa.

OBJECTIVE

This study examined the ability of adolescents with anorexia nervosa (AN) to make treatment decisions.

METHOD

The MacArthur Competence Assessment Tool-Treatment (MacCAT-T) was used to compare the decision making abilities of 35 adolescents with AN who were receiving inpatient treatment with that of 40 healthy, community-based adolescents. Vignettes of both a medical and psychiatric illness were provided, requiring participants to work through the process of making a hypothetical treatment decision. The MacCAT-T was also administered to participants with AN to examine decision-making about their own illness, which allowed for comparison of competencies across contexts.

RESULTS

Group differences were found, with the community group showing superior reasoning skills to the adolescents with AN.

DISCUSSION

The results provide evidence to suggest that adolescents with AN tend toward a thinking disposition that is concrete and lacking in abstract reasoning and reflection, which may negatively affect their ability to reason about treatment options.